{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T02:47:10Z","timestamp":1789786030769,"version":"4.0.1"},"reference-count":23,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"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) is a high-priority healthcare-associated pathogen. This study aimed to estimate rectal CRKP carriage and characterize same-patient clinical-site CRKP detection. Methods: We conducted a single-center retrospective microbiological surveillance study in a Romanian tertiary-care hospital between 1 January 2025 and 1 April 2026. Patient-level prevalence used all 3123 screened patients, with each patient counted once. CRKP recovery from rectal screening specimens was classified as gastrointestinal carriage; non-rectal recovery was reported as clinical-site detection and not as confirmed infection because clinical adjudication was not systematic. Results: Among 3123 screened patients, 712 (22.8%) had a positive rectal screen, 294 (9.4%) had resistant rectal K. pneumoniae carriage, and 168 (5.4%) had rectal CRKP carriage. Of these 168 carriers, 83 (49.4%) also had a retained non-rectal CRKP isolate; rectal recovery occurred first in 45, non-rectal recovery first in 36, and collection timestamps were identical in 2. Healthcare exposures, prior carbapenem-resistant Enterobacterales carriage, and admission-relative timing were analyzed descriptively using the full 168-patient denominator, with unavailable values retained as unknown. Invasive-device, intensive-care, recent hospitalization or readmission, and recent antimicrobial exposures were frequently documented. Admission-relative timing identified early detections, probable within-admission screen conversions, hospital-onset detections without a preceding negative screen, and indeterminate cases. Conclusions: Rectal CRKP carriage was frequent and commonly associated with same-patient CRKP detection at non-rectal clinical sites, indicating a substantial hospital-associated burden. In critically ill patients with sepsis or septic shock, known CRKP carriage should inform the choice of empirical CRKP-active therapy, with prompt de-escalation once microbiological findings and clinical response allow.<\/jats:p>","DOI":"10.3390\/antibiotics15080764","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T10:23:50Z","timestamp":1786357430000},"page":"764","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Rectal Surveillance for Carbapenem-Resistant Klebsiella pneumoniae: Prevalence and Clinical Relevance in a Multidisciplinary Tertiary-Care Hospital"],"prefix":"10.3390","volume":"15","author":[{"given":"Cristiana Ana-Maria Olgu\u021ba","family":"Penea","sequence":"first","affiliation":[{"name":"\u201cAgrippa Ionescu\u201d Clinical Emergency Hospital, 011356 Bucharest, Romania"},{"name":"Department of Infectious Diseases, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Faculty of Medicine, \u201cOvidius\u201d University of Constan\u021ba, 900470 Constan\u021ba, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Violeta","family":"Melinte","sequence":"additional","affiliation":[{"name":"\u201cAgrippa Ionescu\u201d Clinical Emergency Hospital, 011356 Bucharest, Romania"},{"name":"Department of Infectious Diseases, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Cre\u021bu","sequence":"additional","affiliation":[{"name":"\u201cAgrippa Ionescu\u201d Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiberiu","family":"Holban","sequence":"additional","affiliation":[{"name":"\u201cAgrippa Ionescu\u201d Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelina Maria","family":"Radu","sequence":"additional","affiliation":[{"name":"\u201cAgrippa Ionescu\u201d Clinical Emergency Hospital, 011356 Bucharest, Romania"},{"name":"Department of Infectious Diseases, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina Maria","family":"Vacaroiu","sequence":"additional","affiliation":[{"name":"\u201cAgrippa Ionescu\u201d Clinical Emergency Hospital, 011356 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia Simona","family":"Cambrea","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cOvidius\u201d University of Constan\u021ba, 900470 Constan\u021ba, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7819-5464","authenticated-orcid":false,"given":"Valeriu","family":"Gheorghi\u021b\u0103","sequence":"additional","affiliation":[{"name":"\u201cAgrippa Ionescu\u201d Clinical Emergency Hospital, 011356 Bucharest, Romania"},{"name":"Department of Infectious Diseases, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2024). WHO Bacterial Priority Pathogens List, 2024: Bacterial Pathogens of Public Health Importance to Guide Research, Development and Strategies to Prevent and Control Antimicrobial Resistance, World Health Organization."},{"key":"ref_2","unstructured":"Centers for Disease Control and Prevention (2019). Antibiotic Resistance Threats in the United States, 2019."},{"key":"ref_3","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_4","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1128\/MMBR.00078-15","article-title":"Klebsiella pneumoniae: Going on the offense with a strong defense","volume":"80","author":"Paczosa","year":"2016","journal-title":"Microbiol. Mol. Biol. