{"title":"Systematic review and meta-analysis on the carbapenem-resistant hypervirulent Klebsiella pneumoniae isolates.","authors":"Motahareh Sabaghi Qala Nou, Zahra Amirian, Fatemeh Dehghani, Amir-Kazem Vejdan, Roghayeh Rooin, Sadegh Dehghanmehr","doi":"10.1186/s40360-025-00857-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The global dissemination of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKp) poses a critical threat to public health. However, comprehensive data on the prevalence and resistance rates of CR-hvKp are limited. This systematic review and meta-analysis aim to estimate the pooled prevalence of carbapenem resistance among hvKp strains and assess the distribution of carbapenemase genes.</p><p><strong>Materials and methods: </strong>A systematic search of ISI Web of Science, PubMed, and Google Scholar was conducted to identify studies reporting carbapenem resistance rates in hvKp strains. The pooled prevalence of carbapenem resistance and carbapenemase genes was calculated using event rates with 95% confidence intervals.</p><p><strong>Results: </strong>A total of 36 studies encompassing 1,098 hvKp strains were included. The pooled resistance rates were 49% for imipenem, 53.2% for meropenem, and 38.2% for ertapenem. Carbapenemase gene prevalence was 19.1% for bla<sub>VIM</sub>, 22.0% for bla<sub>NDM</sub>, 43.4% for bla<sub>OXA-48</sub>, and 58.8% for bla<sub>KPC</sub>.</p><p><strong>Conclusion: </strong>The high prevalence of carbapenem resistance and the widespread distribution of carbapenemase genes among hvKp strains underscore their significant threat to global health. These findings highlight the urgent need for enhanced surveillance, rapid diagnostic tools, and stringent infection control measures to mitigate the spread of CR-hvKp. Future research should focus on understanding resistance mechanisms and developing targeted therapeutic strategies to address this critical challenge.</p>","PeriodicalId":9023,"journal":{"name":"BMC Pharmacology & Toxicology","volume":"26 1","pages":"25"},"PeriodicalIF":2.7000,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783860/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Pharmacology & Toxicology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40360-025-00857-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
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Abstract
Background: The global dissemination of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKp) poses a critical threat to public health. However, comprehensive data on the prevalence and resistance rates of CR-hvKp are limited. This systematic review and meta-analysis aim to estimate the pooled prevalence of carbapenem resistance among hvKp strains and assess the distribution of carbapenemase genes.
Materials and methods: A systematic search of ISI Web of Science, PubMed, and Google Scholar was conducted to identify studies reporting carbapenem resistance rates in hvKp strains. The pooled prevalence of carbapenem resistance and carbapenemase genes was calculated using event rates with 95% confidence intervals.
Results: A total of 36 studies encompassing 1,098 hvKp strains were included. The pooled resistance rates were 49% for imipenem, 53.2% for meropenem, and 38.2% for ertapenem. Carbapenemase gene prevalence was 19.1% for blaVIM, 22.0% for blaNDM, 43.4% for blaOXA-48, and 58.8% for blaKPC.
Conclusion: The high prevalence of carbapenem resistance and the widespread distribution of carbapenemase genes among hvKp strains underscore their significant threat to global health. These findings highlight the urgent need for enhanced surveillance, rapid diagnostic tools, and stringent infection control measures to mitigate the spread of CR-hvKp. Future research should focus on understanding resistance mechanisms and developing targeted therapeutic strategies to address this critical challenge.
背景：碳青霉烯耐药高致病性肺炎克雷伯菌（CR-hvKp）的全球传播对公共卫生构成严重威胁。然而，关于CR-hvKp流行率和耐药率的综合数据有限。本系统综述和荟萃分析旨在估计hvKp菌株中碳青霉烯类耐药的总流行率，并评估碳青霉烯类酶基因的分布。材料和方法：系统检索ISI Web of Science、PubMed和谷歌Scholar，以确定报告hvKp菌株碳青霉烯耐药率的研究。碳青霉烯耐药和碳青霉烯酶基因的总流行率采用95%置信区间的事件率计算。结果：共纳入36项研究，包括1098株hvKp菌株。亚胺培南耐药率为49%，美罗培南为53.2%，厄他培南为38.2%。blaVIM、blaNDM、bloxa -48和blaKPC的碳青霉烯酶基因患病率分别为19.1%、22.0%、43.4%和58.8%。结论：hvKp菌株中碳青霉烯类耐药的高发率和碳青霉烯酶基因的广泛分布表明了其对全球健康的重大威胁。这些发现强调迫切需要加强监测、快速诊断工具和严格的感染控制措施，以减轻CR-hvKp的传播。未来的研究应侧重于了解耐药机制，并制定有针对性的治疗策略来应对这一关键挑战。
期刊介绍：
BMC Pharmacology and Toxicology is an open access, peer-reviewed journal that considers articles on all aspects of chemically defined therapeutic and toxic agents. The journal welcomes submissions from all fields of experimental and clinical pharmacology including clinical trials and toxicology.
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