Abstract
To delineate the genetic relatedness of Klebsiella pneumoniae causing recurrent bacteremia. Clinical characteristics of patients, distribution of capsular genoserotypes by capsular cps-PCR genotyping and the genetic relatedness of the paired isolates using arbitrarily primed PCR and pulsed-field gel electrophoresis were investigated. Of 3067 patients with K. pneumoniae bacteremia, 129 (4.2%) had recurrent bacteremia (301 episodes). Of 129 patients with recurrent bacteremia, 51 (39.5%) were reinfected by the same strains (paired isolates with identical randomly amplified polymorphic DNA patterns and closely related pulsotypes). Multivariate analysis demonstrated that diabetes mellitus (odds ratio: 5.82; p < 0.001) and infection due to serotype K2 (odds ratio: 13.93; p < 0.001) were associated with relapse in patients with recurrent bacteremia. Recurrent K. pneumoniae bacteremia could occur in patients with underlying hematological malignancies or suffering from primary bacteremia. Relapse infection is associated with serotype K2 strains and underlying diabetes mellitus.
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