Carbapenem Resistance in Klebsiella pneumoniae Infections

Klebsiella pneumoniae is a leading cause of hospital- and community-acquired infections, including pneumonia, bloodstream infections and urinary tract infections. The advent of carbapenem resistance in this species represents a critical threat to public health, as carbapenems constitute the last line of defence against multidrug-resistant Gram-negative bacteria. Resistance is most often mediated by carbapenemase enzymes—such as KPC, NDM and OXA-48 variants—encoded by genes carried on plasmids, transposons and integrons. High-risk clonal lineages (for example ST258, ST101, ST147 and ST307) have emerged worldwide, disseminating resistance determinants through clonal expansion and horizontal gene transfer. Surveillance integrating genomic epidemiology with phylogeographic mapping has revealed regional differences in dominant clones, while also highlighting convergence of resistance and virulence traits. Efforts to curb the spread include strengthened infection control, antimicrobial stewardship and development of rapid molecular diagnostics to guide therapy and limit further dissemination.

Research from Nature Portfolio

Recent studies have mapped the international and regional spread of carbapenem-resistant K. pneumoniae across Europe by combining large-scale genomic surveillance with longitudinal collections from multiple hospitals. Eleven major clonal lineages were identified, with ST258/512 harbouring blaKPC-like genes dominating in Southern Europe and ST101 and ST14 associated with blaOXA-48-like variants in Eastern regions. Analysis of mobile genetic contexts revealed that specific plasmid backbones and transposon arrangements underlie regional differences in resistance gene prevalence. These findings underscore the value of integrated genomic and epidemiological data in guiding local risk mapping, informing targeted control measures and adapting national surveillance strategies to the evolving clonal landscape.

Carbapenem Resistance in Klebsiella pneumoniae Infections publication trend

The graph below shows the total number of articles in carbapenem resistance in klebsiella pneumoniae infections across all publications each year (not limited to Nature Index journals).

Technical terms

Carbapenemase: An enzyme that hydrolyses carbapenem antibiotics, rendering them ineffective.

Mobile genetic element (MGE): A DNA fragment—such as a plasmid, transposon or integron—that can move within or between genomes.

Sequence type (ST): A designation from multilocus sequence typing reflecting a bacterial clone’s allelic profile.

blaKPC / blaNDM / blaOXA-48: Genes encoding distinct classes of carbapenemase enzymes.

Clonal complex (CC): A group of related sequence types sharing recent common ancestry, often associated with outbreak lineages.

References

1. International and regional spread of carbapenem-resistant Klebsiella pneumoniae in Europe. Nature Communications (2024).
2. Dissemination of carbapenemase‐producing Enterobacteriaceae and associated resistance determinants through global food systems. Comprehensive Reviews in Food Science and Food Safety (2023).
3. Various arrangements of mobile genetic elements among CC147 subpopulations of Klebsiella pneumoniae harboring blaNDM-1: a comparative genomic analysis of carbapenem resistant strains. Journal of Biomedical Science (2023).
4. Nested Russian Doll-Like Genetic Mobility Drives Rapid Dissemination of the Carbapenem Resistance Gene blaKPC. Antimicrobial Agents and Chemotherapy (2016).