Antimicrobial Resistance in KPC-producing Klebsiella pneumoniae
DOI:
https://doi.org/10.70577/ASCE/497.515/2025Keywords:
Antimicrobial resistance; Bacterial infections; Klebsiella pneumoniae; Carbapenemases; Combination therapy.Abstract
Carbapenemase-producing Klebsiella pneumoniae (KPC) represents one of the main challenges in clinical practice due to its high capacity for resistance to multiple antimicrobial agents. In Latin America, its dissemination intensified in recent years, compromising therapeutic efficacy. The objective of this study was to analyze antimicrobial resistance in K. pneumoniae producing carbapenemases and its therapeutic implications through a systematic review. An integrative review of recent literature was carried out using PubMed, SciELO, and Elsevier databases, applying MeSH/DeCS descriptors and the PRISMA methodology. Resistance was mainly associated with allelic variants of the blaKPC gene (KPC-2 and KPC-3) and its dissemination through conjugative plasmids. In Ecuador, multidrug-resistant clones, primarily ST258 and ST1199, were identified; most remained susceptible to colistin and tigecycline. However, the emergence of allelic mutations affected the efficacy of ceftazidime–avibactam. Treatment of severe infections caused by KPC-producing strains required a personalized approach based on phenotypic susceptibility testing and genotypic characterization. Combined therapies, the use of new molecules such as cefiderocol, and alternative strategies including bacteriophage therapy showed promising results against highly resistant strains. In conclusion, the management of these infections should rely on a multidisciplinary strategy that integrates advanced microbiological diagnosis and rational antimicrobial use. Strengthening microbiological surveillance and implementing infection control policies are essential to contain the spread of multidrug-resistant strains.
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