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This study characterized the clinical aspects of CA-BSI and CA-UTI caused by\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    and the molecular features of isolates, including their resistance profiles. Sixty-five isolates (CA-BSI,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200924; CA-UTI,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200941) underwent antimicrobial susceptibility testing, \u03b2-lactamase and virulence gene assessment, capsular genotyping, and molecular typing. Older age, male gender, and comorbidities, particularly kidney disease, were significantly associated with CA-BSI. The MDR and carbapenem resistance rates for\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    from CA infections were 24.6% and 4.6%, respectively. CA-BSI isolates were more antibiotic-resistant and had a higher proportion of ESBL-producing (37.5%\n                    <jats:italic>versus<\/jats:italic>\n                    9.8%) and MDR isolates (45.8%\n                    <jats:italic>versus<\/jats:italic>\n                    12.2%) than CA-UTI. The\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>CTX\u2212M\u2212like<\/jats:sub>\n                    or\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>KPC\u2212like<\/jats:sub>\n                    genes was found in all ESBL-producing isolates, while\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>KPC\u2212like<\/jats:sub>\n                    and\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>NDM\u2212like<\/jats:sub>\n                    were detected exclusively in CA-BSI strains. The isolates\u2019 virulence profiles were similar between the groups, although one CA-BSI and two CA-UTI isolates presented hypervirulence biomarkers. A high clonal diversity was observed, with a majority of MDR (81.3%) (ST11, ST15, ST101, ST258, ST307, and ST6852) and hypervirulent (2\/3) (ST23 and ST65) isolates being high-risk pandemic clones in humans. Our data highlight the high prevalence of MDR\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    in CA infections in Brazil, with CA-BSI showing significant differences in resistance profiles compared to CA-UTI.\n                  <\/jats:p>","DOI":"10.1038\/s41598-025-92549-w","type":"journal-article","created":{"date-parts":[[2025,3,20]],"date-time":"2025-03-20T17:10:16Z","timestamp":1742490616000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["High proportions of multidrug-resistant Klebsiella pneumoniae isolates in community-acquired infections, Brazil"],"prefix":"10.1038","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6675-4217","authenticated-orcid":false,"given":"Adriano de Souza Santos","family":"Monteiro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e1rcio de Oliveira","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6796-0610","authenticated-orcid":false,"given":"V\u00edvian Santos","family":"Galv\u00e3o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6180-5764","authenticated-orcid":false,"given":"Adriele Pinheiro","family":"Bomfim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena Galv\u00e3o","family":"de Ara\u00fajo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila Maria Pi\u00f1eiro","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7858-0768","authenticated-orcid":false,"given":"Maria Goreth","family":"Barberino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edilane Lins","family":"Gouveia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5320-892X","authenticated-orcid":false,"given":"Soraia Machado","family":"Cordeiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5273-2658","authenticated-orcid":false,"given":"Joice Neves","family":"Reis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,20]]},"reference":[{"key":"92549_CR1","doi-asserted-by":"publisher","first-page":"1157010","DOI":"10.3389\/fcimb.2023.1157010","volume":"13","author":"D Li","year":"2023","unstructured":"Li, D. et al. 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