{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:03:31Z","timestamp":1792155811358,"version":"4.4.0"},"reference-count":94,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T00:00:00Z","timestamp":1702944000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82000479"],"award-info":[{"award-number":["82000479"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2020M682422"],"award-info":[{"award-number":["2020M682422"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Due to scarce therapeutic options, hospital-acquired infections caused by Klebsiella pneumoniae (KP), particularly carbapenem-resistant KP (CRKP), pose enormous threat to patients\u2019 health worldwide. This study aimed to characterize the epidemiology and risk factors of CRKP among nosocomial KP infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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%\u201330.86%). South Asia had the highest CRKP prevalence at 66.04% (95% CI, 54.22%\u201377.85%), while high-income North America had the lowest prevalence at 14.29% (95% CI, 6.50%\u201322.0%). In the country\/territory level, Greece had the highest prevalence at 70.61% (95% CI, 56.77%\u201384.45%), followed by India at 67.62% (95% CI, 53.74%\u201381.79%) and Taiwan at 67.54% (95% CI, 58.65%\u201376.14%). 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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofad649","type":"journal-article","created":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T11:19:27Z","timestamp":1702898367000},"source":"Crossref","is-referenced-by-count":120,"title":["The Global and Regional Prevalence of Hospital-Acquired Carbapenem-Resistant\n                    <i>Klebsiella pneumoniae<\/i>\n                    Infection: A Systematic Review and Meta-analysis"],"prefix":"10.1093","volume":"11","author":[{"given":"Xing-chen","family":"Lin","sequence":"first","affiliation":[{"name":"Emergency and Trauma Center, The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-li","family":"Li","sequence":"additional","affiliation":[{"name":"Department of FSTC Clinic, The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao-yang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Emergency and Trauma Center, The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-feng","family":"Yang","sequence":"additional","affiliation":[{"name":"Emergency and Trauma Center, The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Jiang","sequence":"additional","affiliation":[{"name":"Emergency and Trauma Center, The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,12,19]]},"reference":[{"key":"2024022019170432700_ofad649-B1","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/S1473-3099(21)00399-6","article-title":"Clinical outcomes and bacterial characteristics of carbapenem-resistant Klebsiella pneumoniae complex among patients from different global regions (CRACKLE-2): a prospective, multicentre, cohort 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