Community-acquired infections caused by Klebsiella pneumoniae (K. pneumoniae) have become a significant global health concern, particularly with the emergence of hypervirulent strains (hvKP). These strains are associated with severe infections, such as pyogenic liver abscesses, even in otherwise healthy individuals. Initially reported in Taiwan in the 1980s, hvKP has now spread worldwide. The pathogenicity of hvKP is attributed to an array of virulence factors that enhance its ability to colonize and evade host immune defenses. Additionally, the convergence of hypervirulence with antibiotic resistance has further complicated treatment strategies. As a member of the ESKAPE group of pathogens, K. pneumoniae exhibits high resistance to multiple antibiotics, posing a challenge for healthcare settings. This review provides a comprehensive overview of hvKP, highlighting its structural and pathogenic differences from classical K. pneumoniae strains, key virulence factors, mechanisms of antibiotic resistance, and the increasing threat of multidrug-resistant hvKP. Lastly, we discuss current treatment guidelines and emerging therapeutic strategies to combat this formidable pathogen.

Antibiotic resistance is a growing global health threat, with critical care settings representing one of the most vulnerable arenas due to the high burden of infection and frequent empirical antibiotic use. Rapid and precise diagnosis of infectious pathogens is crucial for initiating appropriate therapy, minimizing unnecessary antimicrobial exposure, and supporting effective stewardship programs. This review explores how innovative diagnostic technologies are reshaping infection management and antimicrobial stewardship in critical care. We examine the clinical utility of molecular assays, multiplex PCR, MALDI-TOF mass spectrometry, metagenomic sequencing, point-of-care (POC) diagnostics, and emerging tools like biosensors and AI-powered predictive models. These platforms enable earlier pathogen identification and resistance profiling, facilitating timely and targeted therapy while minimizing unnecessary broad-spectrum antibiotic use. By integrating diagnostics into stewardship frameworks, clinicians can optimize antimicrobial regimens, improve patient outcomes, and reduce resistance selection pressure. Despite their promise, adoption is challenged by cost, infrastructure, interpretation complexity, and inequitable access, particularly in low-resource settings. Future perspectives emphasize the need for scalable, AI-enhanced, and globally accessible diagnostic solutions. In bridging innovation with clinical application, diagnostic advancements can serve as pivotal tools in the global effort to curb antimicrobial resistance in critical care environments.

Objectives: Automated drug dispensing system (ADDs) is an emerging technology positively impacts drug dispensing efficiency by minimizing medication errors. However, the pharmacist perception of the impact of ADDs on patient safety is not well-established. This cross-sectional observational study aimed to evaluate the dispensing practice and pharmacist perception of ADDs towards patient safety through a validated questionnaire. Methods: A selfdesigned questionnaire was validated and the pharmacist perception of dispensing practice was compared between two hospitals adopting ADDs and traditional drug dispensing system (TDDs). Results: The developed questionnaire had an excellent internal consistency (both Cronbach’s α and McDonald’s ω coefficients were >0.9). Factor analysis retained three significant factors (subscales) that explained pharmacist perception of dispensing system, dispensing practice, and patient counseling (p<0.001 for each factor). The average number of prescriptions dispensed per day, drugs contained in each prescription, average time for labeling each prescription and inventory management were significantly varied between ADDs and TDDs (p=0.027, 0.013 0.044 and 0.004, respectively). The perception of pharmacists using ADDs on three domains were higher than the TDDs. The pharmacists in ADDs agreed that they had enough time to review the medications before dispensing than TDDs and this difference was found to be statistically significant (p=0.028). Conclusions: ADDs was highly effective in improving dispensing practice and medication review; however, the pharmacists need to emphasize the importance of ADDs to translate the pharmacists’ freed-time towards patient care. Pharmacy Practice is a free full-text journal with a scope on the practice of pharmacy. Pharmacy Practice covers pharmaceutical care, social pharmacy, pharmacy education, process and outcome research, health promotion and education, health informatics, pharmacoepidemiology