2025-05-22-世界卫生组织-WHO_Rapid_Risk_Assessment_-_Hypervirulent_Klebsiella_Pneumoniae,_Global_v.1_28页_603kb

Summary of Rapid Risk Assessment on Hypervirulent Klebsiella Pneumoniae with Carbapenemase Genes

Global Overview

The assessment evaluates risks related to hypervirulent Klebsiella pneumoniae (hvKp) strains with carbapenemase genes on a global scale. The overall risk is Moderate, with moderate confidence in the information, due to factors such as high pathogenicity leading to morbidity and mortality, limited treatment options for carbapenemase-producing strains, potential for outbreaks, and geographical spread facilitated by human mobility. The lack of systematic global surveillance and inadequate laboratory capacity contributes to underreporting and data gaps, affecting the accuracy and completeness of the assessment.

Key Global Risk Factors

• hvKp infections are community-acquired in some regions and healthcare-associated in others, causing severe conditions like pyogenic liver abscesses and metastatic infections with high clinical management complexity.
• Carbapenemase genes confer resistance to critical antibiotics, limiting effective interventions and contributing to higher fatality rates when combined with hypervirulence.
• Insufficient infection prevention and control (IPC) measures, along with inadequate diagnostic and surveillance systems, allow for transmission and spread across regions.

Risk Assessment by Region

• AFRO (Africa): High risk with low confidence. Challenges include high AMR levels, poor surveillance, and limited diagnostic capacity, leading to most infections remaining undetected and uncontrolled.
• AMRO (Eastern Mediterranean): Moderate risk with moderate confidence. Surveillance gaps and inconsistent laboratory testing hinder accurate assessment, with some countries lacking basic resources for detection.
• EURO (Europe): High risk with moderate confidence. Countries like Ireland show sustained transmission, but routine surveillance fails to capture full extent; underdetection is common due to reliance on non-standard diagnostics.
• SEARO (South-East Asia): Moderate risk with low confidence. Historical prevalence and spread documented, but non-systematic surveillance means data are sparse, and resistance is coupled with inadequate local capacities.
• WPRO (Western Pacific): Moderate risk with low confidence. Surveillance is not routine, leading to poor data, though some countries have limited capacity for identification; underreporting is significant due to variability in infrastructure.

Recommendations

Actions recommended include: enhancing laboratory diagnostics for hvKp detection, strengthening global and regional surveillance systems, improving IPC measures to prevent spread, and increasing awareness among clinicians and policymakers to address the public health threat posed by CR-hvKp strains.