{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:58:28Z","timestamp":1790391508506,"version":"4.1.0"},"reference-count":88,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004263","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Rio Grande do Sul","doi-asserted-by":"crossref","award":["23\/2551-0000506-9"],"award-info":[{"award-number":["23\/2551-0000506-9"]}],"id":[{"id":"10.13039\/501100004263","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior\u2014Brasil","doi-asserted-by":"crossref","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["311162\/2023-1"],"award-info":[{"award-number":["311162\/2023-1"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["309387\/2022-1"],"award-info":[{"award-number":["309387\/2022-1"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background\/Objectives:\u00a0Klebsiella spp., particularly K. pneumoniae, are major opportunistic pathogens in healthcare settings driven by carbapenemase- and ESBL-producing strains. We assessed antimicrobial resistance and biofilm formation abilities in Klebsiella spp. from a Brazilian tertiary hospital and related environments and characterized capsular types. Methods: Over six months (July\u2013December 2023), 303 carbapenem-resistant Klebsiella spp. were collected from clinical specimens (n = 198), ICU\/non-ICU surfaces (n = 79), hospital sewage (n = 22), and stream water (n = 4). Species were identified by MALDI-TOF. Susceptibility testing covered eight antibiotic classes, focusing on carbapenems and polymyxin B. Biofilm formation was quantified by crystal violet, and capsular typing used wzi\/K-locus approaches. Results: Most isolates (70.95%) had meropenem MICs \u2265 128 \u03bcg\/mL, while 77.6% (n = 235) remained susceptible to polymyxin B. Resistance profiles largely consisted of extensive drug resistance (95.4%), with 1.3% exhibiting pandrug resistance, including isolates from bed rails. Biofilm formation was detected in 96.7% of isolates, mainly weak (67.6%) or moderate (28%), with 4.4% being strong producers. Among the Klebsiella isolates analyzed, 21 K types were identified with an uneven distribution dominated by K64, followed by K24, K173, and K50. K75 was the only K type detected across all sources\u2014clinical isolates, bed-rail surfaces (non-ICU), wastewater, and fluvial water. Conclusions: Carbapenem-resistant Klebsiella spp. exhibited widespread resistance, with residual susceptibility to aminoglycosides, ceftazidime\u2013avibactam, and polymyxins. Environmental reservoirs\u2014hospital surfaces, sewage, and stream water\u2014harbored resistant biofilm producers, reinforcing their role in persistence and dissemination. K-typing revealed concentrated distribution (predominantly K64) and cross-source K75. These findings underscore the urgency of integrated strategies combining molecular surveillance, antimicrobial stewardship, and environmental control.<\/jats:p>","DOI":"10.3390\/antibiotics14111140","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T13:51:08Z","timestamp":1762782668000},"page":"1140","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Widespread Distribution of Carbapenem-Resistant Klebsiella spp. in Clinical and Environmental Settings"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8470-2671","authenticated-orcid":false,"given":"Karla Vanessa Molina","family":"Maldonado","sequence":"first","affiliation":[{"name":"Laborat\u00f3rio de Imunologia e Microbiologia, Escola de Ci\u00eancias da Sa\u00fade e da Vida, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia Celular e Molecular, Escola de Ci\u00eancias da Sa\u00fade e da Vida, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia Marchese","family":"Pereira","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Imunologia e Microbiologia, Escola de Ci\u00eancias da Sa\u00fade e da Vida, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7979-3872","authenticated-orcid":false,"given":"Tamires Nascimento da","family":"Costa","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Imunologia e Microbiologia, Escola de Ci\u00eancias da Sa\u00fade e da Vida, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia Celular e Molecular, Escola de Ci\u00eancias da Sa\u00fade e da Vida, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Lemos","family":"Buss","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Imunologia e Microbiologia, Escola de Ci\u00eancias da Sa\u00fade e da Vida, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kethlen Natiele de","family":"Almeida Pereira","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Imunologia e Microbiologia, Escola de Ci\u00eancias da Sa\u00fade e da Vida, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9758-3289","authenticated-orcid":false,"given":"Anelise Baptista da","family":"Silva","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Imunologia e Microbiologia, Escola de Ci\u00eancias da Sa\u00fade e da Vida, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia Celular e Molecular, Escola de Ci\u00eancias da Sa\u00fade e da Vida, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6928-4716","authenticated-orcid":false,"given":"Gertrudes","family":"Cor\u00e7\u00e3o","sequence":"additional","affiliation":[{"name":"Departamento de Microbiologia, Imunologia e Parasitologia, Instituto de Ci\u00eancias B\u00e1sicas da Sa\u00fade, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8947-8005","authenticated-orcid":false,"given":"\u00c2ndrea Celestino de","family":"Souza","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio Cl\u00ednico, Hospital S\u00e3o Lucas, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90610-001, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7416-5962","authenticated-orcid":false,"given":"Amanda Silva","family":"Martins","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio Cl\u00ednico, Hospital S\u00e3o Lucas, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90610-001, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8683-3833","authenticated-orcid":false,"given":"Diego Rodrigues","family":"Falci","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Controle de Infec\u00e7\u00e3o, Hospital S\u00e3o Lucas, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90610-001, RS, Brazil"},{"name":"N\u00facleo de Forma\u00e7\u00e3o Espec\u00edfica em Medicina Interna e Diagn\u00f3stica, Escola de Medicina, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90610-001, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4667-0224","authenticated-orcid":false,"given":"Ariane Baptista","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Controle de Infec\u00e7\u00e3o, Hospital S\u00e3o Lucas, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90610-001, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Flores","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Controle de Qualidade em Sa\u00fade INCQS\/FIOCRUZ, Rio de Janeiro 21040-900, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7520-4097","authenticated-orcid":false,"given":"Kayo","family":"Bianco","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Controle de Qualidade em Sa\u00fade INCQS\/FIOCRUZ, Rio de Janeiro 21040-900, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6320-712X","authenticated-orcid":false,"given":"Maysa Mandetta","family":"Clementino","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Controle de Qualidade em Sa\u00fade INCQS\/FIOCRUZ, Rio de Janeiro 21040-900, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3727-5097","authenticated-orcid":false,"given":"Carlos Alexandre Sanchez","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Imunologia e Microbiologia, Escola de Ci\u00eancias da Sa\u00fade e da Vida, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia Celular e Molecular, Escola de Ci\u00eancias da Sa\u00fade e da Vida, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5466-4908","authenticated-orcid":false,"given":"Renata","family":"Medina-Silva","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Imunologia e Microbiologia, Escola de Ci\u00eancias da Sa\u00fade e da Vida, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia Celular e Molecular, Escola de Ci\u00eancias da Sa\u00fade e da Vida, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7296-5085","authenticated-orcid":false,"given":"S\u00edlvia Dias de","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Imunologia e Microbiologia, Escola de Ci\u00eancias da Sa\u00fade e da Vida, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia Celular e Molecular, Escola de Ci\u00eancias da Sa\u00fade e da Vida, Pontif\u00edcia Universidade Cat\u00f3lica do Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S0140-6736(21)02724-0","article-title":"Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis","volume":"399","author":"Murray","year":"2022","journal-title":"Lancet"},{"key":"ref_2","first-page":"100561","article-title":"The burden of antimicrobial resistance in the Americas in 2019: A cross-country systematic analysis","volume":"25","author":"Swetschinski","year":"2023","journal-title":"Lancet Reg. 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