Triple Threat: New Pneumonia Is Drug-Resistant, Deadly And Contagious

In the past few years, there have been so many "superbugs" appearing in hospitals around the world that we here at Goats and Soda haven't had the time or resources to report on all of them.

But a new type of pneumonia emerging in China seems so important that we dropped what we were doing to write about it.

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

The bacterium — a type of Klebsiella pneumoniae — killed five people in an intensive care unit in Hangzhou in 2016, researchers reported Tuesday 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 can fight 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, multiorgan 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 evolutionary event," epidemiologists Liang Chen and 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.

Approval for the new drug in China would help. In the meantime, doctors can stop it from spreading by identifying outbreaks quickly and isolating people.

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