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.mib.2018.04.004","article-title":"Klebsiella pneumoniae as a key trafficker of drug resistance genes","volume":"45","author":"Wyres","year":"2018","journal-title":"Curr. Opin. Microbiol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Martin, R.M., and Bachman, M.A. (2018). Colonization, infection, and the accessory genome of Klebsiella pneumoniae. Front. Cell. Infect. Microbiol., 8.","DOI":"10.3389\/fcimb.2018.00004"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1093\/cid\/cix270","article-title":"Gastrointestinal carriage is a major reservoir of Klebsiella pneumoniae infection in intensive care patients","volume":"65","author":"Gorrie","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1086\/422002","article-title":"The role of the intestinal tract as a reservoir and source for transmission of nosocomial pathogens","volume":"39","author":"Donskey","year":"2004","journal-title":"Clin. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.ajic.2015.12.005","article-title":"Risk of infection following colonization with carbapenem-resistant Enterobacteriaceae: A systematic review","volume":"44","author":"Tischendorf","year":"2016","journal-title":"Am. J. Infect. Control"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"S28","DOI":"10.1093\/infdis\/jiw282","article-title":"The epidemiology of carbapenem-resistant Enterobacteriaceae: The impact and evolution of a global menace","volume":"215","author":"Logan","year":"2017","journal-title":"J. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.3201\/eid1710.110655","article-title":"Global spread of carbapenemase-producing Enterobacteriaceae","volume":"17","author":"Nordmann","year":"2011","journal-title":"Emerg. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"5873","DOI":"10.1128\/AAC.01019-15","article-title":"Carbapenemase-producing Klebsiella pneumoniae, a key pathogen set for global nosocomial dominance","volume":"59","author":"Pitout","year":"2015","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e01148-20","DOI":"10.1128\/AAC.01148-20","article-title":"Emerging antimicrobial-resistant high-risk Klebsiella pneumoniae clones ST307 and ST147","volume":"64","author":"Peirano","year":"2020","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1093\/cid\/ciac791","article-title":"Transmission of Carbapenem-Resistant Klebsiella pneumoniae in US Hospitals","volume":"76","author":"Luterbach","year":"2023","journal-title":"Clin. Infect. Dis."},{"key":"ref_15","unstructured":"European Centre for Disease Prevention and Control (2025). Antimicrobial Resistance in the EU\/EEA (EARS-Net)\u2014Annual Epidemiological Report for 2024, ECDC."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"5092","DOI":"10.1038\/s41467-024-49349-z","article-title":"International and regional spread of carbapenem-resistant Klebsiella pneumoniae in Europe","volume":"15","author":"Kostyanev","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_17","unstructured":"European Committee on Antimicrobial Susceptibility Testing (2026, July 31). Breakpoint Tables for Interpretation of MICs and Zone Diameters, Version 15.0. EUCAST. Available online: https:\/\/www.eucast.org\/fileadmin\/eucast\/pdf\/breakpoints\/v_15.0_Breakpoint_Tables.pdf."},{"key":"ref_18","unstructured":"European Committee on Antimicrobial Susceptibility Testing (2026, July 31). Breakpoint Tables for Interpretation of MICs and Zone Diameters, Version 16.0. EUCAST. Available online: https:\/\/www.eucast.org\/fileadmin\/eucast\/pdf\/breakpoints\/v_16.0_Breakpoint_Tables.pdf."},{"key":"ref_19","unstructured":"CLSI-EUCAST Polymyxin Breakpoints Working Group (2026, July 31). Recommendations for MIC Determination of Colistin (Polymyxin E) as Recommended by the Joint CLSI-EUCAST Polymyxin Breakpoints Working Group. EUCAST. Available online: https:\/\/www.eucast.org\/fileadmin\/src\/media\/PDFs\/EUCAST_files\/General_documents\/Recommendations_for_MIC_determination_of_colistin_March_2016.pdf."},{"key":"ref_20","first-page":"65","article-title":"A simple sequentially rejective multiple test procedure","volume":"6","author":"Holm","year":"1979","journal-title":"Scand. J. Stat."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"148ra116","DOI":"10.1126\/scitranslmed.3004129","article-title":"Tracking a Hospital Outbreak of Carbapenem-Resistant Klebsiella pneumoniae with Whole-Genome Sequencing","volume":"4","author":"Snitkin","year":"2012","journal-title":"Sci. Transl. Med."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Penea, C.A.-M.O., Melinte, V., Cambrea, C.S., Holban, T., Radu, A.M., Vacaroiu, C.M., and Gheorghi\u021b\u0103, V. (2026). Determinants of carbapenem-resistant Klebsiella pneumoniae: Clinical outcomes and epidemiological risk factors in a single-center cohort dataset. Antibiotics, 15.","DOI":"10.3390\/antibiotics15060621"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"101871","DOI":"10.1016\/j.eclinm.2023.101871","article-title":"Risk factors for infections caused by carbapenem-resistant Enterobacterales: An international matched case-control-control study (EURECA)","volume":"57","author":"Paniagua","year":"2023","journal-title":"EClinicalMedicine"}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/8\/764\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T10:58:51Z","timestamp":1786359531000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/8\/764"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,10]]},"references-count":23,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["antibiotics15080764"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics15080764","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,10]]}}}