Eur J Clin Microbiol Infect Dis (2014) 33:1533–1539 DOI 10.1007/s10096-014-2100-4
ARTICLE
Clinical and microbiological characteristics of Klebsiella pneumoniae from community-acquired recurrent urinary tract infections W. H. Lin & C. Y. Kao & D. C. Yang & C. C. Tseng & A. B. Wu & C. H. Teng & M. C. Wang & J. J. Wu
Received: 27 January 2014 / Accepted: 25 March 2014 / Published online: 23 April 2014 # Springer-Verlag Berlin Heidelberg 2014
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 W. H. Lin Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan W. H. Lin : D. C. Yang : C. C. Tseng : A. B. Wu : M. C. Wang Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan C. Y. Kao Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan C. H. Teng Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan M. C. Wang (*) Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan e-mail:
[email protected] J. J. Wu (*) 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 e-mail:
[email protected]
(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
