Recurrent Urinary Tract Infection Caused by Multidrug-Resistant Klebsiella pneumoniae: A Case Report.

Klebsiella pneumoniae is the second most common cause of urinary tract infection (UTI) in most populations; however, few cases of recurrent UTI (rUTI) have been described. In this report, we described a patient who experienced 18 episodes of community-acquired rUTI caused by extended-spectrum β-lactamase (ESBL)-producing and multidrug-resistant (MDR) K. pneumoniae over an 8-year period. All isolates were ESBL producers and MDR, with variable resistance profiles. Molecular analysis of 10 isolates also revealed variations in β-lactamase genes; however, all isolates shared the same capsular serotype (K17) and virulence gene profile. PFGE analysis identified three closely related pulsotypes, and all isolates belonged to ST101, supporting relapse events during recurrent infection. Particular attention should be paid to empirical treatment of UTI due to the high resistance rates observed in K. pneumoniae, even in community-acquired infections.