Peer-reviewedCC BY 4.0International Journal of Molecular Sciences1 Oct 2026

Beyond Resistance: Carbapenemase Gene Profiles and Mortality in ICU Patients with Carbapenem-Resistant Klebsiella pneumoniae Infections

Esra Kaya¹
Elif Okumuş²
Elif Gülsüm Torun¹

¹Department of Medical Microbiology, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş 46050, Türkiye
²Department of Medical Microbiology, Van Training and Research Hospital, Van 65300, Türkiye

Abstract

Carbapenem-resistant Klebsiella pneumoniae (CRKP) causes serious infections in intensive care units (ICUs), but the relationship between carbapenemase gene profiles and mortality remains uncertain. This prospective two-center cohort included 94 adult ICU patients with clinical CRKP infection from April to September 2026. The first clinical isolate from each patient was included. blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48, and blaCTX-M genes were investigated by polymerase chain reaction. The primary outcome was 28-day ICU mortality; 14-day and final ICU mortality were secondary outcomes. blaOXA-48, blaNDM, blaKPC, and blaCTX-M were detected in 65 (69.1%), 49 (52.1%), 19 (20.2%), and 73 (77.7%) of isolates, respectively; blaNDM and blaOXA-48 co-occurred in 39 (41.5%). Fourteen-day, 28-day, and final ICU mortality rates occured in 38 (40.4%), 48 (51.1%), and 53 (56.4%), respectively. No statistically significant associations were observed between individual genes, the presence of two carbapenemase genes, or carbapenemase profiles and any mortality endpoint; adjusted analyses of 28-day ICU mortality yielded similar findings. In the exploratory Firth model, the profile effect was not significant (p = 0.198), whereas a higher age-adjusted Charlson Comorbidity Index and bloodstream infection or ventilator-associated pneumonia, compared with urinary tract infection, were associated with higher odds of 28-day ICU mortality. Frequent gene co-occurrence was observed; however, clinically meaningful gene–mortality associations cannot be excluded because of imprecise estimates.

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Cite

BibTeX RIS

BibTeX

@article{kaya2026beyond,
  title = {{Beyond Resistance: Carbapenemase Gene Profiles and Mortality in ICU Patients with Carbapenem-Resistant Klebsiella pneumoniae Infections}},
  author = {Esra Kaya and Elif Okumuş and Elif Gülsüm Torun},
  journal = {International Journal of Molecular Sciences},
  year = {2026},
  month = oct,
  doi = {10.3390/ijms27209388},
  url = {https://www.mdpi.com/1422-0067/27/20/9388},
  note = {CC BY 4.0},
}

RIS

TY  - JOUR
TI  - Beyond Resistance: Carbapenemase Gene Profiles and Mortality in ICU Patients with Carbapenem-Resistant Klebsiella pneumoniae Infections
AU  - Esra Kaya
AU  - Elif Okumuş
AU  - Elif Gülsüm Torun
PY  - 2026
DA  - 2026/10/01
JO  - International Journal of Molecular Sciences
DO  - 10.3390/ijms27209388
UR  - https://www.mdpi.com/1422-0067/27/20/9388
AB  - Carbapenem-resistant Klebsiella pneumoniae (CRKP) causes serious infections in intensive care units (ICUs), but the relationship between carbapenemase gene profiles and mortality remains uncertain. This prospective two-center cohort included 94 adult ICU patients with clinical CRKP infection from April to September 2026. The first clinical isolate from each patient was included. blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48, and blaCTX-M genes were investigated by polymerase chain reaction. The primary outcome was 28-day ICU mortality; 14-day and final ICU mortality were secondary outcomes. blaOXA-48, blaNDM, blaKPC, and blaCTX-M were detected in 65 (69.1%), 49 (52.1%), 19 (20.2%), and 73 (77.7%) of isolates, respectively; blaNDM and blaOXA-48 co-occurred in 39 (41.5%). Fourteen-day, 28-day, and final ICU mortality rates occured in 38 (40.4%), 48 (51.1%), and 53 (56.4%), respectively. No statistically significant associations were observed between individual genes, the presence of two carbapenemase genes, or carbapenemase profiles and any mortality endpoint; adjusted analyses of 28-day ICU mortality yielded similar findings. In the exploratory Firth model, the profile effect was not significant (p = 0.198), whereas a higher age-adjusted Charlson Comorbidity Index and bloodstream infection or ventilator-associated pneumonia, compared with urinary tract infection, were associated with higher odds of 28-day ICU mortality. Frequent gene co-occurrence was observed; however, clinically meaningful gene–mortality associations cannot be excluded because of imprecise estimates.
SN  - 1422-0067
ER  -

Abstract

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