Current Global Occurrence of Carbapenem-Resistant Klebsiella pneumoniae (CRKP) Infections in Hospitalized Patients: A Literature Review

Abstract

Antimicrobial resistance (AMR) is an escalating global issue. One of the primary resistance mechanisms is the ability of microbes to deactivate antimicrobial drugs through the production of expanded-spectrum β-lactamases enzymes (ESBL), such as carbapenemases. Among the pathogens associated with multidrug resistance, Klebsiella pneumoniae has a high frequency, particularly in hospital settings. This study presents a narrative review of the literature from the scientific databases of the National Library of Medicine (PubMed) and the Cochrane Library on the occurrence of carbapenem-resistant K. pneumoniae (CRKP) infections in hospitalized patients, identifying current studies that may contribute to understand the spread of resistant bacteria. The review was conducted in September 2023 with the aim of summarizing evidence. Inclusion and exclusion criteria were applied, and 20 articles were included, covering the continents of the America, Africa, Asia, and Europe, to select the most recent studies about CRKP. In the studies analyzed, nosocomial isolates predominantly originated from sputum samples, followed by urine and blood. Molecular analysis revealed that most microorganisms exhibiting resistance to carbapenems harbored the blaKPC, blaNDM, and blaOXA-48 genes. However, there is epidemiological variation among continents, underscoring the need for more knowledge about genetic diversity and the implementation of active surveillance culture programs to facilitate prompt action with appropriate therapy and minimal patient risk. These findings indicate a necessity for heightened vigilance by hospital infection control committees to prevent potential spread and outbreaks of bacteria carrying carbapenem resistance genes.