J Hosp Infect. 2026 Apr 2:S0195-6701(26)00120-9. doi: 10.1016/j.jhin.2026.03.030. Online ahead of print.
ABSTRACT
BACKGROUND: Klebsiella spp. are a major cause of antimicrobial-resistant hospital-acquired infections. We aimed to identify possible risk factors for Klebsiella infection during 180 days after transplantation.
METHODS: A multicenter, retrospective, case-control study was conducted in three hospitals (Greece, Italy) between 2016-2021 including patients >50-years old, who had undergone solid organ transplantation.
RESULTS: We included 202 transplant patients (115 liver, 79 kidney, 7 heart and 4 pancreas), of whom 120 (59.4%) suffered from ≥1 infection due to Klebsiella (141 infections). The most common infection site was urinary tract (48/141, 34%), and the most frequent species was Klebsiella pneumoniae (132/141, 93.6%). Among all Klebsiella isolates, 40.3% were carbapenem-resistant. Cardiovascular disease history (OR=2.06; 95% CI: 1.14-3.8; p=0.019) and post-transplant ICU hospitalization for ≥3 days (OR=2.08; 95% CI: 1.18-3.72; p=0.012) were independently associated with Klebsiella infection among all organ recipients. In liver transplants, post-transplant ICU hospitalization for ≥3 days (OR=2.87; 95% CI: 1.25-6.78; p=0.014), and in kidney transplants, cardiovascular disease history was associated with Klebsiella spp. infection (OR=2.84; 95% CI: 1.12-7.48; p=0.03).
CONCLUSION: Post-transplant ICU stay for ≥3 days and history of cardiovascular disease are associated with increased risk of Klebsiella infections in >50-years old solid organ transplant recipients.
PMID:41935744 | DOI:10.1016/j.jhin.2026.03.030