Extending the Cure Researcher Nikolay Braykov Writes on ResistanceMap for Pioneering Ideas

12 Apr 2011

The online tool ResistanceMap has released a new video that shows the spread of a deadly microbe able to survive treatment with the newest and most potent antibiotics in the current arsenal.

That microorganism, called carbapenem-resistant Klebsiella pneumoniae (CRKP), can cause potentially fatal pneumonia, bloodstream, or wound infections among elderly hospital patients. The featured video offers a first-of-its kind geographic retrospective of the pathogen’s emergence using nationally-representative data.

ResistanceMap, is developed by Extending the Cure – a nonprofit project sponsored by the Robert Wood Johnson Foundation’s Pioneer Portfolio that researches policy solutions to prolong the useful life of antibiotics. This online tool, which visualizes changes in resistance levels across regions of the U.S. from 2000 – 2009, summarizes data from microbiological labs across the country that measure bacterial drug resistance – the ability of microbes to survive treatment with antibiotics.

Whereas previous ResistanceMap videos highlighted the geography of established threats like Methicillin-resistant Staphylococcus aureus (MRSA), the new video tracks CRKP since its emergence in the early 2000s and adds to existing evidence that health authorities may be up against a new epidemic unless urgent steps are taken.

As the subject of this year’s World Health Day on April 7, drug resistance has drawn substantial attention from media like The Economist or MSNBC. In many reports, CRKP is heralded as the next “superbug”, particularly following reports on its growing prevalence in Southern California. One reason is the lack of proven treatment options – when last-resort drugs like carbapenems don’t work anymore, physicians can only experiment with combinations of antibiotics, often older drugs that have been shelved because of serious side effects. Another is that, as pointed out by a report in Scientific American, gram-negative bacteria like K. pneumoniae are very common, easily share resistance genes, and have been neglected by pharmaceutical researchers.

ResistanceMap helps us put the media coverage in more context.  In comparison with MRSA or other resistant bacteria, CRKP is still a rare, localized phenomenon - fewer than 3% of K. pneumoniae showed carbapenem resistance in 2009 and the bacteria was exclusively found in hospitals and nursing homes.

Still, the maps show how an outbreak initially confined to few New York hospitals can spread to facilities nationwide in a very short time. First emerging in the Mid-Atlantic with just a few occurrences in other regions, CRKP can now be found in 36 states.

K. pneumoniae are part of the normal microbial flora in humans and like all bacteria, their populations inevitably develop resistance mechanisms as organisms adapt to survive treatment. In order stay ahead in the race between bacterial evolution and drug research, public health officials have to act now – active surveillance and adherence to the latest CDC prevention and control guidelines can curtail the spread of CRKP before it spreads even further.

Enacting sensible, timely policies depends on our ability to inform constituents about emerging threats and to analyze existing ones. Thanks in part to initiatives like Extending the Cure, there is more public awareness and scientific knowledge available to help prevent a major crisis from unfolding and letting CRKP become the next MRSA.

Antibiotic Resistance