Work

Carbapenem-Resistant Klebsiella pneumoniae in Large Public Acute-Care Healthcare System, New York, New York, USA, 2016–2022

Year: 2023

Type: review

Abstract: C arbapenems have long served as tools in our ar- senal against infections caused by multidrug resistant gram-negative bacteria; as such, the spread of carbapenem-resistant Enterobacterales (CRE) represents a serious public health threat.Because CRE infections are associated with poorer clinical outcomes and have limited treatment options, the Centers for Disease Control and Prevention has labeled CRE as an urgent threat (1,2).Since its identification in 2001, Klebsiella pneumoniae carbapenemase (KPC) has been the predominant carbapenemase in CRE in medical centers across the United States (3,4).This carbapenemase has been also problematic in long-term care facilities throughout the United States (5,6).Although isolates with class B carbapenemases, particularly the New Delhi metalloβ-lactamase (NDM), are endemic in several regions of the world, they have been somewhat unusual in the United States, accounting for only ≈10% of identified carbapenemases (4,7).Given their greater resistance to β-lactam antibiotics (e.g., β-lactam/β-lactamaseinhibitor antibiotics, including ceftazidime/avibactam), the spread of isolates harboring metallo-βlactamases is particularly worrisome (8).For more than a decade, KPC has been the predominant carbapenemase found in the New York, New York, USA (New York City), region (9,10).However, in 2018, sporadic instances of residents of longterm care facilities in New York harboring NDMpossessing K. pneumoniae were reported (10,11).In this article, we document the changing epidemiology of carbapenem-resistant K. pneumoniae in hospitals across a large public health system in New York City. MethodsThe New York City Health and Hospitals Enterprise consists of 11 acute care medical centers, of which 5 are level I trauma centers, 1 is a level II trauma center, and 1 is a level II pediatric trauma center.New York City Health and Hospitals serves >1.2 million patients annually.In 2022, >164,000 inpatient visits and 1 million emergency department visits occurred.All of the hospitals are public hospitals that serve patients primarily of low socioeconomic status; health equity Carbapenem-Resistant Klebsiella pneumoniae in Large Public Acute-Care Healthcare System, New York, New York, USA, 2016-2022

Source: Emerging infectious diseases

DOI: 10.3201/eid2910.230153