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. 2024 Dec 3;13(12):1170.
doi: 10.3390/antibiotics13121170.

A Possible Tool for Guiding Therapeutic Approaches to Urinary Infections with Klebsiella pneumoniae: Analyzing a Dataset from a Romanian Tertiary Hospital

Dragos Stefan Lazar  1 , Maria Nica  1 , Daniel Romeo Codreanu  1 , Alma Gabriela Kosa  1 , Lucian L Visinescu  2 , Corneliu Petru Popescu  1 , Ion Cristian Efrem  3 , Simin Aysel Florescu  1 , George Sebastian Gherlan  1
Affiliations

A Possible Tool for Guiding Therapeutic Approaches to Urinary Infections with Klebsiella pneumoniae: Analyzing a Dataset from a Romanian Tertiary Hospital

Dragos Stefan Lazar et al. Antibiotics (Basel). .

Abstract

Introduction: The emergence of carbapenem-resistant pathogenic bacteria is a growing global public health concern. Carbapenem-resistant uropathogenic strains of Klebsiella pneumoniae can cause uncomplicated or complicated urinary tract infections, leading to a high risk of treatment failure and the spread of resistance determinants. The objectives of this 24-month study were to identify the prognostic characteristics of patients who were infected with carbapenem-resistant Klebsiella pneumoniae (CRKpn) and to create a tool to estimate the probability of a CRKpn infection before having the complete results of a patient's antibiogram. Results: We found that 41.6% of all urinary infections with Kpn were caused by CRKpn. Factors such as male gender, the presence of upper urinary tract infections, invasive urinary maneuvers, recent infection with or carriage of the germ, and the nosocomial occurrence of UTIs with Kpn were predictive for CRKpn infection. Based on these factors, we proposed a model to estimate the presence of CRKpn. Methods: A retrospective case-control study including all hospitalized patients with urinary tract infections (UTIs) caused by Klebsiella pneumoniae was carried out. We reported data as percentages, identified independent predictors of the presence of CRKpn, and proposed a tool to evaluate the probability through multivariate analysis. Conclusions: Through this study, we aim to provide clinicians with a tool to support decision making regarding first-line antibiotic treatment.

Keywords: antibiotic therapy; carbapenem-resistant Klebsiella pneumoniae; carbapenemases; risk estimation tool; urinary tract infection.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure A1
Figure A1
Online app for estimating the probability of having CRKpn according to our score.
Figure 1
Figure 1
Distribution of bacteria in rectal swabs from the study groups.
Figure 2
Figure 2
Antibiotic susceptibility of Kpn strains in the CSKpn group based on type of UTI (%).
Figure 3
Figure 3
Antibiotic susceptibility levels in the CRKpn group based on type of UTI (%).
Figure 4
Figure 4
(a) ROC curve evaluating the performance of our prediction model for Klebsiella pneumoniae UTIs; (b) overall model quality and lower limit of the 95% CI.
See this image and copyright information in PMC

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