Palabras clave
Carbapenemasas
Resistencia a los antimicrobianos
Epidemiología
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Resumen
Objetivo: Analizar la situación epidemiológica y terapéutica de Klebsiella pneumoniae productora de carbapenemasas (KPC) en Brasil entre 2015 y 2025, abordando su evolución, los factores asociados a su diseminación y las medidas de prevención y control. Métodos: Esta revisión integrativa de la literatura abarcó el período de 2015 a 2025. La búsqueda incluyó bases de datos importantes como PubMed, SciELO, ScienceDirect e informes de la OMS, utilizando descriptores como "Klebsiella pneumoniae KPC" y "Brasil". Se seleccionaron artículos originales, revisiones y documentos técnicos en portugués, inglés y español, con énfasis en el contexto brasileño. Resultados: Los resultados demostraron un aumento significativo de KPC, destacando la variante KPC-2, responsable de más del 90% de los aislamientos. La pandemia de COVID-19 intensificó la resistencia a los carbapenémicos y la polimixina B. Los análisis genómicos identificaron clones epidémicos (ST11, ST15) y coinfecciones con genes como bla NDM-1, lo que incrementó la morbilidad y la mortalidad, la duración de la hospitalización y los costos hospitalarios. El tratamiento se basa en terapias combinadas y el uso de nuevos inhibidores de β-lactamasas, con eficacia variable. Se destaca la necesidad de un uso racional de los antimicrobianos, el fortalecimiento de la vigilancia integrada (BR-GLASS) y la exploración de alternativas como los compuestos naturales (Origanum vulgare). Consideraciones finales: La propagación de KPC representa una grave amenaza para la salud pública, que exige una vigilancia continua y el desarrollo de nuevas estrategias terapéuticas.
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