Evidence map›Paper›PMID 41023356›Full record

ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2025

Molecular epidemiology of Klebsiella pneumoniae causing bloodstream infections in a district hospital in Northern Portugal (2016-2018): clonal diversity and detection of hypervirulent strains.

Michele Loiodice, Tatiana Ribeiro, Luís Marques Silva, Ana Paula Castro, Luísa Peixe, Ângela Novais

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In one paragraph

Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Risk factors for invasiveFrontiers in cellular and infection microbiology · 2026
    Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Michele LoiodiceUCIBIO, i4HB, Faculdade de Farmácia da Universidade do Porto, Rua Jorge Viterbo Ferreira 228, Porto, 4050-313, Portugal.
Tatiana RibeiroUCIBIO, i4HB, Faculdade de Farmácia da Universidade do Porto, Rua Jorge Viterbo Ferreira 228, Porto, 4050-313, Portugal.
Luís Marques SilvaServiço de Microbiologia. Centro Hospitalar Universitário de Santo António, Largo Prof. Abel Salazar 10, Porto, 4099-001, Portugal.
Ana Paula CastroServiço de Microbiologia. Centro Hospitalar Universitário de Santo António, Largo Prof. Abel Salazar 10, Porto, 4099-001, Portugal.
Luísa PeixeUCIBIO, i4HB, Faculdade de Farmácia da Universidade do Porto, Rua Jorge Viterbo Ferreira 228, Porto, 4050-313, Portugal.
Ângela NovaisUCIBIO, i4HB, Faculdade de Farmácia da Universidade do Porto, Rua Jorge Viterbo Ferreira 228, Porto, 4050-313, Portugal. aamorim@ff.up.pt.

Funding

Associate Laboratory Institute for Health and Bioeconomy - i4HB LA/P/0140/2020Fundação para a Ciência e a Tecnologia UIDP/04378/2020, UIDB/04378/2020
6 · The paper itself

Abstract

purposeKlebsiella pneumoniae (Kp) is a major cause of bloodstream infections (BSI) globally. Yet, detailed characterization of invasive isolates, particularly from datasets not biased toward resistance, remains limited. This baseline study, conducted prior to the expansion of carbapenemase producers in Portugal, characterizes multidrug-resistant (MDR) and non-MDR Kp causing BSIs in a northern district hospital to elucidate resistance emergence and dissemination.

methodsA total of 174 Kp strains isolated from blood cultures of hospitalized patients (2016-2018) were identified by VITEK2 or MALDI-TOF MS. Antibiotic resistance phenotypes were determined by reference methods, β-lactamases screened by PCR/sequencing, and clonal sublineages identified by FT-IR spectroscopy, MLST and/or WGS, including for putative hypervirulent strains (hvKp).

resultsIsolates were categorized as MDR (49%) or non-MDR (51%), with MDR rates nearly double national reports. Most MDR-Kp (67%) produced CTX-M-15, 25% produced carbapenemases (mainly KPC-3 and/or OXA-48/CTX-M-15), and 8% lacked acquired β-lactamases. Half (53%) belonged to three high-risk sublineages (ST147-KL64, ST307-KL102, ST15-KL19), while non-MDR showed greater diversity, with ST14-KL2 most frequent (13%) and consistently resistant to amoxicillin-clavulanate. Several sublineages circulated across both cohorts (e.g., ST307-KL102, ST348-KL62), some with variable β-lactamase content (e.g., ST147-KL64, ST45-KL24). Two hvKp (1.1%) were identified (ST380-KL2, ST268-KL20).

conclusionThis baseline study reveals a high local burden of MDR-Kp driven by CTX-M-15 and KPC-3-producing high-risk sublineages, underscoring the importance of local surveillance beyond national reporting. High clonal diversity and variable β-lactamase content suggest heterogeneous acquisition and dissemination routes, with resistance often preceding clonal expansion. Though rare, hvKp detection underscores the need for continued surveillance and multicenter monitoring.

Indexed as

BacteremiaKlebsiella InfectionsKlebsiella pneumoniaeAdultAgedAged, 80 and overAnti-Bacterial AgentsBacterial Proteinsbeta-LactamasesDrug Resistance, Multiple, BacterialFemaleHumansMaleMicrobial Sensitivity TestsMiddle AgedMolecular EpidemiologyAnti-Bacterial AgentsBacterial Proteinsbeta-LactamasescarbapenemaseBloodstream infection (BSI)Hypervirulent Klebsiella pneumoniae (hvKp)Molecular epidemiologyMultidrug resistance (MDR)

Identifiers

PMID41023356

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.