Open Access

Insights into multidrug‑resistant K. pneumoniae urinary tract infections: From susceptibility to mortality

  • Authors:
    • Ionela-Larisa Miftode
    • Eduard Vasile Nastase
    • Radu-Ștefan Miftode
    • Egidia Gabriela Miftode
    • Luminița Smaranda Iancu
    • Cătălina Luncă
    • Dana-Teodora Anton Păduraru
    • Irina-Iuliana Costache
    • Celina-Silvia Stafie
    • Olivia-Simona Dorneanu
  • View Affiliations

  • Published online on: July 30, 2021     https://doi.org/10.3892/etm.2021.10520
  • Article Number: 1086
  • Copyright: © Miftode et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The incidence of urinary tract infections (UTIs) caused by Klebsiella pneumoniae has exhibited an increasing trend and has become a high burden for many public health systems, especially in hospital settings. Multidrug resistance associated with the production of extended‑spectrum β‑lactamases (ESBL) among K. pneumoniae isolates is endemic in Southeastern Europe. We retrospectively analyzed 75 cases admitted to ‘St. Parascheva’ Clinical Hospital of Infectious Diseases in Iasi, Romania, during the first 6 months of 2019 (January 1 to June 30), who had a confirmed diagnosis of K. pneumoniae UTI at discharge. From a total of 75 patients, 34 (45.3%) presented ESBL+ K. pneumoniae. The mean age was 66 years (70.1 for the ESBL+ patients vs. 62.6 for the ESBL patients, P=0.0365). There was a symmetrical sex distribution (37 men vs. 38 women). Of these, 22 men had ESBL+ K. pneumoniae UTIs, compared to only 15 with an ESBL strain, P=0.0087. Another risk factor for ESBL+ K. pneumoniae UTIs was the presence of hospitalization in the past 6 months; 20 (58.82%) patients with ESBL+ infections were previously hospitalized, compared to only 5 (12.19%) patients with ESBL strains, P<0.0001. The urinary catheter carriers presented an increased prevalence of ESBL+ infections (15/34 vs. 5/41, P=0.0012). Regarding mortality, ESBL+ infections caused 6 fatalities, compared to only 1 death in the ESBL group, P=0.0166. ESBL+ K. pneumoniae strains represent an important cause of healthcare‑related UTIs, with a significantly higher mortality rate compared to ESBL strains. Early identification and adequate management of the risk factors incriminated in ESBL+ UTIs should be a priority for physicians in order to limit the dissemination of the ESBL‑producing strains and thus to improve the outcome of these patients.
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October-2021
Volume 22 Issue 4

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Miftode I, Nastase EV, Miftode R, Miftode EG, Iancu LS, Luncă C, Păduraru DA, Costache I, Stafie C, Dorneanu O, Dorneanu O, et al: Insights into multidrug‑resistant <em>K. pneumoniae</em> urinary tract infections: From susceptibility to mortality. Exp Ther Med 22: 1086, 2021
APA
Miftode, I., Nastase, E.V., Miftode, R., Miftode, E.G., Iancu, L.S., Luncă, C. ... Dorneanu, O. (2021). Insights into multidrug‑resistant <em>K. pneumoniae</em> urinary tract infections: From susceptibility to mortality. Experimental and Therapeutic Medicine, 22, 1086. https://doi.org/10.3892/etm.2021.10520
MLA
Miftode, I., Nastase, E. V., Miftode, R., Miftode, E. G., Iancu, L. S., Luncă, C., Păduraru, D. A., Costache, I., Stafie, C., Dorneanu, O."Insights into multidrug‑resistant <em>K. pneumoniae</em> urinary tract infections: From susceptibility to mortality". Experimental and Therapeutic Medicine 22.4 (2021): 1086.
Chicago
Miftode, I., Nastase, E. V., Miftode, R., Miftode, E. G., Iancu, L. S., Luncă, C., Păduraru, D. A., Costache, I., Stafie, C., Dorneanu, O."Insights into multidrug‑resistant <em>K. pneumoniae</em> urinary tract infections: From susceptibility to mortality". Experimental and Therapeutic Medicine 22, no. 4 (2021): 1086. https://doi.org/10.3892/etm.2021.10520