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Clinical and microbiological characteristics of Klebsiella pneumoniae from community-acquired recurrent urinary tract infections |
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| Authors: | W. H. Lin C. Y. Kao D. C. Yang C. C. Tseng A. B. Wu C. H. Teng M. C. Wang J. J. Wu |
| Affiliation: | 1. Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan 2. Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan 3. Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan 4. Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan 5. Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan 6. Department of Medical Laboratory Science and Biotechnology, Infectious Disease and Signaling Research Center, College of Medicine, National Cheng Kung University, No. 1 University Road, 70101, Tainan, Taiwan |
| Abstract: | Understanding the pathogenesis of recurrent urinary tract infection (RUTI) and whether it is attributable to reinfection with a new strain or relapse with the primary infecting strain is of considerable importance. Because previous studies regarding community-acquired Klebsiella pneumoniae RUTI are inconclusive, we undertook this study to evaluate the characteristics of the host and the bacterial agent K. pneumoniae in RUTI. A prospective study was designed, using consecutive patients diagnosed with community-acquired K. pneumoniae-related UTI from January 2007 to December 2009. Of the total 468 consecutive episodes, we found 7 patients with RUTI. All the patients with RUTI were elderly (median, 74 years), with diabetes (100 %, 7 out of 7). Clinical K. pneumoniae isolates derived from the same patients with RUTI revealed identical genomic fingerprints, indicating that K. pneumoniae UTI relapsed despite appropriate antibiotic therapy. The antimicrobial resistance, growth curve and biofilm formation of the recurrent isolates did not change. K. pneumoniae strains causing RUTI had more adhesion and invasiveness than the colonization strains (p?p?=?0.03) in the RUTI group. Our data suggest that K. pneumoniae strains might be able to persist within the urinary tract despite appropriate antibiotic treatment, and the greater adhesion and invasiveness in the recurrent strains may play an important role in recurrent infections. |
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