CRKP: A Dangerous Hospital-Acquired Infection on the Rise

CRKP and Other Drug-Resistant Hospital-Acquired Infections

Klebsiella pneumoniae bacteria.
Klebsiella pneumoniae bacteria. Callista Images/Getty Images

As if patients, providers and healthcare organizations didn't have enough to worry about with MRSA, C.Diff. and other hospital-acquired infections. Now, another nosocomial infectious agent has made an appearance in U.S. hospitals: Carbapenem-resistant Klebsiella pneumoniae (CRKP). CRKP is a type of gram-negative bacteria that has developed antibiotic resistance to a class of antibiotics known as carbapenems, and can cause infections in healthcare settings such as pneumonia, bloodstream infections, wound or surgical site infections, and meningitis.

CRKP is considered a major infection threat to patient safety. While the numbers of infected patients aren't as large as the numbers of patients who acquire the better known superbugs like MRSA, C.Diff, VRE and others, by early 2011 CRKP had already been identified in hospitals in 36 states. (See a map of states reporting cases of CRKP.)

CRKP and other infections like it (NDM-1, OXA, VIM, all broadly known as the CREs) is resistant to antibiotics, and patients who acquire it are at risk of death, usually within 30 days. Death rates from this newer superbug have been reported to be between 30 percent and 44 percent.

So far, CRKP infections seem confined to healthcare facilities -- both acute-care hospitals and long-term care facilities. The elderly and others who are immunocompromised are at greater risk for contracting it. Since it is not considered a reportable infection by the CDC, the numbers of patients and deaths are very likely under-reported.

Treatment for CRKP Infections

CRKP can't easily be killed even by the specialized drugs developed to kill other known nosocomial infections MRSA, C.Diff or VRE.

One drug, actually an older antibiotic called colistin, has been used with limited success on patients who have acquired CRKP. The problem is that the drug has toxic side effects destructive to the kidneys.

The elderly and other patients who are immunocompromised may be particularly harmed by these effects.

Another drug called tigecycline, was developed in 2005, but is limited in its effectiveness because it doesn't work well in all tissues.

Prevention of CRKP Infection

The best way to prevent transfer of CRKP is by following the standard prevention recommendation for any infection: hand washing and sanitizing. Patients and caregivers should follow the best protocol for preventing spread of any infection in a hospital: insist that anyone who touches an infected patient wash his or her hands thoroughly. Patients should not let a healthcare provider provide reassurances about their hand-washing habits: Instead, they should ask to witness the provider wash his or her hands.

There are other important steps to take to prevent hospital-acquired infections that include items to pack, and activities to undertake when arriving at the hospital. Because infections are so rampant in hospitals, and because too few hospitals take the necessary steps to prevent them, patients must take responsibility for preventing infections themselves.

Wise patients learn the steps to take to prevent hospital acquired infections.

Have you or a loved one been infected with CRKP, MRSA, C.Diff, VRE or any other nosocomial infection? We invite you to share your story with others.

Learn about additional infections hospital patients must be be concerned about:

Sources:

The Centers for Disease Control.

CDC's Public Health Update on CRE.

Continue Reading