Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Apr 21:12:861374.
doi: 10.3389/fcimb.2022.861374. eCollection 2022.

Urinary Tract Infections Caused by K. pneumoniae in Kidney Transplant Recipients - Epidemiology, Virulence and Antibiotic Resistance

Beata Krawczyk  1 , Magdalena Wysocka  1 , Michał Michalik  2 , Justyna Gołębiewska  3
Affiliations
Review

Urinary Tract Infections Caused by K. pneumoniae in Kidney Transplant Recipients - Epidemiology, Virulence and Antibiotic Resistance

Beata Krawczyk et al. Front Cell Infect Microbiol. .

Abstract

Urinary tract infections are the most common complication in kidney transplant recipients, possibly resulting in the deterioration of a long-term kidney allograft function and an increased risk of recipient's death. K. pneumoniae has emerged as one of the most prevalent etiologic agents in the context of recurrent urinary tract infections, especially with multidrug resistant strains. This paper discusses the epidemiology and risk factors associated with urinary tract infections in kidney transplant recipients, multi-drug resistance of K. pneumoniae (ESBL, KPC, NDM), treatment and pathogenesis of K. pneumoniae infections, and possible causes of recurrent UTIs. It also addresses the issue of colonization/becoming a carrier of K. pneumoniae in the gastrointestinal tract and asymptomatic bacteriuria in relation to a symptomatic UTI development and epidemiology.

Keywords: Klebsiella pneumoniae; MDR; UTI; asymptomatic bacteriuria; colonization; kidney transplant recipient; recurrent UTI; virulence factors.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The incidence of K. pneumoniae UTIs in renal transplant recipients by countries in which the study was conducted. The study period (in years) is shown in the labels. This analysis was performed based on following references: Abbott et al., 2004; Charfeddine et al., 2002; Chuang et al., 2005; Alangaden et al., 2006; Dantas et al., 2006; Valera et al., 2006; Dupont et al., 2007; Memikoğlu et al., 2007; Pourmand et al., 2007; López-Medrano et al., 2008; Giullian et al., 2010; Iqbal et al., 2010; Rivera-Sanchez et al., 2010; Fiorante et al., 2011; Gołębiewska et al., 2011; Papasotiriou et al., 2011; Barbouch et al., 2012; Vidal et al., 2012; Lee et al., 2013; Lim et al., 2013; Silva et al., 2013; Wu et al., 2013; Ariza-Heredia et al., 2014; Adamska et al., 2015; Gozdowska et al., 2016; Singh et al., 2016b; Al Midani et al., 2018; Mukherjee et al., 2018; Olenski et al., 2019; Tekkarışmaz et al., 2020; Shimizu et al., 2021.
Figure 2
Figure 2
Risk factors related to K. pneumoniae for renal transplant recipients. BSI, blood stream infection; Vfs, virulence factors; ARG, antibiotic resistance gene/s; ESBL, Extended-spectrum β-lactamases; NDM-1, New Delhi metallo-β-lactamase 1; KPC, carbapenemases.
See this image and copyright information in PMC

References

    1. Abbott K. C., Swanson S. J., Richter E. R., Bohen E. M., Agodoa L. Y., Peters T. G., et al. (2004). Late Urinary Tract Infection After Renal Transplantation in the United States. Am. J. Kidney Dis. 44 (2), 353–362. doi: 10.1053/j.ajkd.2004.04.040 - DOI - PubMed
    1. Adamska Z., Karczewski M., Cichańska L., Więckowska B., Małkiewicz T., Mahadea D., et al. (2015). Bacterial Infections in Renal Transplant Recipients. Transplant. Proc. 47 (6), 1808–1812. doi: 10.1016/j.transproceed.2015.03.046 - DOI - PubMed
    1. Adams M. H., Park B. H. (1956). An Enzyme Produced by a Phage-Host Cell System. II. The Properties of the Polysaccharide Depolymerase. Virol 2, 719–773. doi: 10.1016/0042-6822(56)90054-X - DOI
    1. Alangaden G. J., Thyagarajan R., Gruber S. A., Morawski K., Garnick J., El-Amm J. M., et al. (2006). Infectious Complications After Kidney Transplantation: Current Epidemiology and Associated Risk Factors. Clin. Transpl. 20 (4), 401–409. doi: 10.1111/j.1399-0012.2006.0 - DOI
    1. Al Midani A., Elands S., Collier S., Harber M., Shendi A. M. (2018). Impact of Urinary Tract Infections in Kidney Transplant Recipients: A 4-Year Single-Center Experience. Transplant. Proc. 50 (10), 3351–3355. doi: 10.1016/j.transproceed.2018.08.022 - DOI - PubMed

MeSH terms