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Respiratory Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Ian Pavord, Nayia Petousi, Nick Talbot
Clinical features are similar to those of community-acquired pneumonia but patients are often more ill. Klebsiella infection is characterized by rapid-onset severe cavitating pneumonia, usually in the upper lobes.
Klebsiella spp. as Pathogens: Epidemiology, Pathogenesis, Identification, Treatment, and Prevention
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
Arumugam Kamaladevi, Shanmugaraj Gowrishankar, Krishnaswamy Balamurugan
Klebsiellae can be found in surface water, sewage, soil, and plants,25 and in the mucosal surfaces of mammals such as humans, swine, and horses. The genus Klebsiella is common in humans but not in the environment. In humans, K. pneumoniae occurs as a saprophyte in the nasopharynx and in the gastrointestinal tract. The rate of detection of Klebsiella in stool samples ranges from 5% to 38%, whereas in nasopharynx it ranges from 1% to 6%.4 Since the human skin does not favor the growth of gram-negative bacteria, Klebsiella spp. are hardly found on skin and considered as transient members of the normal flora.4–6 Interestingly, the carrier rate varies drastically in the hospital milieu, where the colonization increases with the length of stay. In hospitalized patients, the rate of carrier was reported to be 77% in the stool, 42% on the hands, and 19% in the pharynx.26 The elevated level of nosocomial colonization by Klebsiella has been associated with the use of antibiotics rather than hospital hygiene. Infection by Klebsiella spp. has been treated by antibiotic therapy. Surprisingly, administration of broad-spectrum or multiple antibiotics increased the colonization of Klebsiella spp. by two- to fourfold in hospitalized patients.27 According to the Centers for Disease Control and Prevention, Klebsiella spp. account for 8% of endemic nosocomial infections and 3% of epidemic outbreaks.4,28
Combination Antimicrobial Therapy for Gram-Negative Infections: What Is the Evidence?
Published in Robert C. Owens, Lautenbach Ebbing, Antimicrobial Resistance, 2007
A major concern regarding infections with Klebsiella spp. is the expanding presence of ESBL-producing strains (16). Infections caused by ESBL-producing strains of Enterobacteriaceae are associated with greater morbidity, and in some studies, mortality, when compared to bacteremia caused by non-ESBL producing K. pneumoniae (31,129–131).
Infective endocarditis by Klebsiella species: a systematic review
Published in Journal of Chemotherapy, 2021
Petros Ioannou, Eugenia Miliara, Stella Baliou, Diamantis P. Kofteridis
The majority of infections by Klebsiella spp. are nosocomially acquired, most commonly in the intensive care unit (ICU), but they can also affect healthy people.3–7 The most common infections caused by Klebsiella spp. are urinary tract infections (UTIs), pneumonia, bacteremia and intra-abdominal infections, such as liver abscess, while, less commonly encountered infections are wound infections, infections of intravascular devices and central nervous system (CNS) infections, such as meningitis and post-neurosurgical infections.1 Interestingly, people with different underlying pathological conditions, such as alcohol abuse, malignancy, immunosuppression, diabetes and end-stage renal disease (ESRD), are more susceptible to infection by Klebsiella spp.8,9
Two ST11 Klebsiella pneumoniae strains exacerbate colorectal tumorigenesis in a colitis-associated mouse model
Published in Gut Microbes, 2021
Ming-Ko Chiang, Pei-Yi Hsiao, Yen-Yi Liu, Hui-Ling Tang, Chien-Shun Chiou, Min-Chi Lu, Yi-Chyi Lai
Klebsiella pneumoniae is a concerning pathogen worldwide. As one of the ESKAPE, K. pneumoniae causes a wide range of infections associated with antimicrobial resistance, challenging to treat with limited therapeutic options.1 Over the past decades, drug-resistant K. pneumoniae has evolved from an extended-spectrum-β-lactamase (ESBL) producer into a carbapenem-resistant superbug. Carbapenems are the “last-line” treatment for infections caused by ESBL K. pneumoniae. The emergence and global spread of carbapenem-resistant K. pneumoniae (CRKP) poses a real threat to public health. Sequence type (ST) 11 constitutes the major CRKP in South America and Asia.2–6 Some lineages of ST11 have transformed into hypervirulent CRKP through acquiring a variant of virulence plasmids and had caused fatal outbreaks in China.7,8
Incidence, impact and natural history of Klebsiella species infections in cystic fibrosis: A longitudinal single center study
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2019
Sen Han Phang, Jasper Greysson-Wong, Ranjani Somayaji, Douglas G. Storey, Harvey R. Rabin, Michael G. Surette, Michael Parkins
Patients harboring Klebsiella spp. infection were predominantly female (15/25, 60%), and the median age was 27 (IQR 22–34). A disproportionally small number of these patients were homozygous for the F508del mutation (8/25, 32%). In terms of comorbidities, 23 (92%) of our patients were pancreatic insufficient, while only 4 (16%) had CF-related diabetes. Seven (28%) were on chronic oral azithromycin and 6 (24%) were on chronic inhaled antibiotics (6/17, 35.2% of individuals with chronic P. aeruginosa infection). There were 13 (52%), 8 (32%), and 7 (28%) patients on short-acting bronchodilators, long-acting bronchodilators and DNase, respectively. At baseline, 17 (68%) of the cohort were chronically infected with P. aeruginosa, 11 (44%) with methicillin-sensitive Staphylococcus aureus, 2 (8%) with MRSA and 5 (20%) with other Gram-negative bacteria (Table 1).