From the Guidelines
Klebsiella bacteria can enter your urinary tract through several routes, including migration from the digestive tract to the urethra, hospital-acquired infections, especially with catheter use, and poor hygiene practices. To acquire Klebsiella in your urine, several factors can contribute, as outlined in the European Association of Urology guidelines on urological infections 1. These factors include:
- Obstruction at any site in the urinary tract
- Recent history of instrumentation
- Health care–associated infections
- Presence of foreign bodies
- Incomplete voiding
- Vesicoureteral reflux
- Diabetes mellitus
- Immunosuppression
- Pregnancy Poor hygiene practices, such as improper wiping after bowel movements, can also transfer bacteria to the urinary opening, and sexual activity can push bacteria toward the urethra. Maintaining good hygiene, wiping from front to back after using the toilet, urinating after sexual activity, staying hydrated, and avoiding unnecessary catheterization are crucial in preventing Klebsiella in urine. If symptoms like painful urination, frequent urination, or cloudy urine develop, seeking medical attention promptly is essential, as antibiotics are typically needed to treat Klebsiella urinary tract infections 1.
From the Research
Acquisition of Klebsiella in Urine
Klebsiella is a type of bacteria that can cause urinary tract infections (UTIs). The acquisition of Klebsiella in urine can occur through various means, including:
- Urethral catheterization, which is a common risk factor for UTIs, especially in hospital settings 2
- Use of invasive devices, such as urinary catheters, which can introduce bacteria into the urinary tract 3
- Recent hospitalization, which can increase the risk of acquiring antibiotic-resistant bacteria, including Klebsiella 4
- Antibiotic therapy, which can disrupt the normal balance of bacteria in the urinary tract and increase the risk of infection 4
- Transfer from other hospitals, which can also increase the risk of acquiring antibiotic-resistant bacteria 4
Risk Factors
Certain risk factors can increase the likelihood of acquiring Klebsiella in urine, including:
- Complicated urinary tract infection (cUTI), which is an independent risk factor for extended-spectrum β-lactamase (ESBL) positive Klebsiella UTIs 3
- Congestive heart failure, which is an independent risk factor for in-hospital mortality in patients with Klebsiella UTIs 3
- Chronic comorbidities, which are common in patients with Klebsiella UTIs 3
- Use of carbapenems, which can increase the risk of acquiring carbapenem-resistant Klebsiella pneumoniae (CRKP) 4
Prevention and Treatment
Prevention and treatment of Klebsiella UTIs are crucial to reduce the risk of complications and mortality. Treatment options include:
- Antibiotic therapy, which should be guided by antibiotic sensitivity tests to ensure effective treatment 2
- Use of new antibiotic drugs, such as cefiderocol, meropenem-vaborbactam, ceftazidim-avibactam, and imipenem-relebactam, which can be effective against CRKP 5
- Infection control measures, such as proper use of invasive devices and hand hygiene, to prevent the spread of antibiotic-resistant bacteria 3