{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:00:45Z","timestamp":1790193645223,"version":"4.1.0"},"reference-count":37,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"\n Background:<\/jats:title>\n \n Carbapenem-resistant\n Klebsiella pneumoniae<\/jats:italic>\n (CRKP) is a critical global health threat, particularl\n y<\/jats:italic>\n for older adults. Understanding its precise burden and the associated health inequalities in the elderl\n y<\/jats:italic>\n population is crucial for informed policy-making.\n <\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n Using data from the Global Burden of Disease 2021 stud\n y<\/jats:italic>\n , we anal\n y<\/jats:italic>\n zed deaths and disabilit\n y<\/jats:italic>\n -adjusted life\n y<\/jats:italic>\n ears attributable to and associated with CRKP in individuals aged \u2265 65\n y<\/jats:italic>\n ears from 1990 to 2021. We calculated age-standardized rates, assessed temporal trends via average annual percentage change (AAPC), and quantified health inequalities using the Slope Index of Inequality (SII) and Relative Concentration Index. Frontier anal\n y<\/jats:italic>\n sis identified countries with the greatest potential for burden reduction.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The CRKP burden in the elderl\n y<\/jats:italic>\n increased substantiall\n y<\/jats:italic>\n over the past three decades, as the age-standardized mortalit\n y<\/jats:italic>\n rate associated with CRKP more than doubled from 7.44 (95% CI: 5.65 to 9.23) to 16.17 (95% CI: 13.1 to 19.25) per 100,000 (AAPC = 2.54,\n p<\/jats:italic>\n < 0.001), with the most rapid increases occurring in South Asia, Eastern Europe, and Latin America. Conversel\n y<\/jats:italic>\n , high-income regions such as Western Europe witnessed substantial declines. Health inequalities widened markedl\n y<\/jats:italic>\n , as the absolute mortalit\n y<\/jats:italic>\n gap (SII) associated with CRKP expanded from \u22128.69 (95% CI: \u221211.25,\u22126.14) to \u221241.96 (95% CI: \u221246.97,\u221236.95), an approximate fivefold increase. Frontier anal\n y<\/jats:italic>\n sis further revealed significant potentiall\n y<\/jats:italic>\n avoidable burden in low- and middle-income countries, independent of socioeconomic development.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Formal assessment of socioeconomic trends and health inequalities demonstrates an increasing concentration of the CRKP burden in low- and middle-income regions, exacerbating global health inequities. Combating this requires integrated strategies that combine antimicrobial stewardship and infection control with broader improvements in health care infrastructure and social determinants.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/10766294261422462","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T14:33:18Z","timestamp":1770733998000},"page":"119-127","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Evolution of the Burden of Carbapenem-Resistant\n Klebsiella pneumoniae<\/i>\n Infections in the Elderly, 1990\u20132021: Global Trends, Regional Heterogeneity, and Health Inequalities"],"prefix":"10.1177","volume":"32","author":[{"given":"Yuehuo","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Healthcare-Associated Infection and Public Health Management, Huadong Hospital Affiliated to Fudan University, Shanghai, China."},{"name":"Institute of Hospital Infection and Control, Fudan University, Shanghai, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Emergency Management, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Healthcare-Associated Infection and Public Health Management, Huadong Hospital Affiliated to Fudan University, Shanghai, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyu","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Emergency Management, Shanghai Xuhui District Center for Disease Control and Prevention (Shanghai Xuhui Health Inspection Agency), Shanghai, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(25)00118-5"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics9080514"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejps.2021.106103"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S431085"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01867-1"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2024.107431"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00757-8"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11102817"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(22)00225-0"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/HC9.0000000000000785"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2025.2529578"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2018.1440783"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-51081-5"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drup.2025.101265"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-017-0260-6"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1089\/hs.2018.0052"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00048-19"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1128\/aem.02457-21"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2023.1159912"},{"key":"e_1_3_5_21_2","first-page":"101095","article-title":"Molecular and clinical epidemiology of carbapenem resistant Acinetobacter baumannii, pseudomonas aeruginosa and enterobacterales in Fiji: A multicentre prospective observational study","volume":"47","author":"Baleivanualala SC","year":"2024","unstructured":"Baleivanualala SC, , Matanitobua S, , Soqo V, et al. 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