Klebsiella
Klebsiella is a genus of bacteria that primarily exists in the human intestines and feces, typically harmless in these locations. However, it can become pathogenic, leading to infections such as pneumonia, urinary tract infections, and blood infections, particularly in healthcare settings like hospitals and nursing homes. There are three main species affecting humans: Klebsiella pneumoniae, Klebsiella oxytoca, and Klebsiella rhinoscleromatis. These bacteria are opportunistic pathogens, often targeting individuals with weakened immune systems, including the elderly and those with chronic illnesses, such as alcoholism. While healthy individuals can contract these infections, they are notably more common in patients who are already ill or receiving medical care.
Symptoms vary by the type of infection but often mimic those of other causes, making accurate diagnosis essential. Treatment typically involves antibiotics, although Klebsiella has shown increasing resistance to many, complicating care. A newer antibiotic combination, ceftazidime/avibactam, was approved in the U.S. in 2015 to address these resistant infections. Overall, Klebsiella poses significant challenges in medical environments due to its ability to exploit vulnerabilities in patients.
On this Page
Subject Terms
Klebsiella
Klebsiella is a genus of bacteria that is usually acquired in health care settings such as hospitals, nursing homes, and other long-term care facilities. Species of Klebsiella can cause a variety of infections, including pneumonia, urinary tract infections, blood infections, meningitis, and infections of wounds or surgical incisions. They present specific problems for health care providers because they often attack people who are already weakened by illness or injury and because they are increasingly resistant to antibiotics.
Overview
Klebsiella bacteria are named for the German biologist who discovered them in the late nineteenth century, Edwin Klebs (1834-1913). They occur naturally in the human intestines, where they are not dangerous, and in human feces. The bacteria are non-motile, or incapable of moving on their own, and are completely covered in a capsule made of carbohydrate molecules known as polysaccharides. This capsule helps to protect the bacterium from attacks by the body's immune system.
Three known species of genus Klebsiella affect humans. These are Klebsiella pneumoniae, Klebsiella oxytoca, and Klebsiella rhinoscleromatis. They are spread by person-to-person contact. The bacteria can also easily enter the body through medical devices such as catheters or ventilators. While otherwise healthy people can contract a Klebsiella infection, they are more common in people whose immune systems are already weakened and by those in an inpatient medical setting.
The type of symptoms that will be exhibited depend on what part of the body is affected by the bacteria and will be the same as an infection in that location from any other cause. For instance, a person who contracts pneumonia from a Klebsiella bacteria will have the same symptoms of fever, chills, chest pain, and breathing issues as a person whose pneumonia has another cause. This is why it is very important for the medical team to order tests to determine the cause and identify the presence of Klebsiella as soon as possible.
Klebsiella bacteria are opportunistic organisms, which means they take advantage of various forms of weakness to enter and infect the body. In addition to the risk from being immunocompromised or a hospital or surgical patient, the elderly are also more likely to be affected. In some parts of the world, such as Asia, senior citizens account for the majority of those who fall victim to a Klebsiella-related infection. In the United States, however, about 66 percent of the patients diagnosed with Klebsiella infections each year are alcoholics. While a Klebsiella infection results in death about 50 percent of the time, that rate soars to nearly 100 percent for patients with alcoholism.
Klebsiella infections are diagnosed by gathering a specimen for testing in the laboratory. They are treated through the use of antibiotics, although the bacteria have developed resistance to many known antibiotics. This includes carbapenems, which are antibiotics that were developed to treat resistant organisms. The antibiotics used most commonly include third-generation cephalosporins such as ceftriaxone, aminoglycosides such as gentamicin, and quinolones. A combination product, ceftazidime/avibactam, was approved for use in the United States for the types of infections caused by Klebsiella bacteria in 2015.
Bibliography
Bush, Larry M. and Charles E. Schmidt. "Klebsiella, Enterobacter, and Serratia Infections." Merck Manuals, www.merckmanuals.com/home/infections/bacterial-infections/klebsiella-,-enterobacter-,-and-serratia-infections. Accessed 24 Feb. 2017.
Galeon, Isobelle. "Symptoms of Klebsiella Bacteria." Livestrong, 24 April 2016, www.livestrong.com/article/179921-symptoms-of-klebsiella-bacteria/. Accessed 24 Feb. 2017.
"Klebsiella Fact Sheet." Pennsylvania Department of Health, 2 Jan. 2013, www.health.pa.gov/My%20Health/Diseases%20and%20Conditions/Documents/Fact%20Sheets%202013/Klebsiella%20Disease%20Fact%20Sheet.pdf. Accessed 24 Feb. 2017.
"Klebsiella Pneumoniae in Health Care Settings." Centers for Disease Control, www.cdc.gov/hai/organisms/klebsiella/klebsiella.html. Accessed 24 Feb. 2017.
"Klebsiella Species." Gov.UK, 15 July 2008, www.gov.uk/guidance/klebsiella-species. Accessed 24 Feb. 2017.
Qureshi, Shahab, et al. "Klebsiella Infections." Medscape, 7 Nov. 2016, emedicine.medscape.com/article/219907-overview. Accessed 24 Feb. 2017.
Shaw, Gina. "Breaking News: Deadly Klebsiella Pneumoniae Strain Resistant to Carbapenems." Emergency Medicine News, March 2013, journals.lww.com/em-news/Fulltext/2013/03000/Breaking‗News‗‗Deadly‗Klebsiella‗Pneumoniae‗Strain.3.aspx. Accessed 24 Feb. 2017.
Srivastava, Roli. "Drug Resistant Bug Klebsiella Causes Worry." The Hindu, 23 May 2016, www.thehindu.com/sci-tech/health/medicine-and-research/drugresistant-bug-klebsiella-causes-worry/article7928014.ece. Accessed 24 Feb. 2017.