Nationwide Evidence of blaKPC-Positive Klebsiella pneumoniae in Brazilian Clinical Isolates: A Systematic Review and Meta-Analysis
Carolynne Silva dos Santos
Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Tv. Perebebuí, 2623-Marco, Belém 66087-662, PA, Brazil.
Marcos Jessé Abrahão Silva
Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Tv. Perebebuí, 2623-Marco, Belém 66087-662, PA, Brazil.
Pabllo Antonny Silva dos Santos
Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Tv. Perebebuí, 2623-Marco, Belém 66087-662, PA, Brazil.
Emilly Victória Correia de Miranda
Bacteriology and Mycology Section, Evandro Chagas Institute (SEBAC/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil.
Ana Beatriz Tavares Duarte
Bacteriology and Mycology Section, Evandro Chagas Institute (SEBAC/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil.
Allysson Freires Diniz
Microbiology Laboratory, Serra Talhada Academic Unit (UAST), Federal Rural University of Pernambuco (UFRPE), Av. Gregório Ferraz Nogueira, Serra Talhada 56909-535, PE, Brazil.
Luana Nepomuceno Gondim Costa Lima
Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Tv. Perebebuí, 2623-Marco, Belém 66087-662, PA, Brazil.
Danielle Murici Brasiliense
Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Tv. Perebebuí, 2623-Marco, Belém 66087-662, PA, Brazil and Bacteriology and Mycology Section, Evandro Chagas Institute (SEBAC/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil.
Cintya de Oliveira Souza
Bacteriology and Mycology Section, Evandro Chagas Institute (SEBAC/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil.
Karla Valéria Batista Lima
Program in Parasitic Biology in the Amazon Region (PPGBPA), State University of Pará (UEPA), Tv. Perebebuí, 2623-Marco, Belém 66087-662, PA, Brazil and Bacteriology and Mycology Section, Evandro Chagas Institute (SEBAC/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil.
Yan Corrêa Rodrigues
*
Bacteriology and Mycology Section, Evandro Chagas Institute (SEBAC/IEC), Ministry of Health, Ananindeua 67030-000, PA, Brazil and Microbiology Laboratory, Serra Talhada Academic Unit (UAST), Federal Rural University of Pernambuco (UFRPE), Av. Gregório Ferraz Nogueira, Serra Talhada 56909-535, PE, Brazil.
*Author to whom correspondence should be addressed.
Abstract
The dissemination of Klebsiella pneumoniae carbapenemase (KPC), encoded by the blaKPC gene, has become a major challenge to antimicrobial therapy. In Brazil, evidence of blaKPC-positive K. pneumoniae is extensive and fragmented. This study aims to systematically review published data to characterize and quantify the prevalence of blaKPC among clinical K. pneumoniae isolates in Brazil. Following PRISMA guidelines, we performed a systematic review and proportion meta-analysis of studies published from 2006–2024 reporting molecular detection of blaKPC in clinical K. pneumoniae isolates across Brazil. Searches in SciELO, PubMed, ScienceDirect, and LILACS identified eligible cross-sectional and case-control studies. Data was independently extracted and appraised quality using Joanna Briggs Institute criteria. Random-effects models estimated pooled prevalence; heterogeneity, publication bias, and meta-regression were assessed. Thirty studies met inclusion criteria, totaling 5,630 isolates, of which 4,175 were screened for blaKPC and 1,488 were positive. The pooled blaKPC prevalence was 44.3% (95% CI= 0.405–0.481; I² = 97.3%). Subgroup analyses revealed regional heterogeneity (36.5–85.5%), and meta-regression showed a significant inverse association between study size and prevalence (p = 0.01). No publication bias was detected (Begg’s p = 0.40). blaKPC-harboring K. pneumoniae is highly prevalent and geographically widespread in Brazil. Study design variability and uneven surveillance likely explain observed heterogeneity, underscoring the need for standardized molecular monitoring and coordinated infection-control strategies.
Keywords: Serine-beta-lactamases, meta-analysis, Beta-lactamases, Brazil, Klebsiella pneumoniae, carbapenemases