Dragos Stefan Lazar, Maria Nica, Corina Oprisan, Maricela Vlasie, Ilie-Andrei Condurache, Simin Aysel Florescu, George Sebastian Gherlan
{"title":"罗马尼亚某传染病医院耐碳青霉烯肺炎克雷伯菌的出现","authors":"Dragos Stefan Lazar, Maria Nica, Corina Oprisan, Maricela Vlasie, Ilie-Andrei Condurache, Simin Aysel Florescu, George Sebastian Gherlan","doi":"10.3390/pathogens14090859","DOIUrl":null,"url":null,"abstract":"<p><p><i>Klebsiella pneumoniae</i>, a member of the Enterobacterales Order, often colonises the gut and causes diverse infections, including bloodstream, urinary, and respiratory infections. The rise in carbapenem-resistant sFtrains, especially those producing enzymes like <i>K. pneumoniae</i> carbapenemase (KPC), New Delhi metallo-β-lactamase (NDM), Oxacillinase 48 (OXA48), or combinations (NDM+OXA48-<i>like</i>), poses a significant threat across Europe, notably in Romania. These strains spread rapidly via mobile genetic elements, complicating treatment.</p><p><strong>Methods: </strong>A retrospective study of multidrug-resistant (MDR) <i>K. pneumoniae</i> strains isolated from clinical samples collected at an infectious diseases hospital in Romania.</p><p><strong>Results: </strong>We analysed the evolution of carbapenemases and their combinations from 2010 to 2024, with the rising antibiotic consumption, particularly during the COVID-19 pandemic. The prevalence of carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP) rose from 4.9% in 2010 to 41.6% in 2024. There was an overall antibiotic use increase, especially colistin (186%) between 2019-2024. Additionally, we examined the dynamics of antibiotic susceptibility that decreased in 2023-2024 and found that susceptibility of NDM+OXA48-<i>like</i> isolates to colistin was 16.5% and to cefiderocol 58.5%.</p><p><strong>Conclusions: </strong>The rising prevalence of <i>K. pneumoniae</i> strains with complex resistance mechanisms, coupled with a significant reduction in available treatment options, demands a fundamental paradigm shift in the management of these infections.</p>","PeriodicalId":19758,"journal":{"name":"Pathogens","volume":"14 9","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12472354/pdf/","citationCount":"0","resultStr":"{\"title\":\"Emergence of Carbapenem-Resistant <i>Klebsiella pneumoniae</i> in a Romanian Infectious Diseases Hospital.\",\"authors\":\"Dragos Stefan Lazar, Maria Nica, Corina Oprisan, Maricela Vlasie, Ilie-Andrei Condurache, Simin Aysel Florescu, George Sebastian Gherlan\",\"doi\":\"10.3390/pathogens14090859\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><i>Klebsiella pneumoniae</i>, a member of the Enterobacterales Order, often colonises the gut and causes diverse infections, including bloodstream, urinary, and respiratory infections. The rise in carbapenem-resistant sFtrains, especially those producing enzymes like <i>K. pneumoniae</i> carbapenemase (KPC), New Delhi metallo-β-lactamase (NDM), Oxacillinase 48 (OXA48), or combinations (NDM+OXA48-<i>like</i>), poses a significant threat across Europe, notably in Romania. These strains spread rapidly via mobile genetic elements, complicating treatment.</p><p><strong>Methods: </strong>A retrospective study of multidrug-resistant (MDR) <i>K. pneumoniae</i> strains isolated from clinical samples collected at an infectious diseases hospital in Romania.</p><p><strong>Results: </strong>We analysed the evolution of carbapenemases and their combinations from 2010 to 2024, with the rising antibiotic consumption, particularly during the COVID-19 pandemic. The prevalence of carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP) rose from 4.9% in 2010 to 41.6% in 2024. There was an overall antibiotic use increase, especially colistin (186%) between 2019-2024. Additionally, we examined the dynamics of antibiotic susceptibility that decreased in 2023-2024 and found that susceptibility of NDM+OXA48-<i>like</i> isolates to colistin was 16.5% and to cefiderocol 58.5%.</p><p><strong>Conclusions: </strong>The rising prevalence of <i>K. pneumoniae</i> strains with complex resistance mechanisms, coupled with a significant reduction in available treatment options, demands a fundamental paradigm shift in the management of these infections.</p>\",\"PeriodicalId\":19758,\"journal\":{\"name\":\"Pathogens\",\"volume\":\"14 9\",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-08-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12472354/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pathogens\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3390/pathogens14090859\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MICROBIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pathogens","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3390/pathogens14090859","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MICROBIOLOGY","Score":null,"Total":0}
Emergence of Carbapenem-Resistant Klebsiella pneumoniae in a Romanian Infectious Diseases Hospital.
Klebsiella pneumoniae, a member of the Enterobacterales Order, often colonises the gut and causes diverse infections, including bloodstream, urinary, and respiratory infections. The rise in carbapenem-resistant sFtrains, especially those producing enzymes like K. pneumoniae carbapenemase (KPC), New Delhi metallo-β-lactamase (NDM), Oxacillinase 48 (OXA48), or combinations (NDM+OXA48-like), poses a significant threat across Europe, notably in Romania. These strains spread rapidly via mobile genetic elements, complicating treatment.
Methods: A retrospective study of multidrug-resistant (MDR) K. pneumoniae strains isolated from clinical samples collected at an infectious diseases hospital in Romania.
Results: We analysed the evolution of carbapenemases and their combinations from 2010 to 2024, with the rising antibiotic consumption, particularly during the COVID-19 pandemic. The prevalence of carbapenem-resistant Klebsiella pneumoniae (CRKP) rose from 4.9% in 2010 to 41.6% in 2024. There was an overall antibiotic use increase, especially colistin (186%) between 2019-2024. Additionally, we examined the dynamics of antibiotic susceptibility that decreased in 2023-2024 and found that susceptibility of NDM+OXA48-like isolates to colistin was 16.5% and to cefiderocol 58.5%.
Conclusions: The rising prevalence of K. pneumoniae strains with complex resistance mechanisms, coupled with a significant reduction in available treatment options, demands a fundamental paradigm shift in the management of these infections.
期刊介绍：
Pathogens (ISSN 2076-0817) publishes reviews, regular research papers and short notes on all aspects of pathogens and pathogen-host interactions. There is no restriction on the length of the papers. Our aim is to encourage scientists to publish their experimental and theoretical research in as much detail as possible. Full experimental and/or methodical details must be provided for research articles.
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