Can a Man with Klebsiella UTI Infect His Female Partner?
Yes, a man with a Klebsiella urinary tract infection can potentially transmit the bacteria to his female sexual partner, though this is not classified as a traditional sexually transmitted infection. Sexual transmission of uropathogenic bacteria, including Klebsiella species, between heterosexual partners has been documented in the medical literature.
Evidence for Sexual Transmission of Uropathogenic Bacteria
Documented Transmission Patterns
Uropathogenic bacteria are significantly more likely to be shared between sexual partners than commensal (normal) bacteria. Research demonstrates that E. coli strains causing UTIs are nine times more likely to be shared between heterosexual partners compared to non-pathogenic strains 1.
Direct evidence of sexual transmission exists: In one study, all eight urinary isolates from men whose partners had UTIs were genetically identical to the bacteria found in their female partner's urine or vagina 1.
Specific Klebsiella transmission has been documented: While most research focuses on E. coli, Klebsiella pneumoniae is an established uropathogenic organism that colonizes the urinary tract and can be transmitted through similar mechanisms 2.
Risk Factors That Increase Transmission
Sexual intercourse is a predominant risk factor for UTIs in women, with uropathogenic bacteria being transferred during sexual activity 3.
Certain sexual behaviors increase bacterial sharing: Oral sex doubles the likelihood of sharing uropathogenic bacteria between partners (odds ratio 1.87-2.09) 1.
Bacterial virulence factors enhance transmission: Organisms with specific virulence characteristics (such as P pili in E. coli) are twice as likely to be shared between partners 1. Klebsiella species possess multiple virulence factors including adherence factors and capsule production that facilitate colonization 2.
Clinical Implications and Management
Partner Evaluation and Treatment
Female partners should be evaluated even if asymptomatic. Women can harbor uropathogenic bacteria asymptomatically and may develop infection later or serve as a reservoir for reinfection 4.
Consider empiric treatment of the female partner if the male has documented Klebsiella UTI and they have had sexual contact within 60 days, particularly if she has any urinary symptoms or risk factors for UTI 5, 6.
Prevention of Transmission and Reinfection
Abstain from sexual intercourse until the infection is treated and symptoms resolve to prevent transmission and reinfection 5, 6.
Both partners should complete full antibiotic courses if treatment is initiated, as incomplete treatment can lead to persistent colonization 6.
Important Caveats
Klebsiella UTIs in men often indicate underlying urological abnormalities such as obstructing lesions, stones, or anatomical issues that require evaluation 2. The infection may not be purely sexually acquired.
Antibiotic resistance is a major concern with Klebsiella species. Most clinical isolates exhibit multidrug resistance, making treatment selection critical 2. Culture and sensitivity testing should guide therapy.
Distinguish between colonization and active infection. Not all bacterial sharing results in symptomatic infection; host factors play a crucial role 2.
Practical Approach
When a man presents with Klebsiella UTI:
- Obtain culture and sensitivity testing to guide antibiotic selection given high resistance rates 2
- Evaluate for underlying urological abnormalities that may have predisposed to infection 2
- Advise sexual abstinence until treatment completion and symptom resolution 5, 6
- Recommend evaluation of the female partner, particularly if she has any urinary symptoms 4
- Consider empiric partner treatment if she has symptoms or risk factors for UTI 5
- Ensure both partners complete full antibiotic courses if treated 6