Klebsiella spp. as Pathogens: Epidemiology, Pathogenesis, Identification, Treatment, and Prevention
Dongyou Liu in Handbook of Foodborne Diseases, 2018
Infection by Klebsiella spp. is predominant in patients with diabetes and alcoholics due to their weakened immune systems. K. pneumoniae is also known to cause community-acquired pneumonia. The symptoms associated with community-acquired pneumonia include sudden onset of high fever, jelly-like sputum, shortness of breath, and cough. When K. pneumoniae enters the bloodstream, it causes meningitis, which affects the central nervous system with the symptoms of sharp head pain, nausea, dizziness, and impaired memory. Urinary tract infection and bacteremia have been the leading consequences of infection by Klebsiella spp. Nosocomial infection due to K. pneumoniae is the most common and alarming issue. Nosocomial infection by Klebsiella is prevalent among patients in intensive care units and recipients of prolonged antibiotics treatment. Long-term antibiotics treatment facilitates development of antibiotic resistance in Klebsiella spp., which poses a serious problem in hospitals, with increased rates of mortality and limited therapeutic options.
Medicine
Andrew Schofield, Paul Schofield in The Complete SAQ Study Guide, 2019
On examination, she has a temperature of 38.4, HR 118 bpm reg, BP 96/64, RR 24, O2 sats 94%, heart sounds are normal and she has signs of consolidation in the left lower lobe. Her AMTS is 9/10. Blood tests on admission include Hb 11.3, WCC 18.12, Neut 16.34, Pits 356, Na 142, K 4.8, urea 8.4, creatinine 114 and CRP 114.5. Her LFTs are normal. You diagnose community-acquired pneumonia. Give two signs on examination of consolidation. (2)Give two farther tests you would arrange at this stage. (2)What is her CURB-65 score (show how you came to this score)? (2)Give the three most likely organisms to cause CAP. (3)You start amoxicillin and clarithromycin. What alteration will you make to her regular medications whilst she is taking these and why? (1)
Respiratory conditions
David M. Luesley, Mark D. Kilby in Obstetrics & Gynaecology, 2016
Frequently, no infectious agent is found and the pneumonia is treated empirically. The most common bacteria causing community-acquired pneumonia are Streptococcus pneumoniae and Haemophilus influenzae, often occurring after a viral infection. Atypical pneumonias caused by Mycoplasma and, less commonly, Legionella must also be considered. Penicillins, macrolides and cephalosporins are the treatments of choice and none is contraindicated in pregnancy. Higher doses of amoxicillin should be used to counteract the increased renal clearance found in pregnancy. Erythromycin or clarithromycin should be added if there is suspicion of an atypical pneumonia, and cephalosporins used for penicillin-allergic individuals or hospital-acquired infections. Pneumonias requiring hospitalisation are usually treated with a third-generation cephalosporin (e.g. ceftriaxone) with erythromycin.
Prognosis of severe lower respiratory tract infected patients with virus detected: a retrospective observational study
Published in Infectious Diseases, 2021
Yuan Zhang, Qiuping Huang, Zhigang Zhou, Yun Xie, Xianchen Li, Wei Jin, Ruilan Wang
Community acquired lower respiratory tract infection (LRTI) is the most common reason for requiring mechanical ventilation (MV) support among cases admitted to an Intensive Care Unit (ICU). In the past, bacterial infection was considered to be the leading cause of community acquired pneumonia (CAP), and the Streptococcus Pneumoniae accounted nearly half of the culprit pathogen. However, since the outbreak of Influenza A (H1N1) in 2009, there was an increasing number of viral pneumonia cases admitted to ICU [1]. Studies on American adult or paediatric CAP patients who required hospitalization indicated that respiratory viral infection accounted for the largest proportion [2,3]. A prospective study on the aetiology of adult LRTI in a European primary hospital found that bacterial infection accounted for only one fifth of the total while viral infection accounted for nearly half [4].
Management of ventilator-associated pneumonia: Need for a personalized approach
Published in Expert Review of Anti-infective Therapy, 2018
Eshwara Vandana Kalwaje, Jordi Rello
Diagnosis of VAP has been classically centered on the performance of Chest X-rays (CXR). Diagnostic criteria have been transferred from the community-acquired pneumonia paradigm, although the presentation of the two conditions is markedly different. Indeed, absence of pulmonary opacities has been used to differentiate between VAP and ventilator-associated tracheobronchitis (VAT). Interestingly, the Center for Disease Control and Prevention (CDC) surveillance definitions changed in 2013, shifting from VAP to “ventilator-associated events” (VAE) to overcome the limitations of VAP diagnostics and make surveillance more “objective,” although with its own set of unique problems. Subjective items (such as CR) were eliminated and the key point for diagnosis focused on the detection of worsening oxygenation. Deterioration of oxygenation should be considered a key parameter in the diagnosis of respiratory infections in mechanically ventilated subjects. It should be carefully monitored because subtle changes may be associated with different outcomes.
The burden of community-acquired bacterial pneumonia in the era of antibiotic resistance
Published in Expert Review of Respiratory Medicine, 2019
Paula Peyrani, Lionel Mandell, Antoni Torres, Glenn S Tillotson
Community-acquired pneumonia affects millions of people worldwide [20]. In the US alone, approximately 5 million CAP ambulatory care visits occur each year [21] and the incidence is expected to increase as the US adult population continues to age [4,9]. Incidence rates of adult CAP occurring in inpatient or outpatient US Veterans Health Administration (VHA) settings have also been reported to be more than 35,000 episodes in 2011 alone [9]. Despite the fact that CAP incidence in the US is commonly cited as 4 to 5 million in the literature, recent antibiotic prescribing data suggest that this may be an underestimation [22]. For the period of 1998 to 2009, data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Care Medical Survey were used to analyze antibiotic prescribing patterns for CAP. In this analysis, CAP accounted for approximately 10 million antibiotic prescriptions per year in the US, which is double the number of cases that are estimated to occur each year in US adults [4,9,22].
Related Knowledge Centers
- Bacteria
- Chest Pain
- Cough
- Fever
- Parasitism
- Pneumonia
- Shortness of Breath
- Virus
- Hospital-Acquired Pneumonia
- Pulmonary Alveolus
- Shortness of Breath