{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:51:17Z","timestamp":1789055477630,"version":"build-2803163510"},"reference-count":67,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Healthcare-associated infections due to carbapenem-resistant Klebsiella pneumoniae (CRKP) are a global public health threat with rising hospital morbidity and mortality. We conducted a meta-analysis to systematically identify CRKP infection risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched Medline, Embase, Web of Science, and Cochrane Library for studies published January 1991\u2013December 2024. Pooled odds ratio (OR)\/95% confidence intervals (CIs) were used to assess risk factors; publication bias was evaluated via funnel plots and Egger\u2019s test, and robustness via leave-one-out sensitivity analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty-one studies (13,860 patients: 4,711 CRKP cases, 9,149 carbapenem-susceptible K. pneumoniae controls) were included, with 43 reported risk factors. Thirty-one were significant: demographic\/underlying diseases [male sex (OR = 1.31), kidney diseases (OR = 1.47), respiratory system diseases (OR = 2.69), cardiovascular diseases (OR = 1.34)]; invasive procedures [endoscopy (OR = 4.08), tracheal cannula (OR = 3.72), mechanical ventilation (OR = 3.61)]; medical environment [ICU admission (OR = 4.27), pre-infection hospital stay (mean difference=14.98 days)]; antibiotics [tigecycline (OR = 5.97), carbapenems (OR = 4.79), which may reflect disease severity, prior colonization]. Subgroup analysis showed regional heterogeneity: Western populations had higher risks with cephalosporins (OR = 2.68 vs. Eastern 1.55) and fluoroquinolones (OR = 3.58 vs. Eastern 1.89), while Eastern populations had higher risks with invasive procedures (dialysis: OR = 4.47 vs. Western 2.03). Sensitivity analysis confirmed robust results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This meta-analysis reports endoscopy and surgical drainage as distinct subtypes of invasive procedural factors associated with hospital-acquired CRKP infection and describes regional differences in associated factors between Eastern and Western populations. These findings, based on observational evidence, provide preliminary insights for targeted prevention strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO<\/jats:ext-link>\n                      , identifier CRD42024628428.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1717419","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T06:42:39Z","timestamp":1773124959000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Risk factors for carbapenem-resistant Klebsiella pneumoniae infection in hospitalized patients: a meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Chengyang","family":"Jin","sequence":"first","affiliation":[{"name":"Department of Disease Prevention and Control, Second Affiliated Hospital of Navy Medical University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuejiao","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Disease Prevention and Control, Second Affiliated Hospital of Navy Medical University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Disease Prevention and Control, Second Affiliated Hospital of Navy Medical University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"key":"B7","doi-asserted-by":"publisher","first-page":"101004","DOI":"10.1016\/j.lana.2025.101004","article-title":"World Health Organization priority antimicrobial resistance in Enterobacterales, Acinetobacter baumannii, Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus faecium healthcare-associated bloodstream infections in Brazil (ASCENSION): a prospective, multicentre, observational study","volume":"43","author":"Antochevis","year":"2025","journal-title":"Lancet Reg. 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