{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:01:19Z","timestamp":1791568879804,"version":"4.3.4"},"reference-count":210,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T00:00:00Z","timestamp":1623369600000},"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. Med."],"abstract":"<jats:p>The convergence of a vulnerable population and a notorious pathogen is devastating, as seen in the case of sepsis occurring during the first 28 days of life (neonatal period). Sepsis leads to mortality, particularly in low-income countries (LICs) and lower-middle-income countries (LMICs). <jats:italic>Klebsiella pneumoniae<\/jats:italic>, an opportunistic pathogen is a leading cause of neonatal sepsis. The success of <jats:italic>K. pneumoniae<\/jats:italic> as a pathogen can be attributed to its multidrug-resistance and hypervirulent-pathotype. Though the WHO still recommends ampicillin and gentamicin for the treatment of neonatal sepsis, <jats:italic>K. pneumoniae<\/jats:italic> is rapidly becoming untreatable in this susceptible population. With escalating rates of cephalosporin use in health-care settings, the increasing dependency on carbapenems, a \u201clast resort antibiotic,\u201d has led to the emergence of carbapenem-resistant <jats:italic>K. pneumoniae<\/jats:italic> (CRKP). CRKP is reported from around the world causing outbreaks of neonatal infections. Carbapenem resistance in CRKP is largely mediated by highly transmissible plasmid-encoded carbapenemase enzymes, including KPC, NDM, and OXA-48-like enzymes. Further, the emergence of a more invasive and highly pathogenic hypervirulent <jats:italic>K. pneumoniae<\/jats:italic> (hvKP) pathotype in the clinical context poses an additional challenge to the clinicians. The deadly package of resistance and virulence has already limited therapeutic options in neonates with a compromised defense system. Although there are reports of CRKP infections, a review on neonatal sepsis due to CRKP\/ hvKP is scarce. Here, we discuss the current understanding of neonatal sepsis with a focus on the global impact of the CRKP, provide a perspective regarding the possible acquisition and transmission of the CRKP and\/or hvKP in neonates, and present strategies to effectively identify and combat these organisms.<\/jats:p>","DOI":"10.3389\/fmed.2021.634349","type":"journal-article","created":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T04:47:34Z","timestamp":1623386854000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":94,"title":["Neonatal Sepsis: The Impact of Carbapenem-Resistant and Hypervirulent Klebsiella 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