Klebsiella pneumonia

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Klebsiella pneumoniae
Classification and external resources
Klebsiella pneumoniae 01.png
K. pneumoniae on a MacConkey agar plate.
ICD-10 B96.1, J15.0
ICD-9 041.3, 482.0
DiseasesDB 7181
eMedicine med/1237
MeSH D007710

Klebsiella pneumonia is a form of bacterial pneumonia associated with Klebsiella pneumoniae.

It is typically due to aspiration by alcoholics, though it is more commonly implicated in hospital-acquired urinary tract and wound infections, particularly in immunocompromised individuals and diabetics.

Presentation

Patients with Klebsiella pneumonia tend to cough up a characteristic sputum that is said to resemble "red-currant jelly".

Klebsiella pneumonia tends to affect people with underlying diseases, such as alcoholism, diabetes and chronic lung disease.

Treatment and resistance

Treatment for Klebsiella pneumonia is by antibiotics such as aminoglycosides and cephalosporins, the choice depending upon the patient’s health condition, medical history and severity of the disease.1

However, Klebsiella possesses a chromosomal class A beta-lactamase giving it resistance to ampicillin. Many strains have acquired an extended-spectrum beta-lactamase with additional resistance to carbenicillin, amoxicillin, and increasingly to ceftazidime. The bacteria remain largely susceptible to aminoglycosides and cephalosporins. Varying degrees of inhibition of the beta-lactamase with clavulanic acid have been reported. Infections due to multidrug-resistant Gram-negative pathogens in the ICU have invoked the re-emergence of colistin, an antibiotic that had rarely been used for decades. However, colistin-resistant strains of K. pneumoniae have been reported in Greek ICUs.2 In 2009, strains of K. pneumoniae with gene called New Delhi metallo-beta-lactamase (shortened NDM-1) that even gives resistance against intravenous antibiotic carbapenem, were discovered in India and Pakistan.

Klebsiella cases in Taiwan have shown abnormal toxicity, causing liver abscesses in patients with diabetes mellitus (DM). Treatment consists of third generation cephalosporins.3

Spread of resistant strains

Klebsiella resistant strains have been recorded in USA with a roughly threefold increase in Chicago cases,4 Brazil 5 with 15 deaths per 163 cases, quarantined individuals in Israel,6 United Kingdom and parts of Europe. Possible ground zero, or location of emergence, is the India-Pakistan border.7

A strain known as Carbapenem-Resistant Klebsiella pneumonia (CRKP) was estimated to be involved in 350 cases in Los Angeles County between June and December 2010.8

Eponym

Community-acquired pneumonia caused by Klebsiella pneumoniae may be called Friedländer's Pneumonia, after Carl Friedländer.

References

  1. ^ Buzzle --> Klebsiella Pneumoniae By Ningthoujam Sandhyarani. Published: 16 December 2008
  2. ^ Antoniadou A, Kontopidou F, Poulakou G, et al. (April 2007). "Colistin-resistant isolates of Klebsiella pneumoniae emerging in intensive care unit patients: first report of a multiclonal cluster". J. Antimicrob. Chemother. 59 (4): 786–90. doi:10.1093/jac/dkl562. PMID 17307769. 
  3. ^ Liu YC, Cheng DL, Lin CL (October 1986). "Klebsiella pneumoniae liver abscess associated with septic endophthalmitis". Arch. Intern. Med. 146 (10): 1913–6. doi:10.1001/archinte.1986.00360220057011. PMID 3532983. 
  4. ^ Bigongiari J (October 26, 2010). "Chicago sees drug-resistant bacteria spreading". VaccineNewsDaily.com. 
  5. ^ http://www.google.com/hostednews/canadianpress/article/ALeqM5iGkjXXk7Wqvs8dTt7CVYVSpFEZXA?docId=4944703
  6. ^ Siegel-Itzcovich J (26 October 2010). "Israelis hospitalized in India to be checked for 'bugs'". The Jerusalem Post. 
  7. ^ Ogundipe S (October 25, 2010). "New ‘superbug’ scare emerges from India, Pakistan". Vanguard. 
  8. ^ Moisse K (March 25, 2011). "Deadly Antibiotic-Resistant Superbug Spreads in Southern California". ABC News. 







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