Carbapenem-Resistance in Clinical Klebsiella pneumoniae Isolates From Iran, Review Article

Background: Because of the current limitations of therapeutic methods, the worldwide appearance and spreading of carbapenem-resistant (CR)-Klebsiella pneumoniae has made it a key concern in the healthcare system. K. pneumoniae, the most frequent Klebsiella species is the cause of human infections, classified as top three pathogens of global concern which was established in the2014 WHO Global Report on Surveillance of Antimicrobial Resistance. Methods: Embase, PubMed/Medline, Scopus, Google Scholar, Web of Sciences, and Iranian databases were searched to retrieve the potentially relevant studies. In this review, we explored the prevalence of K. pneumoniae generating three universal carbapenemases (KPCs, NDMs, and OXA-48-like) by following keywords: carbapenem resistance and blaKPC and Metallo lactamase-beta and blaNDM and blaOXA and Klebsiella pneumoniae and Iran. Results: After exploiting predefined inclusion and exclusion criteria, 37 articles were collected that reported prevalence of carbapenem-resistant Klebsiella pneumoniae. At finally, 20 studies reported blaNDM , 17 studies reported blaKPC, 14 studies reported blaOXA-48 and blaVIM as gene cause resistance among Klebsiella pneumoniae strains. The described resistance to carbapenem varied across different studies, ranging from 4.4% to 100%. Conclusion: Our findings demonstrated that the high prevalence of carbapenem-resistant Klebsiella pneumoniae expresses concern over most Iranian hospitals.