{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T01:30:25Z","timestamp":1780536625757,"version":"3.54.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T00:00:00Z","timestamp":1707868800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T00:00:00Z","timestamp":1707868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Antimicrob Resist Infect Control"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Antimicrobial resistance research in uncomplicated urinary tract infection typically focuses on the main causative pathogen, <jats:italic>Escherichia coli<\/jats:italic>; however, little is known about the antimicrobial resistance burden of <jats:italic>Klebsiella<\/jats:italic> species, which can also cause uncomplicated urinary tract infections. This retrospective cohort study assessed the prevalence and geographic distribution of antimicrobial resistance among <jats:italic>Klebsiella<\/jats:italic> species and antimicrobial resistance trends for <jats:italic>K. pneumoniae<\/jats:italic> in the United States (2011\u20132019).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p><jats:italic>K. pneumoniae<\/jats:italic> and <jats:italic>K. oxytoca<\/jats:italic> urine isolates (30-day, non-duplicate) among female outpatients (aged\u2009\u2265\u200912\u00a0years) with presumed uUTI at 304 centers in the United States were classified by resistance phenotype(s): not\u00a0susceptible to nitrofurantoin, trimethoprim\/sulfamethoxazole, or fluoroquinolone, extended-spectrum \u03b2-lactamase-positive\/not\u00a0susceptible; and multidrug-resistant based on\u2009\u2265\u20092 and\u2009\u2265\u20093 resistance phenotypes. Antimicrobial resistance prevalence by census division and age, as well as antimicrobial resistance trends over time for <jats:italic>Klebsiella<\/jats:italic> species, were assessed using generalized estimating equations.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>270,552 <jats:italic>Klebsiella<\/jats:italic> species isolates were evaluated (250,719 <jats:italic>K. pneumoniae<\/jats:italic>; 19,833 <jats:italic>K. oxytoca<\/jats:italic>). The most frequent resistance phenotypes in 2019 were nitrofurantoin not\u00a0susceptible (<jats:italic>Klebsiella<\/jats:italic> species: 54.0%; <jats:italic>K. pneumoniae<\/jats:italic>: 57.3%; <jats:italic>K. oxytoca<\/jats:italic>: 15.1%) and trimethoprim\/sulfamethoxazole not\u00a0susceptible (<jats:italic>Klebsiella<\/jats:italic> species: 10.4%; <jats:italic>K.\u00a0pneumoniae<\/jats:italic>: 10.6%; <jats:italic>K. oxytoca<\/jats:italic>: 8.6%). Extended-spectrum \u03b2-lactamase-positive\/not\u00a0susceptible prevalence was 5.4%, 5.3%, and 6.8%, respectively. <jats:italic>K. pneumoniae<\/jats:italic> resistance phenotype prevalence varied (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) geographically and by age, and increased over time (except for the nitrofurantoin not susceptible phenotype, which was stable and\u2009&gt;\u200950% throughout).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>There is a high antimicrobial resistance prevalence and increasing antimicrobial resistance trends among <jats:italic>K.\u00a0pneumoniae<\/jats:italic> isolates from female outpatients in the United States with presumed uncomplicated urinary tract infection. Awareness of <jats:italic>K. pneumoniae<\/jats:italic> antimicrobial resistance helps to optimize empiric uncomplicated urinary tract infection treatment.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13756-024-01372-x","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T12:02:22Z","timestamp":1707912142000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Prevalence, regional distribution, and trends of antimicrobial resistance among female outpatients with urine Klebsiella spp. isolates: a multicenter evaluation in the United States between 2011 and 2019"],"prefix":"10.1186","volume":"13","author":[{"given":"Keith S.","family":"Kaye","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aruni","family":"Mulgirigama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish V.","family":"Joshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole E.","family":"Scangarella-Oman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalvin","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanny S.","family":"Mitrani-Gold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,14]]},"reference":[{"key":"1372_CR1","unstructured":"CDC. 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The study was conducted in compliance with Health Insurance Portability and Accountability Act requirements.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participation"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"KSK declares the following: consulting fees from AbbVie, Allecra, Carb-X, Merck, Shionogi, Spero, and Venatorx; and symposia honoraria from GSK. VG was an employee of, and shareholder in, Becton, Dickinson and Company\u00a0at the time of the analysis, and the company received funding from GSK to conduct this study. AM is an employee of, and shareholder in, GSK. AVJ is an employee of, and shareholder in, GSK. GY was an employee of Becton, Dickinson and Company, and the company received funding from GSK to conduct this study. NESO is an employee of, and shareholder in, GSK. KY is an employee of, and shareholder in, Becton, Dickinson and Company, and the company received funding from GSK to conduct this study. FSMG is an employee of, and shareholder in, GSK. Some of the material discussed in this manuscript was previously presented at Infectious Diseases Week (IDWeek) 2022; Kaye, et al., presentation 2227, \u201cPrevalence, Regional Distribution, and Trends of Antimicrobial Resistance Among Female Outpatients With Urine <i>Klebsiella pneumoniae<\/i> Isolates: A Multicenter Evaluation\u201d.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"21"}}