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Klebsiella pneumoniae carbapenemase variants: the new threat to global public health
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SUMMARY: Klebsiella pneumoniae carbapenemase (KPC) variants, which refer to the substitution, insertion, or deletion of amino acid sequence compared to wild bla KPC type, have reduced utility of ceftazidime-avibactam (CZA), a pioneer antimicrobial agent in treating carbapenem-resistant Enterobacterales infections. So far, more than 150 bla KPC variants have been reported worldwide, and most of the new variants were discovered in the past 3 years, which calls for public alarm. The KPC variant protein enhances the affinity to ceftazidime and weakens the affinity to avibactam by changing the KPC structure, thereby mediating bacterial resistance to CZA. At present, there are still no guidelines or expert consensus to make recommendations for the diagnosis and treatment of infections caused by KPC variants. In addition, meropenem-vaborbactam, imipenem-relebactam, and other new β-lactam-β-lactamase inhibitor combinations have little discussion on KPC variants. This review aims to discuss the clinical characteristics, risk factors, epidemiological characteristics, antimicrobial susceptibility profiles, methods for detecting bla KPC variants, treatment options, and future perspectives of bla KPC variants worldwide to alert this new great public health threat.
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“The presence of carbapenemase-producing strains of K. pneumoniae is considered a significant global threat [39]; however, this was not observed in our study.”
From Microbiological Quality of Coconut Water Sold in the Grande Vitória Region, Brazil, and Phenogenotypic Antimicrobial Resistance of Associated Enterobacteria (2024) · cites this paper as [39]
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Metadata
- Authors
- Ding, L., Shen, S., Chen, J., Tian, Z., Shi, Q., Han, R., Guo, Y., & Hu, F.
- Affiliations
- Fudan University (CN)
- Hangzhou Matridx Biotechnology Co., Ltd., Hangzhou, Zhejiang, China
- Corresponding author
- Guo, Yan
- Hu, Fupin
- Venue
- Clinical Microbiology Reviews
- Publisher
- American Society for Microbiology
- Published
- 2023-12-20
- Volume
- 36
- Issue
- 4
- Pages
- e0000823-e0000823
- ISSN
- 0893-8512 (ISSN-L)
- 1098-6618
- PMC
- PMC10732083
- OpenAlex
- W4388500625
- Cited by
- 222
- References
- 128
- Citations by year
- 2026: 84 · 2025: 91 · 2024: 47
- FWCI
- 4.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Microbiology Reviews (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (32141002, 82172311, 82302574)
- China Antimicrobial Surveillance Network (2020QD049)
- Topics
- Health Sciences › Medicine › Microbiology (medical) › Antibiotic Resistance in Bacteria
- Life Sciences › Immunology and Microbiology › Microbiology › Enterobacteriaceae and Cronobacter Research
- Health Sciences › Medicine › Microbiology (medical) › Bacterial Identification and Susceptibility Testing
- Keywords
- KPC, carbapenem resistance, ceftazidime-avibactam resistance, beta-lactamase inhibitors, meropenem-vaborbactam, imipenem-relebactam, antimicrobial susceptibility, risk factors, treatment options, public health risk
- MeSH terms
- Anti-Bacterial Agents, Bacterial Proteins, beta-Lactamases, Drug Combinations, Klebsiella pneumoniae, Microbial Sensitivity Tests, Public Health, beta-Lactamase Inhibitors
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