Klebsiella pneumoniae

Other Names: Klebsiella

• Klebsiella [kleb−see−ell−uh] is a type of Gram-negative bacteria that can cause different types of healthcare-associated infections, including pneumonia, bloodstream infections, wound or surgical site infections, and meningitis.
• Increasingly, Klebsiella bacteria have developed antimicrobial resistance, most recently to the class of antibiotics known as carbapenems.

Risk factors

• Klebsiella bacteria are normally found in the human intestines (where they do not cause disease).
• They are also found in human stool (feces).
• In healthcare settings, Klebsiella infections commonly occur among sick patients who are receiving treatment for other conditions.
• Patients whose care requires devices like ventilators (breathing machines) or intravenous (vein) catheters, and patients who are taking long courses of certain antibiotics are most at risk for Klebsiella infections.
• Healthy people usually do not get Klebsiella infections.

Transmission

• To get a Klebsiella infection, a person must be exposed to the bacteria.
• For example, Klebsiella must enter the respiratory (breathing) tract to cause pneumoniae, or the blood to cause a bloodstream infection.
• In healthcare settings, Klebsiella bacteria can be spread through person-to-person contact (for example, from patient to patient via the contaminated hands of healthcare personnel, or other persons) or, less commonly, by contamination of the environment.
• The bacteria are not spread through the air.

Symptoms

Klebsiella can cause infection in different parts of the body including the lungs, urinary tract, or the bloodstream. The signs and symptoms of a Klebsiella infection will vary with the site of infection.

Diagnosis

• Klebsiella infections are usually diagnosed by examining a sample of the infected tissue such as sputum, urine, or blood.
• Depending on the site of infection, imaging tests such as ultrasounds, X-rays, and computerized tomography (CT) may also be useful. Susceptibility testing can help determine which antibiotics are likely to be effective.

Drug-resistant Klebsiella

• Some Klebsiella bacteria have become highly resistant to antibiotics.
• When bacteria such as Klebsiella pneumoniae produce an enzyme known as a carbapenemase (referred to as KPC-producing organisms), then the class of antibiotics called carbapenems will not work to kill the bacteria and treat the infection.
• Klebsiella species are examples of Enterobacteriaceae, a normal part of the human gut bacteria, that can become carbapenem-resistant.
• CRE, which stands for carbapenem-resistant enterobacteriaceae, are a family of germs that are difficult to treat because they have high levels of resistance to antibiotics.
• Unfortunately, carbapenem antibiotics often are the last line of defense against Gram-negative infections that are resistant to other antibiotics.

Treatment

• Klebsiella infections that are not drug-resistant can be treated with antibiotics.
• Infections caused by KPC-producing bacteria can be difficult to treat because fewer antibiotics are effective against them.
• In such cases, a microbiology laboratory must run tests to determine which antibiotics will treat the infection.

Prevention

• To prevent spreading Klebsiella infections between patients, healthcare personnel must follow specific infection control precautions.
• These precautions may include strict adherence to hand hygiene and wearing gowns and gloves when they enter rooms where patients with Klebsiella–related illnesses are housed.
• Healthcare facilities also must follow strict cleaning procedures to prevent the spread of Klebsiella.
• To prevent the spread of infections, patients also should clean their hands very often, including:
• Before preparing or eating food
• Before touching their eyes, nose, or mouth
• Before and after changing wound dressings or bandages
• After using the restroom
• After blowing their nose, coughing, or sneezing
• After touching hospital surfaces such as bed rails, bedside tables, doorknobs, remote controls, or the phone

External links

• CDC Klebsiella pneumoniae