Carbapenem and Colistin Resistance Trends in Klebsiella pneumoniae Strains Isolated from Blood Cultures: A Pediatric-Adult Comparative Study
Selin Uğraklı11Department of Medical Microbiology, Necmettin Erbakan University Faculty of Medicine, Konya, Türkiye
Objectives: Turkish surveillance data on carbapenem-resistant Klebsiella pneumoniae (CRKP) bacteremia are largely restricted to adults. We investigated resistance trends and factors associated with carbapenem resistance among K. pneumoniae blood culture isolates at a tertiary center. Methods: Between October 2022 and November 2024, 625 non-duplicate K. pneumoniae blood culture isolates were analyzed. Susceptibilities were tested with BD Phoenix panels except colistin (reference broth microdilution) and interpreted using EUCAST breakpoints, except tigecycline (FDA criteria). Isolates resistant to ertapenem, imipenem or meropenem were defined as CRKP. Results: CRKP comprised 556 isolates (88.9%). Carbapenem resistance rate was 68.4%, 84.0% and 93.2% in 2022, 2023 and 2024 (p-trend<0.001); colistin resistance increased from 10.5% to 35.0% (p-trend=0.004). Fluoroquinolone resistance rate in isolates from children was lower (ciprofloxacin 30.6% vs. 89.9%; p<0.001), whereas gentamicin resistance rate was higher (68.4% vs. 44.8%; p<0.001) compared to adults. Multivariate regression analysis identified calendar year (adj. OR=2.472) and adult ward versus ICU origin (adj. OR=0.087) as factors independently associated with CRKP (both p<0.001). Conclusion: CRKP rates were high and rising, and increasing colistin resistance limits treatment options. Distinct pediatric and adult resistance patterns may inform age-stratified interpretation of local antibiograms and empirical therapy. Multicenter studies incorporating outcome data are needed. Keywords: Blood culture, carbapenems, Klebsiella pneumoniae
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Uğraklı S. Carbapenem and Colistin Resistance Trends in Klebsiella pneumoniae Strains Isolated from Blood Cultures: A Pediatric-Adult Comparative Study. EJMI. 2026; 10(4): 531-539
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