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Abstract：
UNASSIGNED: Due to scarce therapeutic options, hospital-acquired infections caused by Klebsiella pneumoniae (KP), particularly carbapenem-resistant KP (CRKP), pose enormous threat to patients\' health worldwide. This study aimed to characterize the epidemiology and risk factors of CRKP among nosocomial KP infections.
UNASSIGNED: MEDLINE, Embase, PubMed, and Google Scholar were searched for studies reporting CRKP prevalence from inception to 30 March 2023. Data from eligible publications were extracted and subjected to meta-analysis to obtain global, regional, and country-specific estimates. To determine the cause of heterogeneity among the selected studies, prespecified subgroup analyses and meta-regression were also performed. Odds ratios of CRKP-associated risk factors were pooled by a DerSimonian and Laird random-effects method.
UNASSIGNED: We retained 61 articles across 14 countries and territories. The global prevalence of CRKP among patients with KP infections was 28.69% (95% CI, 26.53%-30.86%). South Asia had the highest CRKP prevalence at 66.04% (95% CI, 54.22%-77.85%), while high-income North America had the lowest prevalence at 14.29% (95% CI, 6.50%-22.0%). In the country/territory level, Greece had the highest prevalence at 70.61% (95% CI, 56.77%-84.45%), followed by India at 67.62% (95% CI, 53.74%-81.79%) and Taiwan at 67.54% (95% CI, 58.65%-76.14%). Hospital-acquired CRKP infections were associated with the following factors: hematologic malignancies, corticosteroid therapies, intensive care unit stays, mechanical ventilations, central venous catheter implantations, previous hospitalization, and antibiotic-related exposures (antifungals, carbapenems, quinolones, and cephalosporins).
UNASSIGNED: Study findings highlight the importance of routine surveillance to control carbapenem resistance and suggest that patients with nosocomial KP infection have a very high prevalence of CRKP.
UNASSIGNED: MEDLINE, Embase, PubMed, and Google Scholar were searched for studies reporting CRKP prevalence from inception to 30 March 2023. Data from eligible publications were extracted and subjected to meta-analysis to obtain global, regional, and country-specific estimates. To determine the cause of heterogeneity among the selected studies, prespecified subgroup analyses and meta-regression were also performed. Odds ratios of CRKP-associated risk factors were pooled by a DerSimonian and Laird random-effects method.
UNASSIGNED: We retained 61 articles across 14 countries and territories. The global prevalence of CRKP among patients with KP infections was 28.69% (95% CI, 26.53%-30.86%). South Asia had the highest CRKP prevalence at 66.04% (95% CI, 54.22%-77.85%), while high-income North America had the lowest prevalence at 14.29% (95% CI, 6.50%-22.0%). In the country/territory level, Greece had the highest prevalence at 70.61% (95% CI, 56.77%-84.45%), followed by India at 67.62% (95% CI, 53.74%-81.79%) and Taiwan at 67.54% (95% CI, 58.65%-76.14%). Hospital-acquired CRKP infections were associated with the following factors: hematologic malignancies, corticosteroid therapies, intensive care unit stays, mechanical ventilations, central venous catheter implantations, previous hospitalization, and antibiotic-related exposures (antifungals, carbapenems, quinolones, and cephalosporins).
UNASSIGNED: Study findings highlight the importance of routine surveillance to control carbapenem resistance and suggest that patients with nosocomial KP infection have a very high prevalence of CRKP.
摘要：
■由于治疗选择很少，肺炎克雷伯菌（KP）引起的医院获得性感染，特别是耐碳青霉烯的KP（CRKP），对全球患者的健康构成巨大威胁。本研究旨在描述医院KP感染中CRKP的流行病学和危险因素。
■MEDLINE,Embase,PubMed,和谷歌学者被搜索报告从开始到2023年3月30日CRKP患病率的研究。从符合条件的出版物中提取数据，并进行荟萃分析，以获得全球，区域,和特定国家的估计。为了确定所选研究之间异质性的原因，我们还进行了预设的亚组分析和meta回归.CRKP相关危险因素的几率通过DerSimonian和Laird随机效应方法汇总。
■我们在14个国家和地区保留了61篇文章。KP感染患者中CRKP的全球患病率为28.69％（95％CI，26.53％-30.86％）。南亚的CRKP患病率最高，为66.04%（95%CI，54.22%-77.85%），而高收入北美地区的患病率最低,为14.29%(95%CI,6.50%-22.0%).在国家/地区层面，希腊的患病率最高，为70.61％（95％CI，56.77％-84.45％），其次是印度为67.62%（95%CI，53.74%-81.79%）和台湾为67.54%（95%CI，58.65%-76.14%）。医院获得性CRKP感染与以下因素相关：血液系统恶性肿瘤，皮质类固醇治疗,重症监护室停留,机械通风,中心静脉导管植入,以前住院，和抗生素相关的暴露(抗真菌药，碳青霉烯类,喹诺酮类药物,和头孢菌素）。
■研究结果强调了常规监测对控制碳青霉烯类耐药的重要性，并表明医院KP感染患者CRKP的患病率很高。
■MEDLINE,Embase,PubMed,和谷歌学者被搜索报告从开始到2023年3月30日CRKP患病率的研究。从符合条件的出版物中提取数据，并进行荟萃分析，以获得全球，区域,和特定国家的估计。为了确定所选研究之间异质性的原因，我们还进行了预设的亚组分析和meta回归.CRKP相关危险因素的几率通过DerSimonian和Laird随机效应方法汇总。
■我们在14个国家和地区保留了61篇文章。KP感染患者中CRKP的全球患病率为28.69％（95％CI，26.53％-30.86％）。南亚的CRKP患病率最高，为66.04%（95%CI，54.22%-77.85%），而高收入北美地区的患病率最低,为14.29%(95%CI,6.50%-22.0%).在国家/地区层面，希腊的患病率最高，为70.61％（95％CI，56.77％-84.45％），其次是印度为67.62%（95%CI，53.74%-81.79%）和台湾为67.54%（95%CI，58.65%-76.14%）。医院获得性CRKP感染与以下因素相关：血液系统恶性肿瘤，皮质类固醇治疗,重症监护室停留,机械通风,中心静脉导管植入,以前住院，和抗生素相关的暴露(抗真菌药，碳青霉烯类,喹诺酮类药物,和头孢菌素）。
■研究结果强调了常规监测对控制碳青霉烯类耐药的重要性，并表明医院KP感染患者CRKP的患病率很高。
