Global spread of carbapenemase-producing Klebsiella pneumoniae

• Since an isolate of K. pneumoniae with the KPC carbapenemase was first identified from a patient in North Carolina in 1996, similar isolates have been recovered on four continents. • The gene encoding this β-lactamase resides on a plasmid, making it readily available for transfer to other gram-negative pathogens. • Clinical laboratories face difficulties in identifying carbapenemase-producer strains, particularly when using automatic systems. • Aminoglycosides, tigecycline, and the polymyxins are among the few agents available for treating patients who are infected with carbapenemase-producer strains.