Have You Heard of Klebsiella Pneumonia and How Can We Stop It?

In the past few years, there have been many "superbugs" appearing in hospitals around the world.

But a new type of pneumonia has emerged in China that is important.

Doctors in Hangzhou in southeastern China have detected a type of pneumonia that is both highly drug-resistant and very deadly. It also spreads easily.

The bacterium, a type of Klebsiella pneumoniae, pictured above, killed five people in an intensive care unit in Hangzhou in 2016, researchers reported in the journal Lancet Infectious Diseases.

"This fatal outbreak happened in a brand new hospital with very good hygiene," says microbiologist Sheng Chen, who co-led the study at the Hong Kong Polytechnic University. "Drug-resistant strains shouldn't have appeared so quickly." The microbe canan fights off all drugs available in China, Chen says. "We don't have anything in China to stop it," he says. "There is a drug available in the U.S. that should be effective against it, but we haven't tested it yet."

In the outbreak, the five patients who died were all older than 53. They were all on ventilators after undergoing major surgeries. And they died from severe lung failure, multi organ failure or septic shock, the researchers found.

When Chen and his team sequenced the microbes found in the infections, they were shocked at what they saw. These bacteria aren't like other multidrug-resistant pneumonia reported before. They are a fusion of two dangerous forms.

In the past three decades, two types of K. pneumoniae have appeared in hospitals. The first is a drug-resistant form, called CRE, which can fight off even the toughest antibiotics. Last January, this type of pneumonia killed a woman in Nevada. That strain resisted 26 antibiotics.

The second type of K. pneumoniae causes a very severe form of the disease and is known as "hypervirulent."

"The disease progresses very fast," Chen says. "It starts in the lungs and then infects other organs, like the liver."

This hypervirulent form — which is widespread across Chinese hospitals — causes more damage to the body than other strains do. It can spread through communities. And it can even sicken young, healthy adults, Chen says.

For years, doctors feared the two types would one day combine. And now that it has happened, scientists around the world need to be on alert for these triple-threat strains, researchers at Rutgers University write in a commentary about the new study.

"Their study describes an alarming event," epidemiologists Liang Chenand Barry Kreiswirth write about the emergence of this worrying pneumonia. "Failure to control its early spread right now, will make a global epidemic of carbapenem-resistant [CRE], hypervirulent K. pneumoniae hard to avoid," the researchers write.

How can we stop the spread of antimicrobial resistance?

New drug-resistant pathogens are cropping up around the world every year. Many have adapted to resist a few drugs. Others are "superbugs," resistant to many, many drugs, including last-resort antibiotics.

Eventually, all the antibiotics we have could become ineffective, scientists say. Medicine would step back in time to the 19th century, when doctors' hands were tied, when a simple cut on your finger could be deadly. Basic medical procedures, such as C-sections, would be too dangerous to perform.

But this medical dystopia is not inevitable, says Ramanan Laxminarayan, who directs the Center for Disease Dynamics, Economics & Policy in Washington, D.C.

"This is an avoidable disaster," he says. And even reversible — maybe, to a degree, he says.

Take for instance, the antibiotic chloroquine in Malawi. Back in 1993, the country stopped using chloroquine to treat malaria because of rising resistance. By 2009, the malaria pathogen had largely lost its resistance and once again became vulnerable to the antibiotic, a study reported a few years ago. All the pathogen needed was a hiatus from the drug to drop its resistance. And the country could again use chloroquine to treat malaria.

Other experts we talked to share Laxminarayan's optimism. They say individuals can take a few precautions and really help stop the spread of antibiotic resistance globally — and keep their home and communities safer, at the same time.

So what can you do?

1. Put down that strip of bacon.

In the U.S., doctors and nurses prescribe about 8 million pounds of antibiotics each year, says Lance Price, who directs the Antibiotic Resistance Action Center at George Washington University.

But farmers use more than four times that much — or 34 million pounds, Price says. That's about the weight of two Eiffel Towers.

Farmers use antibiotics to prevent disease among livestock but also because the drugs — for reasons that are still unclear — boost animals' growth.

"This is a big driving force of antibiotic resistance," he says. "The conditions in modern farms are perfect for the spread of bacteria. You've got 10,000 pigs or birds all crammed together, all defecating on each other. Introducing antibiotics is the magic ingredient for creating drug-resistant bacteria."

And to make matters worse, this wellspring of resistance is all attached to a massive distribution system — America's supermarkets.

"The meat is inevitably tainted with these bacteria," Price says. "So they end up in stores across the country."

To stop the spread of these superbugs, Price says, Americans need to stop buying meat raised with antibiotics. Period. "This is a really, really important choice to make," he says. "It's the only way to make progress in this area."

"This makes demands on retailers to stock antibiotic-free meat," he says, "which then places demands on producers to raise animals without antibiotics." Look for meat labeled as "No antibiotics," "Raised without antibiotics" or "USDA-certified organic." For organic meats, animals can't be given antibiotics, although this doesn't apply to eggs and small chicks destined to be chicken.

Raising animals without antibiotics is typically more expensive. So if your budget can't afford organic meat, then think about simply cutting out pork.

With pigs, farmers often use massive amount of antibiotics, Price says.

"It's the way they're typically raised," Price says. The animals spend almost their entire lives in confined pens. And they're given antibiotics throughout almost their entire life.

We often hear that antibiotic resistance is like climate change: A few countries ruin it for everybody. Any one person's contribution is a tiny drop in the world's vast ocean of antibiotic use.

That is true, Price says. But with antibiotic resistance, you can have an impact on your local community — or even state — which can protect you and your family from superbugs.

There's even proof of this: Sweden.

Every time you use an antibiotic, you raise the risk of developing resistant bacteria on your skin or inside your body. Those pathogens can spread through households, classrooms and communities.

But Sweden has been ultravigilant about keeping antibiotic-resistant bacteria out of the country. Doctors are extremely prudent about prescribing antibiotics. The health care system constantly monitors for the presence of resistant strains. And the government banned the use of antibiotics as growth promoters on farms way back in 1986.

As a result, the country is a sanctuary for antibiotics. The drugs have preserved their potency. And doctors can prescribe antibiotics that here in the U.S. we've essentially abandoned because of built-up resistance.

"America can revitalize these amazing antibiotics, too, if we start using them more carefully," Price says adds. "But everybody needs to change. It needs to be across the board."

To make your home, town or country an antibiotic sanctuary, don't demand antibiotics from doctors. Better yet, be proactive, says James Johnson, an infectious disease doctor at the University of Minnesota.

"Tell your doctor, 'We'd like to talk about ways to avoid using antibiotics. Are there alternatives we can try or use a wait-and-see approach more often?' " he says.

"When a doctor offers antibiotics, challenge it!" Johnson adds. "Ask, 'How confident are you in the diagnosis? Are you sure it's caused by bacteria, not a virus? If it is a bacterial infection, how sure are you that this drug will work?' Sometimes doctors need permission not to prescribe antibiotics, and they might be relieved."

Then try out a similar conversation at your kids' play groups, he says. Try something like: "We're working to keep superbugs out of our home. So we're being careful about using antibiotics and eating meat raised with antibiotics. Are you interested in doing the same?"

Bacteria easily pass around families and communities, Johnson says. Every time an antibiotic gets used, resistant strains gain an advantage and can crop up. Once they're out in the community, everyone is vulnerable.