Invasive Klebsiella pneumoniae syndrome: Five-year experience in a hospital in Medellín, Colombia.

Abstract

Backgriound: Klebsiella pneumoniae invasive syndrome (KpIS) is increasingly recognized as a global clinical concern. It is community-acquired, predominantly affects patients with diabetes mellitus, and is characterized by hepatic abscesses and various metastatic complications. Its diagnosis requires clinical and microbiological confirmation. Aim: To describe the clinical, demographic, and microbiological characteristics of patients with KpIS treated at a high-complexity hospital in Medellín, Colombia. Patients and Methods: Retrospective, observational, and descriptive study of patients over 18 years of age admitted to the Alma Mater Hospital of Antioquia between 2019 and 2024, with clinical manifestations suggestive of KpIS, classified as “probable” or “confirmed” based on a predefined clinical definition. Results: 47 cases were identified; 42.6% confirmed and 57.4% probable. 89.4% were men, and 55.3% had diabetes mellitus. Liver involvement was observed in 89.4%. The lungs, kidneys, and eyes were the most common sites of metastatic spread. The overall mortality rate was 4.2%. Conclusions: KpIS is rare. Most isolates were sensitive to first-line antimicrobials, and treatment required drainage in conjunction with targeted antibiotic therapy. Suspected cases require evaluation for metastatic spread. There is an urgent need to develop validated, cost-effective, and accessible diagnostic algorithms that incorporate clinical and laboratory findings in resource-limited settings.