Carbapenem-Resistant Klebsiella pneumoniae: Resistance Mechanisms, Epidemiology, and Mortality

Gumus, Hatice Hale; KÖKSAL, fatih

doi:10.5578/flora.20239913

Carbapenem-Resistant Klebsiella pneumoniae: Resistance Mechanisms, Epidemiology, and Mortality

Hatice Hale GÜMÜŞ, (Tıbbi Mikrobiyoloji Anabilim Dalı, Çukurova Üniversitesi Tıp Fakültesi, Adana, Türkiye)

Fatih KÖKSAL (Tıbbi Mikrobiyoloji Anabilim Dalı, Çukurova Üniversitesi Tıp Fakültesi, Adana, Türkiye)

Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi

21 2

Yıl: 2023 Cilt: 28 Sayı: 2 Sayfa Aralığı: 131 - 143 Metin Dili: İngilizce DOI: 10.5578/flora.20239913 İndeks Tarihi: 10-07-2023

Carbapenem-Resistant Klebsiella pneumoniae: Resistance Mechanisms, Epidemiology, and Mortality

Öz:

Antimicrobial resistance has become an urgent global public health problem. It is predicted that deaths due to bacterial antimicrobial resistance will reach 10 million per year by 2050, if no action is taken. Antimicrobial resistance also causes prolonged hospitalization, failure of treatment, spread of resistant bacteria in the community, and a serious economic burden. Carbapenem-resistant Klebsiella pneumoniae is among the bacteria that the World Health Organization gives critical priority to and poses the greatest threat to human health. The main mechanisms of carbapenem resistance are loss of porins, activation of efflux pumps, modification of target structure, and production of beta-lactamases. There are several risk factors associated with mortality in cases of carbapenem resistance, including older age, prolonged hospitalization, high Acute Physiology and Chronic Health Evaluation II scores, as well as the presence of conditions such as diabetes mellitus, hemato-oncological diseases, chemotherapy, and corticosteroid treatment. In this review, data, extracted by PubMed and Web of Science Databases searching with the terms “carbapenem-resistant Klebsiella pneumoniae”, “carbapenem resistance mechanisms”, “carbapenemases”, “resistance to meropenem-vaborbactam”, “resistance to imipenem-relebactam”, is summarized and briefly discussed with recommendations.

Anahtar Kelime:

Karbapenem Dirençli Klebsiella pneumoniae: Direnç Mekanizmaları, Epidemiyoloji ve Mortalite

Öz:

Antimikrobiyal direnç, acil bir küresel halk sağlığı sorunu haline gelmiştir. Herhangi bir önlem alınmadığı takdirde bakteriyel antimikro- biyal dirence bağlı ölümlerin 2050 yılına kadar yılda 10 milyona ulaşacağı tahmin edilmektedir. Antimikrobiyal direnç aynı zamanda hastanede yatış süresinin uzamasına, tedavi başarısızlığına, dirençli bakterilerin toplumda yayılmasına ve ciddi bir ekonomik yüke neden olmaktadır. Karbapenem dirençli Klebsiella pneumoniae, Dünya Sağlık Örgütünün antimikrobiyal ilaç geliştirmeye ihtiyaç duyulan en tehlikeli patojenlerin listesinde kritik öncelik verdiği ve insan sağlığı için en büyük tehdidi oluşturan bakteriler arasında yer almaktadır. Karbapenem direncinin ana mekanizmaları, porinlerin kaybı, akış pompalarının aktivasyonu, hedef yapının modifikasyonu ve beta-laktamazların üretimidir. Karbapenem direncine bağlı mortalite risk faktörleri vardır; yaşlı olmak, hastanede uzun süre kalmak, Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi II skorunun yüksek olması, diyabetes mellitus varlığı, hemato-onkolojik hastalıklar, kemoterapi ve kortikosteroid tedavisi olarak sıralanabilir. Bu derlemede, PubMed ve Web of Science veri tabanlarında “Karbapenem- dirençli Klebsiella pneumoniae”, “Karbapenem direnç mekanizmaları”, “Karbapenemazlar”, “meropenem-vaborbaktama direnç”, “imipenem-relebaktama direnç” terimleriyle arama yapılarak elde edilen veriler özetlenmiş ve önerilerle birlikte kısaca tartışılmıştır.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık

