This has driven an epidemic of highly resistant gram-negative organisms throughout much of the United States.ĭr.
This enzyme basically renders all beta-lactams, penicillins, and cephalosporins ineffective but also is associated with other mutations that render it resistant to many other antibiotics as well. Since that time we have seen the emergence of a specific enzyme of carbapenamases called Klebsiella pneumoniae carbapenemase (KPC) that has spread widely throughout the United States. These carbapenem-resistant Enterobacteriaceae were very uncommon in the United States before about 2000. The main issue today, in the United States at least, is the emergence of very highly resistant Enterobacteriaceae - such as Escherichia coli and Klebsiella - that are resistant to our last-stage antibiotics, the carbapenems. Kallen, MD, MPH: That's a great question, John. Why? A Surge of Highly Resistant EnterobacteriaceaeĪlexander J. Why is there a great surge of this problem in the United States, Europe, and around much of the world that we have not really encountered since penicillin was discovered? We have always had something with which to treat these pathogens. Every doctor in the United States who works in a hospital, and many who work in outpatient settings, are encountering more and more resistance among gram-negative bacilli, as well as Staphylococcus aureus.
Some of this has been presented at the meeting, and we need to get updated information. Thank you for joining me here today, Alex. Obviously, his work is very important in terms of what we are discussing today with respect to resistant gram-negative bacilli and the infections they cause. Kallen works in the hospital infection control section of the CDC. Alex Kallen from the Centers for Disease Control and Prevention (CDC). I am John Bartlett from Johns Hopkins University School of Medicine and I am here at the annual Infectious Diseases Society of America (IDSA) meeting for 2011.
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