title: Reinfection and relapse of recurrent bacteremia caused by Klebsiella pneumoniae in a medical center in Taiwan.
abstract: To delineate the genetic relatedness of Klebsiella pneumoniae causing recurrent bacteremia.
  
  
  
  Clinical characteristics of patients, distribution of capsular genoserotypes by capsular cps-PCR genotyping and the genetic relatedness of the paired isolates using arbitrarily primed PCR and pulsed-field gel electrophoresis were investigated.
  
  
  
  Of 3067 patients with K. pneumoniae bacteremia, 129 (4.2%) had recurrent bacteremia (301 episodes). Of 129 patients with recurrent bacteremia, 51 (39.5%) were reinfected by the same strains (paired isolates with identical randomly amplified polymorphic DNA patterns and closely related pulsotypes). Multivariate analysis demonstrated that diabetes mellitus (odds ratio: 5.82; p < 0.001) and infection due to serotype K2 (odds ratio: 13.93; p < 0.001) were associated with relapse in patients with recurrent bacteremia.
  
  
  
  Recurrent K. pneumoniae bacteremia could occur in patients with underlying hematological malignancies or suffering from primary bacteremia. Relapse infection is associated with serotype K2 strains and underlying diabetes mellitus.
authors.affiliation: Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.|Department of Laboratory Medicine, National Taiwan University College of Medicine, National Taiwan University Hospital, Taipei City, Taiwan.|Department of Clinical Laboratory Science & Medical Biotechnology College of Medicine, National Taiwan University, Taipei City, Taiwan.
authors.forename: Yu-Tsung
authors.initials: YT
authors.lastname: Huang
authors.affiliation: Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.|College of medicine, Yang-Ming University, Taipei City, Taiwan.
authors.forename: Chun-Hsing
authors.initials: CH
authors.lastname: Liao
authors.affiliation: Department of Clinical Laboratory Science & Medical Biotechnology College of Medicine, National Taiwan University, Taipei City, Taiwan.
authors.forename: Lee-Jene
authors.initials: LJ
authors.lastname: Teng
authors.affiliation: Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Hsin-Sui
authors.initials: HS
authors.lastname: Hsu
authors.affiliation: Department of Laboratory Medicine, National Taiwan University College of Medicine, National Taiwan University Hospital, Taipei City, Taiwan.|Department of Internal Medicine, National Taiwan University College of Medicine, National Taiwan University Hospital, Taipei City, Taiwan.
authors.forename: Po-Ren
authors.initials: PR
authors.lastname: Hsueh
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000368:Aged; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D005838:Genotype; D006801:Humans; D007710:Klebsiella Infections / Q000453:epidemiology / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013624:Taiwan
keywords: Klebsiella pneumoniae; genetic relatedness; recurrent bacteremia; reinfection; relapse; serotypes