Multicenter Point-Prevalence Study of Carbapenem-Resistant Klebsiella spp. in Türkiye: Epidemiology, Antimicrobial...

Carbapenem-resistant Klebsiella spp. have emerged as major healthcare-associated pathogens worldwide, posing significant therapeutic and infection control challenges. Despite the growing burden of antimicrobial resistance, contemporary multicenter epidemiological data regarding carbapenem-resistant Klebsiella spp. in Türkiye remain limited. This study aimed to determine the culture-based prevalence of carbapenem-resistant Klebsiella spp. and to describe the clinical, microbiological, and institutional characteristics associated with these organisms.

This multicenter cross-sectional point-prevalence study was conducted in seven tertiary-care hospitals located in different regions of Türkiye. On 19 February 2026, all hospitalized adult patients and microbiological cultures obtained on the study day were evaluated. Demographic, clinical, microbiological, antimicrobial treatment, infection control, and hospital-level data were collected using a standardized case report form. Culture-based prevalence estimates were calculated with 95% confidence intervals (CIs).

A total of 26 patients with carbapenem-resistant Klebsiella spp. colonization and/or infection were included. The mean age was 68.5 ± 14.1 years, and 61.5% were male. Most patients had at least one comorbidity (84.6%), and recent antibiotic exposure was common (88.5%). Urinary tract infection was the most frequently identified infection type (53.8%), followed by pneumonia (19.5%) and bloodstream infection (19.2%). Urinary catheterization was present in 73.1% of patients, while central venous catheters and mechanical ventilation were present in 46.2% and 34.6%, respectively. Ceftazidime-avibactam susceptibility results were available for 20 isolates, of which 12 (60.0%; 95% CI, 38.66-78.12) were resistant. Colistin susceptibility results were available for 17 isolates, of which four (23.5%; 95% CI, 9.56-47.26) were resistant. The culture-based prevalence of carbapenem-resistant Klebsiella spp. was 1.69% (95% CI, 1.16-2.46) among all cultures obtained on the study day and 8.94% (95% CI, 6.17-12.77) among culture-positive specimens.

Carbapenem-resistant Klebsiella spp. remain important healthcare-associated pathogens in Türkiye, particularly among patients with substantial healthcare exposure, invasive device use, and recent antibiotic treatment. Continued surveillance, strengthened infection prevention measures, and expanded molecular characterization are essential for improving the understanding and control of antimicrobial resistance in the country.