An outbreak of deadly antibiotic-resistant bacteria in Brazil has killed at least 18 people around Brazil's capital, officials said Tuesday, and has prompted hurried measures to keep the problem from spreading.

The outbreak of klebsiella pneumoniae carbapenemase in Brasilia follows others in Israel in 2007 and in Puerto Rico in 2008, according to the U.S. Centers for Disease Control and Prevention.

Brazil's national health agency said the known toll so far stands at 18 dead, with 183 people hospitalized with the infection in the nation's capital as last Thursday. The figures are updated on a weekly basis.

According to a statement on the website of the Federal District's Health Secretariat, from Jan. 1 to Oct. 1, the number of known cases in Brasilia was 108 people — meaning there was a spike of nearly 70 percent in the last three weeks.

A spokeswoman for the agency said the rise did not necessarily mean the danger of infections was growing; it might be due to increasing vigilance and testing for the infections.

An official with the CDC in the U.S. said the figures are significant.

"There is no reason to panic, but there is a need for a call for action," said Denise Cardo, director of the division that monitors hospital infections at the CDC. "We are seeing an increase in hospital infections in recent years and if health professionals don't take action now it will be harder and harder to contain them in the future."

Klebsiella pneumoniae carbapenemase - often just called KPC — is enzyme produced by bacteria that annuls the effectiveness of modern antibiotics and it tends to infect patients who have had surgery or other invasive procedures. Most of the cases are seen in intensive care unit patients.

Cardo said the infections are hard to treat and have a fatality rate of about 40 percent.

Brazil's National Agency for Sanitary Vigilance announced on Tuesday it was ordering all hospitals and clinics in the nation to require the use of alcohol-based hand cleaners for everyone entering any health unit. It called the step "the most important and inexpensive" means of controlling infections.

Health Minister Jose Temporao told the Agencia Brasil news agency last week that "citizens can remain calm because this is a situation that only happens in hospital environments and with debilitated patients."

KPC was first identified in the late 1990s, according to the CDC, and since then nearly 35 American states have reported cases of the infection. Chicago and New York both reported outbreaks of KPC recently, and cases have also been seen in Colombia, Greece, France and China.

Cardo said basic hygiene can help prevent the spread of the infection in hospitals, along with proper isolation of infected patients and a better control of antibiotic use.

"It seems that health professionals are not taking these threats seriously," Cardo told The Associated Press. "These outbreaks could become more and more common and harder to treat if those working in hospitals don't start paying more attention to preventive measures, not only when there is an outbreak, but all the time."


Associated Press writer Bradley Brooks in Sao Paulo contributed to this report.