Community-and hospital-acquired Klebsiella Pneumoniae urinary tract infections in Portugal: Virulence and antibiotic resistance

Cátia Caneiras, Luis Lito, José Melo-Cristino, Aida Duarte

Research output: Contribution to journalArticlepeer-review

91 Citations (Scopus)

Abstract

Klebsiella pneumoniae is a clinically relevant pathogen and a frequent cause of hospital-acquired (HA) and community-acquired (CA) urinary tract infections (UTI). The increased resistance of this pathogen is leading to limited therapeutic options. To investigate the epidemiology, virulence, and antibiotic resistance profile of K. pneumoniae in urinary tract infections, we conducted a multicenter retrospective study for a total of 81 isolates (50 CA-UTI and 31 HA-UTI) in Portugal. The detection and characterization of resistance and virulence determinants were performed by molecular methods (PCR, PCR-based replicon typing, and multilocus sequence typing (MLST)). Out of 50 CA-UTI isolates, six (12.0%) carried β-lactamase enzymes, namely blaTEM-156 (n = 2), blaTEM-24 (n = 1), blaSHV-11 (n = 1), blaSHV-33 (n = 1), and blaCTX-M-15 (n = 1). All HA-UTI were extended-spectrum β-lactamase (ESBL) producers and had a multidrug resistant profile as compared to the CA-UTI isolates, which were mainly resistant to ciprofloxacin, levofloxacin, tigecycline, and fosfomycin. In conclusion, in contrast to community-acquired isolates, there is an overlap between virulence and multidrug resistance for hospital-acquired UTI K. pneumoniae pathogens. The study is the first to report different virulence characteristics for hospital and community K. pneumoniae pathogens, despite the production of β-lactamase and even with the presence of CTX-M-15 ESBL, a successful international ST15 clone, which were identified in both settings. This highlights that a focus on genomic surveillance should remain a priority in the hospital environment.

Original languageEnglish
Article number138
JournalMicroorganisms
Volume7
Issue number5
DOIs
Publication statusPublished - May 2019
Externally publishedYes

Keywords

  • Klebsiella pneumoniae
  • Multidrug resistance
  • Urinary tract infections
  • Virulence genes

Fingerprint

Dive into the research topics of 'Community-and hospital-acquired Klebsiella Pneumoniae urinary tract infections in Portugal: Virulence and antibiotic resistance'. Together they form a unique fingerprint.

Cite this