Carbapenem-Resistant Klebsiella pneumoniae Infections in ICU COVID-19 Patients-A Scoping Review
Wioletta Mędrzycka-Dąbrowska1, Sandra Lange2, Katarzyna Zorena3
1Department of Anaesthesiology Nursing & Intensive Care, Faculty of Health Sciences, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland.
Introduction:
The spread of multidrug-resistant pathogens is a serious problem and challenge for the whole medical community. Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections in immunocompromised patients have a severe course and may be fatal. Increasingly, these bacteria are exhibiting resistance to carbapenem antibiotics, which have been used as so-called drugs of last resort. The emergence of the new coronavirus and the pandemic that it has caused require changes to protect against the spread of the new SARS-CoV-2. These changes paradoxically may contribute to the spread of other infections.
Methods:
PubMed, Cochrane Library databases were searched using relevant keywords. A literature review of carbapenem-resistant Klebsiella pneumoniae infection in patients hospitalized for COVID-19 was conducted according to PRISMA recommendations. A written review protocol was not prepared.
Results:
1016 studies in scientific databases were searched. After rejecting duplicate studies, 964 results were obtained. Inclusion and exclusion criteria were then applied, and studies were qualitatively analyzed. Finally, 11 studies were included in the review. The results of infected patients were from six countries. The prevalence of CRKP in Covid-19 patients ranged from 0.35-53%. The majority of CRKP infected patients were male (85%), with a mean age of 61 years. Among isolates, the predominant genes were KPC, OXY-48, CTX-M, TEM, NDM and SHV.
Conclusion:
The results presented in our review indicate the necessity of paying attention to carbapenem-resistant Klebsiella pneumoniae infections in patients with COVID-19. In order to prevent the increase of bacterial resistance, rational antibiotic therapy should be used, as well as continuous control and surveillance of hospital infections caused by multidrug-resistant organisms.
Insights
The COVID-19 pandemic has increased the risk of carbapenem-resistant Klebsiella pneumoniae (CRKP) infections in hospitalized patients. Vigilance and rational antibiotic use are crucial to combat multidrug-resistant organisms.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Microbiology
Background:
- The global rise of multidrug-resistant pathogens poses a significant threat to healthcare.
- Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections are particularly dangerous in immunocompromised individuals.
- The COVID-19 pandemic may inadvertently facilitate the spread of other resistant infections.
Purpose of the Study:
- To review the prevalence and characteristics of CRKP infections in patients hospitalized with COVID-19.
- To highlight the challenges posed by CRKP in the context of the COVID-19 pandemic.
Main Methods:
- A systematic literature review was performed using PubMed and Cochrane Library databases.
- Studies were selected based on inclusion and exclusion criteria and qualitatively analyzed.
- PRISMA recommendations guided the review process.
Main Results:
- Eleven studies from six countries were included, analyzing data from CRKP-infected COVID-19 patients.
- The prevalence of CRKP in COVID-19 patients varied widely (0.35-53%).
- Affected patients were predominantly male (85%), with a mean age of 61; key resistance genes included KPC, OXY-48, CTX-M, TEM, NDM, and SHV.
Conclusions:
- Increased attention to CRKP infections in COVID-19 patients is essential.
- Rational antibiotic therapy and continuous surveillance of hospital-acquired infections are vital to prevent further antimicrobial resistance.
- Effective strategies are needed to manage CRKP in the context of ongoing global health challenges.
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