{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:36:02Z","timestamp":1790732162460,"version":"4.1.0"},"reference-count":46,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["MicrobiologyOpen"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Antimicrobial resistance (AMR) poses a critical global health threat, with\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    emerging as a high\u2010priority pathogen due to escalating resistance rates. This systematic review and meta\u2010analysis evaluated the AMR profiles of\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    isolates from South Africa, a resource\u2010limited setting where AMR burdens remain understudied. A comprehensive search of PubMed, Web of Science, and Google Scholar (January 2000 to June 2024) identified studies reporting resistance data. Nineteen studies comprising 9402 isolates were included, and data were analyzed using random\u2010effects models. Pooled resistance prevalence was highest for amoxicillin (69.3%; 95% CI: 64.1%\u201374.1%), followed by second\u2010generation cephalosporins (70.9%; 95% CI: 65.3%\u201375.8%), trimethoprim\u2010sulfamethoxazole (57.8%; 95% CI: 52.4%\u201363.0%), and carbapenems, with imipenem resistance at 33.2% (95% CI: 28.5%\u201338.3%). Significant heterogeneity was observed (\n                    <jats:italic>I\u00b2<\/jats:italic>\n                    \u2009&gt;\u200990%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), likely due to differences in study populations such as clinical versus environmental isolates, and regional prescribing practices. Publication bias was detected (Egger's test:\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20091.45\u2009\u00d7\u200910\u207b\u00b9\u2074), indicating possible underreporting of small\u2010scale studies with null findings. These findings highlight alarming resistance rates to first\u2010line antibiotics in South Africa and underscore the urgent need for multisectoral interventions. Priority actions should include standardized AMR surveillance to harmonize data collection, expanded antimicrobial stewardship programs particularly in high\u2010resistance settings such as hospitals, and greater investment in novel therapies targeting carbapenem\u2010resistant strains. Addressing methodological heterogeneity and minimizing publication bias in future research will be critical to strengthening the evidence base for informed policymaking.\n                  <\/jats:p>","DOI":"10.1002\/mbo3.70037","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T05:40:11Z","timestamp":1753422011000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Prevalence of Antimicrobial Resistance in\n                    <i>Klebsiella pneumoniae<\/i>\n                    in the South African Populations: A Systematic Review and Meta\u2010Analysis of Surveillance Studies"],"prefix":"10.1002","volume":"14","author":[{"given":"Sinethemba H.","family":"Yakobi","sequence":"first","affiliation":[{"name":"Patho\u2010Biocatalysis Group (PBG), Department of Biochemistry and Biological Sciences University of Fort Hare Alice South 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