Keywords
Carbapenemases
Microbialdrug resistance
Epidemiology
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Abstract
Objective: To analyze the epidemiological and therapeutic situation of carbapenemase-producing Klebsiella pneumoniae (KPC) in Brazil between 2015 and 2025, addressing its evolution, factors associated with its dissemination, and prevention and control measures. Methods: This Integrative Literature Review covered the period from 5 to 2025. The search included major databases such as PubMed, SciELO, ScienceDirect, and WHO reports, using descriptors such as "Klebsiella pneumoniae KPC" and "Brazil". Original articles, reviews, and technical documents in Portuguese, English, and Spanish were selected, focusing on the Brazilian context. Results: The results demonstrated a significant increase in KPC, highlighting the KPC-2 variant, responsible for more than 90% of isolates. The COVID-19 pandemic intensified resistance to carbapenems and polymyxin B. Genomic analyses identified epidemic clones (ST11, ST15) and co-infections with genes such as bla NDM-1, increasing morbidity and mortality, length of hospital stay, and hospital costs. Treatment is based on combination therapies and the use of new β-lactamase inhibitors, with variable efficacy. Key points include the need for the rational use of antimicrobials, strengthening integrated surveillance (BR-GLASS), and exploring alternatives such as natural compounds (Origanum vulgare). Final considerations: The spread of KPC represents a serious threat to public health, requiring continuous surveillance and the development of new therapeutic strategies.
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