Scholarlink

<p><i>Klebsiella pneumoniae</i> is a major causative agent of urinary tract infections (UTIs), exhibiting high adaptability and an increasing resistance to antibiotics. This narrative review summarizes current knowledge regarding the pathogenesis of <i>K. pneumoniae</i> in UTIs, highlighting key virulence factors, such as capsular polysaccharide production, siderophore-mediated iron acquisition, biofilm formation, and immune evasion strategies. Conventional urine culture remains the diagnostic standard; however, it is limited by detection thresholds, turnaround time, and difficulty in identifying polymicrobial or low-abundance infections. Although implementation remains resource-dependent, rapid molecular and proteomic techniques such as whole-genome sequencing, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and polymerase chain reaction have improved pathogen identification and resistance profiling. Treatment options are becoming increasingly limited as <i>K. pneumoniae</i> strains develop resistance to β-lactam antibiotics, carbapenems, and aminoglycosides. The emergence of extended-spectrum β-lactamase-producing and carbapenem-resistant <i>K. pneumoniae</i> underscores the urgent need for novel therapeutic strategies, including bacteriophage therapy, probiotics, and other emerging approaches, which are currently under investigation and require further clinical validation, and non-traditional antimicrobial agents such as NSAIDs with reported antibiofilm activity (e.g., ibuprofen and diclofenac, which have demonstrated inhibition of biofilm formation in vitro). Preventive measures, particularly in healthcare settings, focus on strict infection control protocols, antimicrobial stewardship programs, and the exploration of vaccine candidates. Despite the absence of an approved <i>K. pneumoniae</i> vaccine, ongoing research into live-attenuated and subunit vaccines offers potential future prospects. The role of global collaboration in combating MDR <i>K. pneumoniae</i> is critical, as international surveillance efforts and policy-driven antimicrobial stewardship programs help mitigate the spread of resistant strains. Future research must prioritize understanding <i>K. pneumoniae</i>’s interaction with the urinary microbiome, as well as advancing genomic editing approaches, such as CRISPR–Cas systems, which have shown potential for targeted disruption of resistance genes in gram-negative bacteria. A multidisciplinary approach is required. This should integrate advanced diagnostics, optimized antimicrobial stewardship, innovative therapeutic strategies, and global surveillance efforts to address the growing threat of <i>K. pneumoniae</i>-associated UTIs and antimicrobial resistance.</p> Graphical abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Klebsiella pneumoniae and urinary tract infections: pathogenesis, resistance, and advances in management

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月20日

查看全文
  • Tasmia Jahin Mim,
  • Iftakhar Ahmad,
  • Victoria Lee Hrach,
  • Kingsley Kwaku Amoateng,
  • Md. Piar Rahaman Shihab,
  • Hafsa Abdulhamid Abdulsalam,
  • Dinesh Kumar,
  • Neeraj Choudhary,
  • Suresh Babu Kondaveeti

摘要

Klebsiella pneumoniae is a major causative agent of urinary tract infections (UTIs), exhibiting high adaptability and an increasing resistance to antibiotics. This narrative review summarizes current knowledge regarding the pathogenesis of K. pneumoniae in UTIs, highlighting key virulence factors, such as capsular polysaccharide production, siderophore-mediated iron acquisition, biofilm formation, and immune evasion strategies. Conventional urine culture remains the diagnostic standard; however, it is limited by detection thresholds, turnaround time, and difficulty in identifying polymicrobial or low-abundance infections. Although implementation remains resource-dependent, rapid molecular and proteomic techniques such as whole-genome sequencing, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and polymerase chain reaction have improved pathogen identification and resistance profiling. Treatment options are becoming increasingly limited as K. pneumoniae strains develop resistance to β-lactam antibiotics, carbapenems, and aminoglycosides. The emergence of extended-spectrum β-lactamase-producing and carbapenem-resistant K. pneumoniae underscores the urgent need for novel therapeutic strategies, including bacteriophage therapy, probiotics, and other emerging approaches, which are currently under investigation and require further clinical validation, and non-traditional antimicrobial agents such as NSAIDs with reported antibiofilm activity (e.g., ibuprofen and diclofenac, which have demonstrated inhibition of biofilm formation in vitro). Preventive measures, particularly in healthcare settings, focus on strict infection control protocols, antimicrobial stewardship programs, and the exploration of vaccine candidates. Despite the absence of an approved K. pneumoniae vaccine, ongoing research into live-attenuated and subunit vaccines offers potential future prospects. The role of global collaboration in combating MDR K. pneumoniae is critical, as international surveillance efforts and policy-driven antimicrobial stewardship programs help mitigate the spread of resistant strains. Future research must prioritize understanding K. pneumoniae’s interaction with the urinary microbiome, as well as advancing genomic editing approaches, such as CRISPR–Cas systems, which have shown potential for targeted disruption of resistance genes in gram-negative bacteria. A multidisciplinary approach is required. This should integrate advanced diagnostics, optimized antimicrobial stewardship, innovative therapeutic strategies, and global surveillance efforts to address the growing threat of K. pneumoniae-associated UTIs and antimicrobial resistance.

Graphical abstract