Co-Occurrence of Resistance to Aminoglycosides and Carbapenems in Klebsiella pneumoniae: A Critical Threat to Public Health.

Antimicrobial resistance (AMR) in Klebsiella pneumoniae, especially the co-occurrence of resistance to aminoglycosides and carbapenems, represents a serious threat to global public health. This study reviews the prevalence of this combined resistance, analyzes the underlying mechanisms, and evaluates its impact on clinical practice and public health. To this end, a narrative literature review was carried out, using databases such as PubMed, SciELO, Google Scholar, DOAJ, Virtual Health Library (VHL), and ScienceDirect. Studies published in the last 10 years in English and Portuguese, related to resistance to these two drugs in K. pneumoniae, were included. The qualitative analysis of the data revealed an alarming increase in the prevalence of resistant strains, mainly associated with the production of Aminoglycoside Modifying Enzymes (AME) and carbapenemases, resulting in significantly high rates of mortality, morbidity, and treatment costs. To mitigate this threat, multifaceted strategies are needed, such as the rational use of antibiotics, epidemiological surveillance, education programs, and investment in research for new antimicrobials. In addition, it is observed that multisectoral collaboration is essential to face this challenge, requiring coordinated and continuous efforts in research, education, and public health practices.