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APA	Gumus H, KÖKSAL f (2023). Carbapenem-Resistant Klebsiella pneumoniae: Resistance Mechanisms, Epidemiology, and Mortality. , 131 - 143. 10.5578/flora.20239913
Chicago	Gumus Hatice Hale,KÖKSAL fatih Carbapenem-Resistant Klebsiella pneumoniae: Resistance Mechanisms, Epidemiology, and Mortality. (2023): 131 - 143. 10.5578/flora.20239913
MLA	Gumus Hatice Hale,KÖKSAL fatih Carbapenem-Resistant Klebsiella pneumoniae: Resistance Mechanisms, Epidemiology, and Mortality. , 2023, ss.131 - 143. 10.5578/flora.20239913
AMA	Gumus H,KÖKSAL f Carbapenem-Resistant Klebsiella pneumoniae: Resistance Mechanisms, Epidemiology, and Mortality. . 2023; 131 - 143. 10.5578/flora.20239913
Vancouver	Gumus H,KÖKSAL f Carbapenem-Resistant Klebsiella pneumoniae: Resistance Mechanisms, Epidemiology, and Mortality. . 2023; 131 - 143. 10.5578/flora.20239913
IEEE	Gumus H,KÖKSAL f "Carbapenem-Resistant Klebsiella pneumoniae: Resistance Mechanisms, Epidemiology, and Mortality." , ss.131 - 143, 2023. 10.5578/flora.20239913
ISNAD	Gumus, Hatice Hale - KÖKSAL, fatih. "Carbapenem-Resistant Klebsiella pneumoniae: Resistance Mechanisms, Epidemiology, and Mortality". (2023), 131-143. https://doi.org/10.5578/flora.20239913

APA	Gumus H, KÖKSAL f (2023). Carbapenem-Resistant Klebsiella pneumoniae: Resistance Mechanisms, Epidemiology, and Mortality. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, 28(2), 131 - 143. 10.5578/flora.20239913
Chicago	Gumus Hatice Hale,KÖKSAL fatih Carbapenem-Resistant Klebsiella pneumoniae: Resistance Mechanisms, Epidemiology, and Mortality. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi 28, no.2 (2023): 131 - 143. 10.5578/flora.20239913
MLA	Gumus Hatice Hale,KÖKSAL fatih Carbapenem-Resistant Klebsiella pneumoniae: Resistance Mechanisms, Epidemiology, and Mortality. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, vol.28, no.2, 2023, ss.131 - 143. 10.5578/flora.20239913
AMA	Gumus H,KÖKSAL f Carbapenem-Resistant Klebsiella pneumoniae: Resistance Mechanisms, Epidemiology, and Mortality. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi. 2023; 28(2): 131 - 143. 10.5578/flora.20239913
Vancouver	Gumus H,KÖKSAL f Carbapenem-Resistant Klebsiella pneumoniae: Resistance Mechanisms, Epidemiology, and Mortality. Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi. 2023; 28(2): 131 - 143. 10.5578/flora.20239913
IEEE	Gumus H,KÖKSAL f "Carbapenem-Resistant Klebsiella pneumoniae: Resistance Mechanisms, Epidemiology, and Mortality." Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi, 28, ss.131 - 143, 2023. 10.5578/flora.20239913
ISNAD	Gumus, Hatice Hale - KÖKSAL, fatih. "Carbapenem-Resistant Klebsiella pneumoniae: Resistance Mechanisms, Epidemiology, and Mortality". Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi 28/2 (2023), 131-143. https://doi.org/10.5578/flora.20239913