A
team of researchers from the University
of Houston (UH) and St. Luke’s
Episcopal Hospital (SLEH) are working to develop improved screening methods to
detect a potentially lethal, drug-resistant superbug that has made its way to Texas.
Specifically,
the research team looked at a multi-drug resistant bacterium called Klebsiella
pneumoniae, which is increasingly resistant to most drugs of last resort.
Commonly called CRKP, which is short for carbapenem-resistant Klebsiella
pneumoniae, the bacteria were found in three patients at St. Luke’s in
2010, and the team published a report about it in 2011 in Diagnostic Microbiology & Infectious Disease. Endemic to the
northeastern United States
and recently making its way to California,
reports of this particular superbug have remained uncommon throughout the
majority of the country. The researchers believe these are the first confirmed
cases in Texas.
“The
key to effective therapy is to identify the infection quickly and accurately,
so you can initiate the appropriate measures that will benefit the patient,
prevent it from spreading and discourage the development of resistance,” says
Vincent Tam, associate professor of clinical sciences at the UH College of
Pharmacy and coauthor of the report. “The current methods of detection are far
from perfect, but following national and international resistance trends, we
are being proactive in anticipating problems so we can deal with them when
they’re in the initial, budding stage.”
Although
it’s virtually impossible to pinpoint when or how this superbug arrived in Texas, researchers are
working to determine its prevalence here and to develop strategies to deal with
potential outbreaks. The bacteria can cause an array of infections, including
pneumonia, bloodstream, and urinary tract infections, and are becoming
increasingly worrisome for clinicians.
Although
Klebsiella pneumoniae is naturally found in the intestinal tract and
relatively harmless to healthy individuals, it can lead to potentially deadly
infections in people with weakened immune systems, such as patients in ICUs,
long-term care facilities, or nursing homes. These bacteria, for instance, are
resistant to the carbapenem class of antibiotics, which are among the
antimicrobials of last resort for this type of bacteria. As a result,
clinicians managing the infection are left with few options but to employ more
toxic drugs that pose an increased risk of damage to the kidneys or other
organs.
The
automated systems used in clinical microbiology laboratories can misclassify
certain bacteria as being susceptible to carbapenems, potentially leading to
inappropriate treatment and unfavorable patient outcomes. More accurate methods
for identifying these specific bacteria require time- and labor-intensive
processes and are typically only available in research laboratories outside of
the clinical setting, such as at the Centers for Disease Control and academic
research institutions such as UH.
With
support from the Roderick D. MacDonald Research Fund at SLEH, Tam and his
collaborators are working to determine the prevalence of CRKP and to employ
promising techniques for rapid and accurate detection of these bacteria in the
clinical setting, as well as prevent its spread within the health care system.
Filed Under: Drug Discovery
