Assessment of β-lactamase gene–phenotype concordance in predicting carbapenem resistance in Klebsiella pneumoniae

This study aims to evaluate the relationship between β-lactamase gene presence and phenotypic carbapenem resistance in Klebsiella pneumoniae isolates using data from the ATLAS antimicrobial surveillance program. Although molecular diagnostics increasingly rely on the detection of resistance genes to guide therapy, the extent to which gene presence reliably predicts phenotypic resistance at a global scale remains insufficiently characterized.
The proposed analysis will focus on Klebsiella pneumoniae isolates with available carbapenem susceptibility data (e.g., imipenem and meropenem) and corresponding β-lactamase gene profiles. The study will quantify the association between gene presence and resistance phenotype, while also identifying instances of discordance, such as gene-positive but phenotypically susceptible isolates, and gene-negative but resistant isolates. Additional stratified analyses will explore whether these patterns vary across geographic regions or over time.
This work addresses an important gap between genotypic prediction and phenotypic expression of antimicrobial resistance. By systematically evaluating the reliability of commonly detected resistance genes as predictors of carbapenem resistance, the study will help improve patient outcomes by informing more accurate diagnostic interpretation and antibiotic selection. The findings will also support antimicrobial stewardship efforts by highlighting limitations of relying solely on molecular detection for resistance prediction.
From a public health perspective, this study will contribute to improved understanding of resistance mechanisms and their clinical implications across diverse settings. Identifying discrepancies between genotype and phenotype may indicate the presence of alternative resistance pathways or regulatory factors, guiding future research and surveillance strategies. Overall, this analysis seeks to strengthen the evidence base for integrating genotypic and phenotypic data in antimicrobial resistance management and to support more effective clinical and public health decision-making.