{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T12:06:50Z","timestamp":1778846810242,"version":"3.51.4"},"reference-count":56,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background\/Objectives: Carbapenem-resistant Klebsiella pneumoniae (CRKp) remains a critical driver of antimicrobial resistance (AMR) in hospital settings worldwide. Methods: This study examined trends in CRKp bloodstream infections over a seven-year period (2019\u20132025) in a tertiary care hospital in Greece, with particular attention given to resistance patterns and patient outcomes, including the impact of the COVID-19 pandemic. Results: A total of 671 non-duplicate CRKp isolates were analyzed and classified into three groups: KPC producers (67.4%), dual carbapenemase producers (dual CP) (17.4%), and single metallo-\u03b2-lactamase (MBL) producers (15.2%). Overall incidence showed a slight but non-significant increase over time. KPC-producing strains rose significantly until 2022 (p &lt; 0.001), followed by a marked decline (p &lt; 0.001). In contrast, dual CPs\u2014mainly KPC combined with VIM or NDM\u2014and single-MBL producers, particularly NDM, increased steadily, indicating a notable epidemiological shift. Resistance to aminoglycosides and tigecycline increased around 2021, followed by partial declines, whereas colistin resistance demonstrated a continuous upward trend throughout the study period. Despite phenotypic differences, overall mortality remained high, with no statistically significant differences between groups (p = 0.37), likely reflecting either the severity of patients\u2019 clinical condition or inadequate empirical antibiotic therapy. Conclusions: This study highlights a dynamic evolution in CRKp epidemiology with decreasing KPC dominance and increasing prevalence of MBL- and dual CP strains. This transition, which became evident during and after the COVID-19 pandemic, underscores ongoing epidemiological adaptation and the urgent need for improved antimicrobial stewardship, rapid diagnostics, and broader access to effective therapies.<\/jats:p>","DOI":"10.3390\/antibiotics15050491","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T10:33:21Z","timestamp":1778841201000},"page":"491","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Seven-Year Study of Carbapenem-Resistant Klebsiella pneumoniae Bloodstream Infections in a Tertiary Hospital in Greece: A Shift Toward Metallo-\u03b2-Lactamase and Dual Carbapenemase Strains"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9937-1844","authenticated-orcid":false,"given":"Eleni","family":"Mylona","sequence":"first","affiliation":[{"name":"Fifth Department of Internal Medicine and Infectious Diseases, Evaggelismos General Hospital, 10676 Athens, Greece"},{"name":"Infection Control Committee, Evaggelismos General Hospital, 10676 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofia","family":"Kostourou","sequence":"additional","affiliation":[{"name":"Infection Control Committee, Evaggelismos General Hospital, 10676 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitroula","family":"Giankoula","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Outcomes Research (CLEO), 15451 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chrysoula","family":"Kolokotroni","sequence":"additional","affiliation":[{"name":"Infection Control Committee, Evaggelismos General Hospital, 10676 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6595-8058","authenticated-orcid":false,"given":"Paraskevas","family":"Tsilikis","sequence":"additional","affiliation":[{"name":"Microbiology Department, Evaggelismos General Hospital, 10676 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaos","family":"Koudoumnakis","sequence":"additional","affiliation":[{"name":"Microbiology Department, Evaggelismos General Hospital, 10676 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Papagianni","sequence":"additional","affiliation":[{"name":"Fifth Department of Internal Medicine and Infectious Diseases, Evaggelismos General Hospital, 10676 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4338-4879","authenticated-orcid":false,"given":"Dimitris","family":"Kounatidis","sequence":"additional","affiliation":[{"name":"Diabetes Center, First Propaedeutic Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3874-5393","authenticated-orcid":false,"given":"Natalia","family":"Vallianou","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine, Sismanogleio General Hospital, 15126 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Efstathia","family":"Perivolioti","sequence":"additional","affiliation":[{"name":"Microbiology Department, Evaggelismos General Hospital, 10676 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasileios","family":"Papastamopoulos","sequence":"additional","affiliation":[{"name":"Fifth Department of Internal Medicine and Infectious Diseases, Evaggelismos General Hospital, 10676 Athens, Greece"},{"name":"Infection Control Committee, Evaggelismos General Hospital, 10676 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2024). 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