Background/Objectives: Carbapenem-resistant Klebsiella pneumoniae (CRKp) remains a critical driver of antimicrobial resistance (AMR) in hospital settings worldwide. Methods: This study examined trends in CRKp bloodstream infections over a seven-year period (2019–2025) in a tertiary care hospital in Greece, with particular attention given to resistance patterns and patient outcomes, including the impact of the COVID-19 pandemic. Results: A total of 671 non-duplicate CRKp isolates were analyzed and classified into three groups: KPC producers (67.4%), dual carbapenemase producers (dual CP) (17.4%), and single metallo-β-lactamase (MBL) producers (15.2%). Overall incidence showed a slight but non-significant increase over time. KPC-producing strains rose significantly until 2022 (p < 0.001), followed by a marked decline (p < 0.001). In contrast, dual CPs—mainly KPC combined with VIM or NDM—and single-MBL producers, particularly NDM, increased steadily, indicating a notable epidemiological shift. Resistance to aminoglycosides and tigecycline increased around 2021, followed by partial declines, whereas colistin resistance demonstrated a continuous upward trend throughout the study period. Despite phenotypic differences, overall mortality remained high, with no statistically significant differences between groups (p = 0.37), likely reflecting either the severity of patients’ clinical condition or inadequate empirical antibiotic therapy. Conclusions: This study highlights a dynamic evolution in CRKp epidemiology with decreasing KPC dominance and increasing prevalence of MBL- and dual CP strains. This transition, which became evident during and after the COVID-19 pandemic, underscores ongoing epidemiological adaptation and the urgent need for improved antimicrobial stewardship, rapid diagnostics, and broader access to effective therapies.

Background: Carbapenem-resistant Klebsiella pneumoniae (CRKp) remains a critical driver of antimicrobial resistance (AMR) in hospital settings worldwide. Methods: This study examined trends in CRKp bloodstream infections over a seven-year period (2019–2025) in a tertiary care hospital in Greece, with particular attention to resistance patterns and patient outcomes, including the impact of the COVID-19 pandemic. Results: A total of 671 non-duplicate CRKp isolates were analyzed and classified into three groups: KPC producers (67.4%), dual carbapenemase producers (17.4%), and single metallo-β-lactamase (MBL) producers (15.2%). Overall incidence showed a slight but non-significant increase over time. KPC-producing strains rose significantly until 2022 (p<0.001), followed by a marked decline (p<0.001). In contrast, dual carbapenemase producers—mainly KPC combined with VIM or NDM—and single-MBL producers, particularly NDM, increased steadily, indicating a notable epidemiological shift. Resistance to aminoglycosides and tigecycline increased around 2021, followed by partial declines, whereas colistin resistance demonstrated a continuous upward trend throughout the study period. Despite phenotypic differences, overall mortality remained high, with no statistically significant differences between groups (p = 0.37), likely reflecting either the severity of patients’ clinical condition or inadequate empirical antibiotic therapy. Conclusions: This study highlights a dynamic evolution in CRKp epidemiology with decreasing KPC dominance and increasing prevalence of MBL- and dual carbapenemase- producing strains. This transition, which became evident during and after the COVID-19 pandemic, underscores ongoing epidemiological adaptation and the urgent need for improved antimicrobial stewardship, rapid diagnostics, and broader access to effective therapies.

Objectives: To evaluate whether a multifaceted educational intervention was associated with changes in healthcare professionals’ knowledge, attitudes, self-reported practices, and catheter-associated urinary tract infection incidence in medical wards. Methods: This before-and-after intervention study was conducted in three internal medicine wards of a tertiary general hospital between September 2023 and December 2025, including a pre-intervention period (September 2023–April 2025), an intervention period (May–June 2025), and a post-intervention period (July–December 2025). The intervention included face-to-face education, interactive discussions, printed materials, posters, and ward-based reminders on evidence-based urinary catheter care. Healthcare professionals completed an anonymous structured questionnaire before and after the intervention, while catheter-associated urinary tract infection surveillance was conducted prospectively. Pre- and post-intervention questionnaire data were analyzed as independent groups. Results: We obtained questionnaire responses from 85 healthcare workers before the intervention and 78 after the intervention. The median total knowledge score increased significantly from 21 (interquartile range [IQR], 19–22) to 23 (IQR, 22–25; P < 0.001). Selected self-reported practices also improved significantly, whereas attitudes and perceptions were generally favorable at baseline and did not change significantly. The overall CAUTI rate decreased from 3.79 to 1.94 episodes per 1,000 catheter-days. After adjustment for ward, the post-intervention period was associated with a significantly lower CAUTI incidence (incidence rate ratio, 0.50; 95% confidence interval, 0.28–0.90; P = 0.020). Conclusion: The educational intervention was associated with improved knowledge, selected improvements in self-reported catheter-care practices, and lower catheter-associated urinary tract infection incidence.