DANGEROUS new strains of a superbug have been found in 16 countries, a World Health Organization (WHO) report warns.
Hypervirulent Klebsiella pneumoniae (hvKp) was detected across Africa, Europe, the East Mediterranean, Western Pacific, American and South-East Asia.
It is a type of drug-resistant bacteria that can cause serious and life-threatening infections.
"Classic" Klebsiella pneumoniae (Kp) causes major problems in hospitals, where it can contaminate medical equipment, spread quickly and is resistant to many antibiotics.
It is known to cause pneumonia, urinary tract infections (UTIs), bloodstream infections and meningitis - inflammation of the lining around your brain and spinal cord - particularly among vulnerable patients.
But experts say the newer "hypervirulent" version is even more dangerous as it can make even healthy people seriously ill.
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"It can cause severe invasive infections in healthy individuals that develop quickly and spread to various body sites," the Center for Infectious Disease Research and Policy () said.
"Infections caused by hvKp strains have been associated with high morbidity and mortality."
The looked at data from 43 countries and territories globally, of which 16 reported hvKp. This included:
- Algeria*
- Argentina*
- Australia*
- Canada*
- Cambodia
- Hong Kong
- India*
- Iran*
- Japan*
- Oman*
- Papua New Guinea
- Philippines*
- Switzerland*
- Thailand*
- United Kingdom*
- United States
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Twelve of these (starred) said they had found a particularly concerning strain called sequence type (ST)23.
This carries carbapenemase genes that are resistant to carbapenem antibiotics and all available beta-lactam antibiotics.
The combination of hypervirulence and carbapenem-resistance genes in Kp strains is "worrisome", according to CIDRAP.
Dr Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security, said: "In general, carbapenem-resistant gram-negative bacteria are a major concern as the ability to treat them is severely constrained.
"When you couple carbapenem-resistance with the hypervirulence exhibited by certain strains of Kp, it is a recipe for increased morbidity and mortality from this bacterium."
The risk of spread could increase due to high movements of people (within and between countries and regions)
World Health Organization
The WHO also warned that (ST)23 strains "out-compete" other gut bacteria, which can lead to colonisation and spread, and generate outbreaks.
"It is expected that there will be an increased risk of spread of these strains at both the community and hospital levels," the agency said.
The global risk is deemed moderate - but the prevalence of kvKp "may be underestimated" due to surveillance limitations and the fact infections "may go unnoticed", officials added.
"With the concurrence of hypervirulence and antibiotic resistance, it is expected that there will be an increased risk of spread of these strains at both the community and hospital levels," the WHO said.
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"The prevention and control of carbapenem-resistant hvKp poses significant challenges because it has not been possible to establish the extent of its dissemination in the countries of the different regions and information on this subject is currently limited.
"As with other resistance mechanisms, the risk of spread could increase due to high movements of people (within and between countries and regions)."
What is Klebsiella pneumoniae?
Klebsiella pneumoniae is a type of bacteria.
It is usually found in human poo, as well as in soil, water and on medical devices.
It is becoming increasingly resistant to antibiotics, including carbapenems - often the last line of defence against multidrug-resistant bacterial infections.
Klebsiella can cause pneumonia, bloodstream infections, wound or surgical site infections, and meningitis - inflammation of the lining around your brain and spinal cord.
It is more common among vulnerable patients in hospital, those who use ventilators or intravenous catheters, and people who take long courses of antibiotics.
"Klebsiella pneumoniae is a leading cause of infections acquired in healthcare institutions globally and has been considered an opportunistic pathogen, as it typically causes infections in hospitalised or immunocompromised individuals," the World Health Organization said.
Healthy people usually do not get Klebsiella infections, however new strains seem to be more dangerous to everyone.
"Klebsiella pneumoniae strains that can cause severe infections in healthy individuals and have been identified with increasing frequency in recent years are considered hypervirulent compared to classical strains because of their ability to infect both healthy and immunocompromised individuals and because of their increased tendency to produce invasive infections," officials added.
The bacteria spreads through person-to-person contact, contaminated water, soil or equipment, and wounds caused by injury or surgery.
To prevent infection, health officials recommend people wash their hands:
- Before preparing or eating food
- Before touching their eyes, nose or mouth
- Before and after changing wound dressings or bandages
- After using the toilet
- After blowing their nose, coughing or sneezing
- After touching hospital surfaces, such as bed rails, bedside tables, door handles, remote controls, or phones
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