Qala Nou Motahareh Sabaghi, Amirian Zahra, Dehghani Fatemeh, Vejdan Amir-Kazem, Rooin Roghayeh, Dehghanmehr Sadegh
Paramedical Faculty of Iranshahr, Iranshahr, Iran.
Department of Surgery, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
BMC Pharmacol Toxicol. 2025 Jan 30;26(1):25. doi: 10.1186/s40360-025-00857-8.
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.
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.
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, 22.0% for bla, 43.4% for bla, and 58.8% for bla.
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.
耐碳青霉烯类高毒力肺炎克雷伯菌（CR-hvKp）在全球范围内的传播对公共卫生构成了严重威胁。然而，关于CR-hvKp的流行率和耐药率的全面数据有限。本系统评价和荟萃分析旨在估计hvKp菌株中碳青霉烯类耐药的合并流行率，并评估碳青霉烯酶基因的分布情况。
对科学网（ISI Web of Science）、PubMed和谷歌学术进行系统检索，以确定报告hvKp菌株碳青霉烯类耐药率的研究。使用事件发生率及95%置信区间计算碳青霉烯类耐药和碳青霉烯酶基因的合并流行率。
共纳入36项研究，涉及1098株hvKp菌株。亚胺培南的合并耐药率为49%，美罗培南为53.2%，厄他培南为38.2%。碳青霉烯酶基因bla的流行率为19.1%，bla为22.0%，bla为 43.4%，bla为58.8%。
hvKp菌株中碳青霉烯类耐药的高流行率以及碳青霉烯酶基因的广泛分布凸显了它们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。未来的研究应专注于了解耐药机制并制定针对性的治疗策略，以应对这一严峻挑战。
