Global Epidemiology and Antimicrobial Resistance of Klebsiella Pneumoniae Carbapenemase (KPC)-Producing Gram-Negative Clinical Isolates: A Review
<i>Klebsiella pneumoniae</i> carbapenemases (KPCs) are a group of class A β-lactamases of Gram-negative bacteria leading to difficult-to-treat infections. We evaluated the global epidemiology of KPC-producing Gram-negative clinical isolates. A systematic search of six databases (Cochrane...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-07-01
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| Series: | Microorganisms |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-2607/13/7/1697 |
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| Summary: | <i>Klebsiella pneumoniae</i> carbapenemases (KPCs) are a group of class A β-lactamases of Gram-negative bacteria leading to difficult-to-treat infections. We evaluated the global epidemiology of KPC-producing Gram-negative clinical isolates. A systematic search of six databases (Cochrane Library, Embase, Google Scholar, PubMed, Scopus, and Web of Science) was conducted. Extracted data were tabulated and evaluated. After screening 1993 articles, 119 were included in the study. The included studies originated from Asia (<i>n</i> = 49), Europe (<i>n</i> = 29), North America (<i>n</i> = 14), South America (<i>n</i> = 11), and Africa (<i>n</i> = 3); 13 studies were multicontinental. The most commonly reported KPC-producing species were <i>Klebsiella pneumoniae</i> (96 studies) and <i>Escherichia coli</i> (52 studies), followed by <i>Enterobacter cloacae</i> (31), <i>Citrobacter</i> spp. (24), <i>Klebsiella oxytoca</i> (23), <i>Serratia</i> spp. (15), <i>Enterobacter</i> spp. (15), <i>Acinetobacter baumannii</i> complex (13), <i>Providencia</i> spp. (11), <i>Morganella</i> spp. (11), <i>Klebsiella aerogenes</i> (9), <i>Pseudomonas aeruginosa</i> (8), <i>Raoultella</i> spp. (8), <i>Proteus</i> spp. (8), and <i>Enterobacter aerogenes</i> (6). Among the studies with specific <i>bla</i><sub>KPC</sub> gene detection, 52/57 (91%) reported the isolation of <i>bla</i><sub>KPC-2</sub> and 26/57 (46%) reported <i>bla</i><sub>KPC-3</sub>. The antimicrobial resistance of the studied KPC-producing isolates was the lowest for ceftazidime–avibactam (0–4%). Resistance to polymyxins, tigecycline, and trimethoprim–sulfamethoxazole in the evaluated studies was 4–80%, 0–73%, and 5.6–100%, respectively. <b>Conclusions:</b> The findings presented in this work indicate that KPC-producing Gram-negative bacteria have spread globally across all continents. Implementing proper infection control measures, antimicrobial stewardship programs, and enhanced surveillance is crucial. |
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| ISSN: | 2076-2607 |