Escalating carbapenem-resistant Klebsiella burden and mortality in Bangladeshi infants

  1. Yogesh Hooda
  2. Arif Mohammad Tanmoy
  3. Naito Kanon
  4. Hafizur Rahman
  5. Mohammad Shahidul Islam
  6. Zabed Bin Ahmed
  7. Afroza Akter Tanni
  8. Md Mobarok Hossain
  9. Md Hasanuzzaman
  10. Sharmistha Goswami
  11. Tasnim Jabin
  12. Rajib Chandra Das
  13. Mohmmad Belal Hossain
  14. Shampa Saha
  15. Md Jamal Uddin
  16. Anannya Barman Jui
  17. Mohammod Shahidullah
  18. Nobo Krishna Ghosh
  19. AKM Shamsuzzaman
  20. Nahid Sultana
  21. Sanjoy Kanti Biswas
  22. Feroza Akter
  23. Wazir Ahmed
  24. Mohammed Monir Hossain
  25. Mahbubul Hoque
  26. ASM Nawshad Uddin Ahmed
  27. Samir K. Saha
  28. Senjuti Saha
0 evaluations Published on
Read the full article Related papers
This article on Sciety

Abstract

Klebsiella infections in young infants are an escalating threat in low- and middle-income countries, yet robust hospital burden and antimicrobial-resistance data informed by genomics remain scarce. We performed an 18-year (2004-2021) prospective, multicenter genomics epidemiology study across four hospitals in Bangladesh. Among 122,353 enrolled children with suspected sepsis, 1,600 (1.3%) yielded culture-confirmed Klebsiella pneumoniae species complex (KpSC) isolates, which increased from 16 per 1,000 cases tested in 2004 to 37 in 2021. Hospital case-fatality rate (CFR) increased from 21.4% to 51.4%, following an increase in carbapenem resistance (first detected in 2008; 81% by 2021). Neonates accounted for 80.7% of infections with a CFR of 40.8%. Whole-genome sequencing of 599 representative isolates revealed four Klebsiella species, 145 sequence types and 92 capsular loci. Global high-risk clones ST11, ST16 and ST147 harbouring NDM-type carbapenemases dominated recent cases. Stronger infection control, access to new drugs, and multivalent vaccines are urgently needed. 

Related articles

Related articles are currently not available for this article.