TOPLINE:

Among solid organ transplant recipients older than 50 years, over half had at least one infection episode of Klebsiella spp. within 180 days after transplantation. A history of cardiovascular disease (CVD) and posttransplant ICU stay for 3 or more days were each significantly associated with a more than twofold increased risk.

METHODOLOGY:

• Researchers conducted a retrospective case-control study to identify the potential risk factors associated with Klebsiella spp. infection within 180 days after solid organ transplantation.
• They included 202 patients older than 50 years (70.3% men) who underwent transplantation; of these, 115 had liver transplant, 79 kidney, 7 heart, 4 pancreas, and 3 had double organ transplant.
• Cases were recipients with at least one positive clinical culture for Klebsiella spp. after the transplant; control recipients had no positive Klebsiella spp. cultures after the transplant during the same period.
• Factors captured included demographics, comorbidities, ICU hospitalization immediately after transplantation for 3 or more days, and pretransplant rectal colonization with carbapenem-resistant Klebsiella.

TAKEAWAY:

• Overall, 59.6% of recipients had at least one Klebsiella infection episode, with a total of 141 infection episodes; the median time of infection onset was 34 days.
• After adjustment for covariates, a history of CVD was significantly associated with a more than twofold increased risk for Klebsiella infection (odds ratio [OR], 2.32); among kidney transplant recipients, it predicted a similar increase in the risk (OR, 2.84; P < .05 for both).
• Posttransplant ICU hospitalization for ≥ 3 days was also significantly associated with a more than twofold increased risk for Klebsiella infection (OR, 2.36) among liver transplant recipients, the risk was higher (OR, 3.32; P < .05 for both).
• The most common infection site was the urinary tract (34% of the infection episodes), and Klebsiella pneumoniae (93.6%) was the predominant species. Among all Klebsiella isolates, 40.3% were resistant to carbapenems.

IN PRACTICE:

“This suggests the need of strict posttransplantation infection surveillance, the intensification of infection prevention strategies, and the possibility of preemptive therapy in patients with known history of cardiovascular disease and in those who have long hospitalization in the ICU,” the authors wrote.

SOURCE:

The study was led by Argyro Ftergioti, Aristotle University School of Medicine, Hippokration General Hospital, Thessaloniki, Greece. It was published online on April 1, 2026, in The Journal of Hospital Infection.

LIMITATIONS:

The study had a relatively small sample size. Most transplantation cases were those of the liver and kidney, potentially limiting generalizability to other organs. In addition, information on the pretransplant colonization status for Klebsiella was unavailable for some recipients.

DISCLOSURES:

The study was funded by the University Medical Center Utrecht and LimmaTech Biologics AG. Some authors reported receiving fees paid to their institutions, unconditional grants, speaker honoraria, or honoraria for participating as part of scientific boards or being employed or holding equity in multiple pharmaceutical companies, including LimmaTech Biologics AG.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.