Introduction: Klebsiella pneumoniae is a major agent of healthcare-associated infections and a cause of some community-acquired infections, including severe bacteremic infections associated with metastatic abscesses in liver and other organs. Clinical relevance is compounded by its outstanding propensity to evolve antibiotic resistance. In particular, the emergence and dissemination of carbapenem resistance in K. pneumoniae has posed a major challenge due to the few residual treatment options, which have only recently been expanded by some new agents. The epidemiological success of carbapenem-resistant K. pneumoniae (CR-Kp) is mainly linked with clonal lineages that produce carbapenem-hydrolyzing enzymes (carbapenemases) encoded by plasmids. Areas covered: Here, we provide an updated overview on the mechanisms underlying the emergence and dissemination of CR-Kp, focusing on the role that plasmids have played in this phenomenon and in the co-evolution of resistance and virulence in K. pneumoniae. Expert opinion: CR-Kp have disseminated on a global scale, representing one of the most important contemporary public health issues. These strains are almost invariably associated with complex multi-drug resistance (MDR) phenotypes, which can also include recently approved antibiotics. The heterogeneity of the molecular bases responsible for these phenotypes poses significant hurdles for therapeutic and diagnostic purposes.

Di Pilato, V., Pollini, S., Miriagou, V., Rossolini, G.m., D’Andrea, M.m. (2024). Carbapenem-resistant Klebsiella pneumoniae: the role of plasmids in emergence, dissemination, and evolution of a major clinical challenge. EXPERT REVIEW OF ANTI-INFECTIVE THERAPY, 22(13), 25-43 [10.1080/14787210.2024.2305854].

Carbapenem-resistant Klebsiella pneumoniae: the role of plasmids in emergence, dissemination, and evolution of a major clinical challenge

D’Andrea, Marco Maria
2024-01-01

Abstract

Introduction: Klebsiella pneumoniae is a major agent of healthcare-associated infections and a cause of some community-acquired infections, including severe bacteremic infections associated with metastatic abscesses in liver and other organs. Clinical relevance is compounded by its outstanding propensity to evolve antibiotic resistance. In particular, the emergence and dissemination of carbapenem resistance in K. pneumoniae has posed a major challenge due to the few residual treatment options, which have only recently been expanded by some new agents. The epidemiological success of carbapenem-resistant K. pneumoniae (CR-Kp) is mainly linked with clonal lineages that produce carbapenem-hydrolyzing enzymes (carbapenemases) encoded by plasmids. Areas covered: Here, we provide an updated overview on the mechanisms underlying the emergence and dissemination of CR-Kp, focusing on the role that plasmids have played in this phenomenon and in the co-evolution of resistance and virulence in K. pneumoniae. Expert opinion: CR-Kp have disseminated on a global scale, representing one of the most important contemporary public health issues. These strains are almost invariably associated with complex multi-drug resistance (MDR) phenotypes, which can also include recently approved antibiotics. The heterogeneity of the molecular bases responsible for these phenotypes poses significant hurdles for therapeutic and diagnostic purposes.
2024
Pubblicato
Rilevanza internazionale
Review
Esperti anonimi
Settore BIO/19
Settore MED/07
Settore MEDS-03/A - Microbiologia e microbiologia clinica
English
Con Impact Factor ISI
Klebsiella pneumoniae
carbapenem resistance
carbapenemase-encoding plasmids
high-risk clones
mobile genetic elements
virulence
Di Pilato, V., Pollini, S., Miriagou, V., Rossolini, G.m., D’Andrea, M.m. (2024). Carbapenem-resistant Klebsiella pneumoniae: the role of plasmids in emergence, dissemination, and evolution of a major clinical challenge. EXPERT REVIEW OF ANTI-INFECTIVE THERAPY, 22(13), 25-43 [10.1080/14787210.2024.2305854].
Di Pilato, V; Pollini, S; Miriagou, V; Rossolini, Gm; D’Andrea, Mm
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/350023
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