Antimicrobial resistance in hypermucoviscous and non-hypermucoviscous Klebsiella pneumoniae: a systematic review and meta-analysis
Antimicrobial resistance has recently increased due to emerging carbapenem-resistant Klebsiella pneumoniae and extended-spectrum β-lactamase (ESBL)-producing strains of K. pneumoniae, especially among hypermucoviscous K. pneumoniae (hmKp) strains. To evaluate the prevalence of ESBL-producing and car...
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Taylor & Francis Group
2025-12-01
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| Series: | Emerging Microbes and Infections |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/22221751.2024.2438657 |
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| author | Hiroki Namikawa Ken-Ichi Oinuma Yukihiro Kaneko Hiroshi Kakeya Taichi Shuto |
| author_facet | Hiroki Namikawa Ken-Ichi Oinuma Yukihiro Kaneko Hiroshi Kakeya Taichi Shuto |
| author_sort | Hiroki Namikawa |
| collection | DOAJ |
| description | Antimicrobial resistance has recently increased due to emerging carbapenem-resistant Klebsiella pneumoniae and extended-spectrum β-lactamase (ESBL)-producing strains of K. pneumoniae, especially among hypermucoviscous K. pneumoniae (hmKp) strains. To evaluate the prevalence of ESBL-producing and carbapenem-resistant strains in hmKp and non-hmKp clinical isolates through a systematic review and meta-analysis. We searched PubMed, Scopus, and Cochrane Library databases from January 2000 to June 2023. Clinical and in vivo/in vitro studies involving confirmed K. pneumoniae clinical isolates differentiated into hmKP and non-hmKP strains based on string test results. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated based on the number of individuals in each target group. Forest plots were used to visualize the effect sizes and 95% CIs of individual studies estimated using the inverse variance and DerSimonian – Laird methods with fixed – and random-effects models, respectively. Heterogeneity was assessed using Cochran’s Q test (I2 ≥ 50%). Fifteen studies comprising 2049 clinical isolates of K. pneumoniae met the inclusion criteria. Meta-analysis revealed that hmKp strains were associated with a significantly lower prevalence of ESBL-producing strains (pooled OR: 0.26, 95% CI: 0.11–0.63, P = 0.003) and a slightly lower prevalence of carbapenem-resistant strains than non-hmKp strains (pooled OR: 0.63, 95% CI: 0.40–0.97, P = 0.038). hmKp strains exhibited lower and slightly lower prevalence of ESBL production and carbapenem resistance, respectively, than non-hmKp strains. However, given the rising prevalence of ESBL-producing and carbapenem-resistant hmKp strains, patients infected by string-test-positive K. pneumoniae must be managed prudently, considering the potential for highly resistant strains. |
| format | Article |
| id | doaj-art-2f9b00cdc7fc42289e739d06749352af |
| institution | OA Journals |
| issn | 2222-1751 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Emerging Microbes and Infections |
| spelling | doaj-art-2f9b00cdc7fc42289e739d06749352af2025-08-20T01:58:19ZengTaylor & Francis GroupEmerging Microbes and Infections2222-17512025-12-0114110.1080/22221751.2024.2438657Antimicrobial resistance in hypermucoviscous and non-hypermucoviscous Klebsiella pneumoniae: a systematic review and meta-analysisHiroki Namikawa0Ken-Ichi Oinuma1Yukihiro Kaneko2Hiroshi Kakeya3Taichi Shuto4Department of Medical Education and General Practice, Graduate School of Medicine, Osaka Metropolitan University, Osaka, JapanDepartment of Bacteriology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, JapanDepartment of Bacteriology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, JapanResearch Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University, Osaka, JapanDepartment of Medical Education and General Practice, Graduate School of Medicine, Osaka Metropolitan University, Osaka, JapanAntimicrobial resistance has recently increased due to emerging carbapenem-resistant Klebsiella pneumoniae and extended-spectrum β-lactamase (ESBL)-producing strains of K. pneumoniae, especially among hypermucoviscous K. pneumoniae (hmKp) strains. To evaluate the prevalence of ESBL-producing and carbapenem-resistant strains in hmKp and non-hmKp clinical isolates through a systematic review and meta-analysis. We searched PubMed, Scopus, and Cochrane Library databases from January 2000 to June 2023. Clinical and in vivo/in vitro studies involving confirmed K. pneumoniae clinical isolates differentiated into hmKP and non-hmKP strains based on string test results. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated based on the number of individuals in each target group. Forest plots were used to visualize the effect sizes and 95% CIs of individual studies estimated using the inverse variance and DerSimonian – Laird methods with fixed – and random-effects models, respectively. Heterogeneity was assessed using Cochran’s Q test (I2 ≥ 50%). Fifteen studies comprising 2049 clinical isolates of K. pneumoniae met the inclusion criteria. Meta-analysis revealed that hmKp strains were associated with a significantly lower prevalence of ESBL-producing strains (pooled OR: 0.26, 95% CI: 0.11–0.63, P = 0.003) and a slightly lower prevalence of carbapenem-resistant strains than non-hmKp strains (pooled OR: 0.63, 95% CI: 0.40–0.97, P = 0.038). hmKp strains exhibited lower and slightly lower prevalence of ESBL production and carbapenem resistance, respectively, than non-hmKp strains. However, given the rising prevalence of ESBL-producing and carbapenem-resistant hmKp strains, patients infected by string-test-positive K. pneumoniae must be managed prudently, considering the potential for highly resistant strains.https://www.tandfonline.com/doi/10.1080/22221751.2024.2438657Klebsiella pneumoniaehypermucoviscousantimicrobial resistanceextended-spectrum beta-lactamasecarbapenem-resistant |
| spellingShingle | Hiroki Namikawa Ken-Ichi Oinuma Yukihiro Kaneko Hiroshi Kakeya Taichi Shuto Antimicrobial resistance in hypermucoviscous and non-hypermucoviscous Klebsiella pneumoniae: a systematic review and meta-analysis Emerging Microbes and Infections Klebsiella pneumoniae hypermucoviscous antimicrobial resistance extended-spectrum beta-lactamase carbapenem-resistant |
| title | Antimicrobial resistance in hypermucoviscous and non-hypermucoviscous Klebsiella pneumoniae: a systematic review and meta-analysis |
| title_full | Antimicrobial resistance in hypermucoviscous and non-hypermucoviscous Klebsiella pneumoniae: a systematic review and meta-analysis |
| title_fullStr | Antimicrobial resistance in hypermucoviscous and non-hypermucoviscous Klebsiella pneumoniae: a systematic review and meta-analysis |
| title_full_unstemmed | Antimicrobial resistance in hypermucoviscous and non-hypermucoviscous Klebsiella pneumoniae: a systematic review and meta-analysis |
| title_short | Antimicrobial resistance in hypermucoviscous and non-hypermucoviscous Klebsiella pneumoniae: a systematic review and meta-analysis |
| title_sort | antimicrobial resistance in hypermucoviscous and non hypermucoviscous klebsiella pneumoniae a systematic review and meta analysis |
| topic | Klebsiella pneumoniae hypermucoviscous antimicrobial resistance extended-spectrum beta-lactamase carbapenem-resistant |
| url | https://www.tandfonline.com/doi/10.1080/22221751.2024.2438657 |
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