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

<b>Introduction:</b> The emergence of carbapenem-resistant pathogenic bacteria is a growing global public health concern. Carbapenem-resistant uropathogenic strains of <i>Klebsiella pneumoniae</i> 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 <i>Klebsiella pneumoniae</i> (<i>CRKpn</i>) and to create a tool to estimate the probability of a <i>CRKpn</i> infection before having the complete results of a patient's antibiogram. <b>Results:</b> We found that 41.6% of all urinary infections with <i>Kpn</i> were caused by <i>CRKpn</i>. 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 <i>Kpn</i> were predictive for <i>CRKpn</i> infection. Based on these factors, we proposed a model to estimate the presence of <i>CRKpn</i>. <b>Methods:</b> A retrospective case-control study including all hospitalized patients with urinary tract infections (UTIs) caused by <i>Klebsiella pneumoniae</i> was carried out. We reported data as percentages, identified independent predictors of the presence of <i>CRKpn</i>, and proposed a tool to evaluate the probability through multivariate analysis. <b>Conclusions:</b> Through this study, we aim to provide clinicians with a tool to support decision making regarding first-line antibiotic treatment.