Epidemiology of Antimicrobial-Resistant Klebsiella pneumoniae

Klebsiella pneumoniae has emerged as a leading cause of hospital- and community-acquired infections, propelled by its capacity to acquire and disseminate antimicrobial-resistance determinants. Key drivers of resistance include the global proliferation of carbapenemases such as KPC (Klebsiella pneumoniae carbapenemase) and NDM (New Delhi metallo-β-lactamase), often carried on mobile plasmids that facilitate rapid horizontal transfer. High-risk clones, notably those of sequence types ST258, ST11 and ST15, have been implicated in widespread outbreaks across continents. Epidemiological surveillance has revealed shifting patterns of resistance: while ST258 predominated in many regions throughout the early 2010s, ST11 and ST15 have more recently expanded in Asia, Europe and the Americas. The interplay between pandemic pressures, health-care disruptions and antimicrobial usage has also influenced detection rates, with evidence of altered carbapenemase gene frequencies following the COVID-19 pandemic. Community reservoirs—including environmental and agricultural settings—have been increasingly recognised as sources of resistant strains, underscoring the need for integrated One Health approaches. Insights from national and international surveillance networks guide infection-control policies, antibiotic stewardship and the development of novel therapeutics, including β-lactamase inhibitors and phage therapies. Continued investment in genome-based monitoring and rapid diagnostics is essential to track evolving lineages, detect emergent resistance mechanisms and mitigate the global burden of antimicrobial-resistant K. pneumoniae.

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Epidemiology of Antimicrobial-Resistant Klebsiella pneumoniae publication trend

The graph below shows the total number of articles in epidemiology of antimicrobial-resistant klebsiella pneumoniae across all publications each year (not limited to Nature Index journals).

Technical terms

Carbapenemase: Enzyme that hydrolyses carbapenem antibiotics, conferring high-level resistance.

Plasmid: Self-replicating extrachromosomal DNA element capable of carrying resistance genes between bacteria.

Sequence type (ST): Numerical designation of bacterial lineage based on allelic profiles from multilocus sequence typing.

Metallo-β-lactamase: Class of carbapenemase requiring divalent metal ions to inactivate β-lactam antibiotics.

Minimum inhibitory concentration (MIC): Lowest concentration of an antimicrobial that prevents visible growth of a microorganism under standard conditions.

References

1. A 7-Year Brazilian National Perspective on Plasmid-Mediated Carbapenem Resistance in Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumannii Complex and the Impact of the Coronavirus Disease 2019 Pandemic on Their Occurrence. Clinical Infectious Diseases (2023).
2. Characterization of blaKPC-2 and blaNDM-1 Plasmids of a K. pneumoniae ST11 Outbreak Clone. Antibiotics (2023).
3. The Spread of NDM-1 and NDM-7-Producing Klebsiella pneumoniae Is Driven by Multiclonal Expansion of High-Risk Clones in Healthcare Institutions in the State of Pará, Brazilian Amazon Region. Antibiotics (2021).