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Article

Epidemiology of Carbapenem-Resistant Klebsiella Pneumoniae Co-Producing MBL and OXA-48-like in a Romanian Tertiary Hospital: A Call to Action

by
Violeta Melinte
1,2,*,
Maria Adelina Radu
1,2,
Maria Cristina Văcăroiu
2,
Luminița Mîrzan
2,
Tiberiu Sebastian Holban
2,
Bogdan Vasile Ileanu
3,4,
Ioana Miriana Cismaru
2 and
Valeriu Gheorghiță
1,2
1
Department of Infectious Diseases, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
2
“Agrippa Ionescu” Clinical Emergency Hospital, 050474 Bucharest, Romania
3
Center for Health Outcomes and Evaluation, 050474 Bucharest, Romania
4
Faculty of Cybernetics, Statistics and Informatics, University of Economic Studies, 050474 Bucharest, Romania
*
Author to whom correspondence should be addressed.
Antibiotics 2025, 14(8), 783; https://doi.org/10.3390/antibiotics14080783 (registering DOI)
Submission received: 9 June 2025 / Revised: 22 July 2025 / Accepted: 28 July 2025 / Published: 1 August 2025

Abstract

Introduction: Carbapenem-resistant Klebsiella pneumoniae (CRKP) represents a critical public health threat due to its rapid nosocomial dissemination, limited therapeutic options, and elevated mortality rates. This study aimed to characterize the epidemiology, carbapenemase profiles, and antimicrobial susceptibility patterns of CRKP isolates, as well as the clinical features and outcomes observed in infected or colonized patients. Materials and Methods: We conducted a retrospective analysis of clinical and microbiological data from patients with CRKP infections or colonization admitted between January 2023 and January 2024. Descriptive statistics were used to assess prevalence, resistance patterns, and patient outcomes. Two binary logistic regression models were applied to identify independent predictors of sepsis and in-hospital mortality. Results: Among 89 CRKP isolates, 45 underwent carbapenemase typing. More than half were metallo-β-lactamase (MBL) producers, with 44.4% co-harbouring NDM and OXA-48-like enzymes. Surgical intervention was associated with a significantly lower risk of sepsis (p < 0.01) and in-hospital mortality (p = 0.045), whereas intensive care unit (ICU) stay was a strong predictor of both outcomes. ICU admission conferred a 10-fold higher risk of sepsis (95%Cl 2.4–41.0) and a 40.8-fold higher risk of in-hospital death (95% Cl 3.5–473.3). Limitations: This single-center retrospective study included a limited number of isolates in certain groups. Additionally, cefiderocol (FDC) susceptibility was assessed by disk diffusion rather than by the broth microdilution method. Conclusions: Our study underscores the increasing prevalence of metallo-beta-lactamase-producing CRKP, particularly strains harbouring dual carbapenemases. Timely recognition of high-risk patients, combined with the implementation of targeted infection control measures and the integration of novel therapeutic options, is crucial to optimize clinical management and reduce mortality associated with CRKP.
Keywords: Carbapenem-resistant; Klebsiella pneumoniae; metallo-b-lactamases; NDM/OXA-48-like carbapenemases; cefiderocol susceptibility; antimicrobial stewardship Carbapenem-resistant; Klebsiella pneumoniae; metallo-b-lactamases; NDM/OXA-48-like carbapenemases; cefiderocol susceptibility; antimicrobial stewardship

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MDPI and ACS Style

Melinte, V.; Radu, M.A.; Văcăroiu, M.C.; Mîrzan, L.; Holban, T.S.; Ileanu, B.V.; Cismaru, I.M.; Gheorghiță, V. Epidemiology of Carbapenem-Resistant Klebsiella Pneumoniae Co-Producing MBL and OXA-48-like in a Romanian Tertiary Hospital: A Call to Action. Antibiotics 2025, 14, 783. https://doi.org/10.3390/antibiotics14080783

AMA Style

Melinte V, Radu MA, Văcăroiu MC, Mîrzan L, Holban TS, Ileanu BV, Cismaru IM, Gheorghiță V. Epidemiology of Carbapenem-Resistant Klebsiella Pneumoniae Co-Producing MBL and OXA-48-like in a Romanian Tertiary Hospital: A Call to Action. Antibiotics. 2025; 14(8):783. https://doi.org/10.3390/antibiotics14080783

Chicago/Turabian Style

Melinte, Violeta, Maria Adelina Radu, Maria Cristina Văcăroiu, Luminița Mîrzan, Tiberiu Sebastian Holban, Bogdan Vasile Ileanu, Ioana Miriana Cismaru, and Valeriu Gheorghiță. 2025. "Epidemiology of Carbapenem-Resistant Klebsiella Pneumoniae Co-Producing MBL and OXA-48-like in a Romanian Tertiary Hospital: A Call to Action" Antibiotics 14, no. 8: 783. https://doi.org/10.3390/antibiotics14080783

APA Style

Melinte, V., Radu, M. A., Văcăroiu, M. C., Mîrzan, L., Holban, T. S., Ileanu, B. V., Cismaru, I. M., & Gheorghiță, V. (2025). Epidemiology of Carbapenem-Resistant Klebsiella Pneumoniae Co-Producing MBL and OXA-48-like in a Romanian Tertiary Hospital: A Call to Action. Antibiotics, 14(8), 783. https://doi.org/10.3390/antibiotics14080783

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