A Cross-Sectional Study of Risk Factors for Gastrointestinal Carriage of Klebsiella Pneumoniae and Bacterial Genomic Diversity

We looked into the prevalence of Kp carriage and related risk factors in Pakistan's adult population as a whole. Furthermore, in our study, we clarified the carriage isolates' Kp genomic population structure. This research is a population-based study conducted in the Pakistani municipality using recurrent cross-sectional health inspections. Two clinical visits were part of the study survey, which ran from March 2023 to March 2024. We invited all citizens over 40 years old using their distinctive national identity cards from the official population registration. The study involved 934 participants aged 40-84, randomly selected for therapeutic visits. After a second visit, 584 participants were offered a fecal self-sampling kit to collect excrement. The first 300 stool specimens were checked for Kp detection. Data was analyzed using the Anatomical Therapeutic Chemical classification system. Sequencing libraries were created and a core genome alignment performed. Kp carriage prevalence was highest among those who had used antibiotics in the previous month and two months, declining in the previous six to twelve months. The population that did not use antibiotics had a significantly reduced prevalence of Kp carriage. Kp gastrointestinal carriage was linked to ulcerative colitis and age 60 years and older. The research concluded that non-antibiotic medications and inflammatory bowel conditions increase the frequency of Kp gastrointestinal carriage, suggesting risk stratification in healthcare infections prevention and opportunities for gut microbiome modulation. The diversified Kp population structure challenges vaccine prospects and identifies potential cross-niche transmission.