RESISTANCE TO β-LACTAMS: EMPHASIS ON KPC CARBAPENEMASE IN BRAZIL

Introduction: β-lactam antibiotics constitute the most widely used class in clinical practice and are essential in the treatment of bacterial infections. Their mechanism of action is based on the inhibition of bacterial cell wall synthesis through binding to penicillin-binding proteins (PBPs). However, their efficacy has been progressively compromised by bacterial resistance, especially mediated by the production of β-lactamases, with emphasis on carbapenemases such as Klebsiella pneumoniae Carbapenemase (KPC). Objective: To analyze the scientific production regarding bacterial resistance mechanisms to β-lactam antibiotics, with emphasis on KPC and its relevance in the Brazilian epidemiological scenario. Methodology: This is an integrative literature review of a qualitative nature, conducted in the SciELO, PubMed, and Virtual Health Library (VHL) databases, using controlled descriptors (DeCS/MeSH) combined with Boolean operators. Studies published between 2021 and 2026 in Portuguese, English, and Spanish were included. Results: Resistance to β-lactams occurs mainly through reduced membrane permeability, alteration of PBPs, and predominantly through the production of β-lactamases. In Brazil, KPC remains the main resistance mechanism in Enterobacterales, with an average detection rate of 68.6%, although it has shown a reduction (74.5% in 2015 to 55.1% in 2022), associated with an increase in NDM β-lactamase (4.1% to 39.4%). Coproduction of carbapenemases has also been observed, increasing therapeutic complexity and configuring a scenario of epidemiological alert. Conclusion: Resistance mediated by β-lactamases, especially carbapenemases, represents a major public health challenge, requiring continuous surveillance, rational use of antimicrobials, and strengthening of infection control strategies.