ReviewInfection2026
Prevalence, mortality, risk factors, and treatment of carbapenem-resistant hypervirulent Klebsiella pneumoniae: an evidence map.
Review in Infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCarbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) is a critical global health threat due to its hypervirulence and multidrug resistance, causing severe, high-mortality infections. This study systematically reviews its epidemiology, risk factors, treatment strategies, and activity.
methodsWe searched databases to identify studies reporting CR-hvKP prevalence, resistance profiles, risk factors, treatment strategies, and activity. Two reviewers independently extracted data; a third resolved discrepancies. Results were summarized descriptively.
resultsForty-three studies involving 9283 carbapenem-resistant K. pneumoniae (CRKP) strains were included. The median prevalence of CR-hvKP among CRKP was 9.40% (IQR 4.40-14.80%) via the string test plus virulence assay. Diabetes (OR = 10.947, P = 0.010) and ICU admission (OR = 16.012, P = 0.003) were independent risk factors for CR-hvKP infection. Among 130 patients, the most commonly used antibiotics included meropenem (34.62%), cefoperazone-sulbactam (31.54%), and tigecycline (28.46%). However, treatment failure remains a significant concern. Antimicrobial resistance analysis indicated that CR-hvKP exhibited high resistance rates to cephalosporins (> 80%) and quinolones (45-100%). One study found high susceptibility (92.50-100.00%) to nitrofurantoin, polymyxins, imipenem-relebactam, tigecycline, and colistin. Mortality analysis revealed a median mortality rate of 30.30% (IQR 13.33-53.06%).
conclusionCR-hvKP remains a formidable public health threat due to its substantial prevalence, elevated mortality, and multidrug resistance. Current therapeutic strategies lack standardization, and widely applied combination therapy has inconsistent efficacy. Further research is urgently needed to optimize treatment regimens. Early detection, precise antimicrobial stewardship, and stringent infection control measures are crucial to mitigate the spread and impact of CR-hvKP.
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