title: Critical issues for Klebsiella pneumoniae KPC-carbapenemase producing K. pneumoniae infections: a critical agenda.
abstract: The wide dissemination of carbapenemase producing K. pneumoniae (KPC-Kp) has caused a public health crisis of global dimensions, due to the serious infections in hospitalized patients associated with high mortality. In 2014, we aim to review clinical data on KPC-Kp at a time when a pro-active strategy (combating the problem before it is established) is no longer useful, focusing on epidemiology, patient risk profile, infection control, digestive tract colonization and treatment issues such as the role of carbapenems or carbapenem sparing strategies, colistin and resistance, dual carbapenem administration and the role of tigecycline. All these issues are illustrated prospectively to provide a forum for a Consensus strategy when not only intensive care units but also medical and surgical wards are affected by the epidemics.
authors.affiliation: Department of Medical Sciences, Infectious Diseases, University of Turin, Ospedale Amedeo di Savoia, Corso Svizzera 164, 10149 Torino, Italy.
authors.forename: Francesco G
authors.initials: FG
authors.lastname: De Rosa
authors.forename: Silvia
authors.initials: S
authors.lastname: Corcione
authors.forename: Rossana
authors.initials: R
authors.lastname: Cavallo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Perri
authors.forename: Matteo
authors.initials: M
authors.lastname: Bassetti
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001426:Bacterial Proteins / Q000096:biosynthesis; D015780:Carbapenems / Q000627:therapeutic use*; D003091:Colistin / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology; D004360:Drug Therapy, Computer-Assisted; D006801:Humans; D017053:Infection Control; D007710:Klebsiella Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000201:enzymology; D008911:Minocycline / Q000031:analogs & derivatives / Q000627:therapeutic use; D012307:Risk Factors; D000078304:Tigecycline; D001618:beta-Lactamases / Q000096:biosynthesis
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D000078304:Tigecycline; D001618:beta-Lactamases; C063912:carbapenemase; D008911:Minocycline; D003091:Colistin
keywords: KPC; KPC-Kp; Klebsiella pneumoniae; colistin; epidemiology; infection control; mortality; therapy; tigecycline; treatment