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Review
. 2024 Sep 12;17(9):1206.
doi: 10.3390/ph17091206.

Transmission Dynamics and Novel Treatments of High Risk Carbapenem-Resistant Klebsiella pneumoniae: The Lens of One Health

Jiaying Zhu  1   2 , Taoyu Chen  3 , Yanmin Ju  1 , Jianjun Dai  1   4 , Xiangkai Zhuge  2
Affiliations
Review

Transmission Dynamics and Novel Treatments of High Risk Carbapenem-Resistant Klebsiella pneumoniae: The Lens of One Health

Jiaying Zhu et al. Pharmaceuticals (Basel). .

Abstract

The rise of antibiotic resistance and the dwindling antimicrobial pipeline have emerged as significant threats to public health. The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a global threat, with limited options available for targeted therapy. The CRKP has experienced various changes and discoveries in recent years regarding its frequency, transmission traits, and mechanisms of resistance. In this comprehensive review, we present an in-depth analysis of the global epidemiology of K. pneumoniae, elucidate resistance mechanisms underlying its spread, explore evolutionary dynamics concerning carbapenem-resistant hypervirulent strains as well as KL64 strains of K. pneumoniae, and discuss recent therapeutic advancements and effective control strategies while providing insights into future directions. By going through up-to-date reports, we found that the ST11 KL64 CRKP subclone with high risk demonstrated significant potential for expansion and survival benefits, likely due to genetic influences. In addition, it should be noted that phage and nanoparticle treatments still pose significant risks for resistance development; hence, innovative infection prevention and control initiatives rooted in One Health principles are advocated as effective measures against K. pneumoniae transmission. In the future, further imperative research is warranted to comprehend bacterial resistance mechanisms by focusing particularly on microbiome studies' application and implementation of the One Health strategy.

Keywords: CR-hvKP; KL64; One Health; antibiotic resistance; foodborne; microbiome; nanoparticles; phage.

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Conflict of interest statement

The authors declare that they have no conflicts of interests.

Figures

Figure 1
Figure 1
Carbapenem-resistance mechanisms and virulence features of CRKP.
Figure 2
Figure 2
Visualization depicting the keywords related to Klebsiella pneumoniae. The varying sizes of the data points correspond to their respective frequencies.
Figure 3
Figure 3
Keywords distributed based on order of appearance over time. Blue keywords precede yellow ones.
Figure 4
Figure 4
The keywords categorized based on frequency of occurrence. The ones highlighted in yellow are the most frequent and those in green follow closely behind.
See this image and copyright information in PMC

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