Scary KPC outbreak at the NIH

Today's Washington Post contains an article that will send chills down the spine of every hospital epidemiologist and infection preventionist in the world. It describes an outbreak of carbapenem-resistant Klebsiella pneumoniae (KPC) at the hospital of the National Institutes of Health in Bethesda. Over a 6-month period last year, 17 patients became colonized or infected with KPC; of these 8 developed bloodstream infections. A total of 11 patients died; 6 of these deaths were attributed to the infection.

The outbreak was terminated using typical interventions (cohorting of patients and staff, active surveillance cultures, contact precautions, and enhanced cleaning protocols). Further details can be found in a report in Science Translational Medicine (abstract here, full text requires subscription). This report outlines how the outbreak was able to be tracked using whole genome sequencing, which allowed the epidemiologists to determine that the entire outbreak could be traced to a single patient. Traditional molecular typing with PFGE would not have provided enough discriminatory power to do this.

KPC is a horrible organism. As shown here, over half of colonized patients developed bloodstream infection and three-quarters of those died. This bug makes MRSA look like a teddy bear. We desperately need new antibiotics to combat this organism as many strains are resistant to all available antibiotics.