Clinical and Microbiological Characteristics of Carbapenem-Resistant Klebsiella pneumoniae Associated Recurrent Urinary Tract Infections
Abstract
Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a major pathogen responsible for urinary tract infections (UTIs). However, its role and characteristics in recurrent urinary tract infections (rUTIs) remain poorly understood. Investigating its features in rUTIs may provide insights into effective prevention strategies. Methods: We analyzed a cohort of patients with rUTIs caused by Klebsiella pneumoniae from April 2020 to April 2024. Antibiotic susceptibility of the isolates was evaluated. Biofilm Formation Assay and Galleria mellonella infection models were employed to assess the virulence of the strains. Polymerase Chain Reaction (PCR) and whole-genome sequencing (WGS) were utilized to determine multilocus sequence typing (MLST) and capsular serotyping, as well as to identify resistance genes, virulence genes, and plasmid replicons. Phylogenetic relationships among the isolates were also established. Results: A total of 41 patients with rUTIs were included, with 56.1% caused by CRKP. 97.01% of CRKP carry the blaKPC-2 gene. Compared to patients infected with carbapenem-susceptible Klebsiella pneumoniae (CSKP), those infected with CRKP had a higher prevalence of underlying diseases and complications. Both groups of strains exhibited a high degree of antibiotic resistance. CRKP strains demonstrated enhanced biofilm formation capacity and greater lethality in Galleria mellonella infection models. The predominant phenotype of the CRKP strain was ST11 KL64, whereas…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 41 participants or records.
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