Klebsiella Pneumoniae: Causes, Symptoms and Treatment

Klebsiella pneumoniae

 

Klebsiella pneumonia is a bacteria that results in infections like sepsis and pneumonia, among others. The most common symptoms of Klebsiella infection are fever and cough. Most infections by this bacterium are hospital-acquired and needs a quick diagnosis to prevent severe side-effects.

In this blog, we have discussed everything about Klebsiella Pneumoniae that you must know for a healthy life.

What is Klebsiella Pneumoniae?

In 1882, Calf Friedlander was the first person to describe Klebsiella pneumoniae as a bacterium isolated from the lungs of the individuals who died from pneumonia. The species of this bacterium are easily found in nature, including animals, plants and humans. The bacteria are a causative agent of several infections in our body, such as bloodstream infections, UTIs, Respiratory tract infections, etc.

Mostly these infections occur in hospital settings or patients with a compromised immune system. These patients are generally treated with β-lactams and several other antibiotics that fight against Enterobacteriaceae. However, hypervirulent K. pneumoniae and antibiotic-resistant K.pneumoniae strains are emerging separately in the atmosphere. According to the latest advancements in molecular capabilities, it is seen that a section of clinical isolates known as K.pneumoniae are nothing but other Klebsiella species.

This review focused on the epidemiology of epidemic antibiotic-resistant, endemic opportunistic and evolving hypervirulent strains of K. pneumoniae. Moreover, it will also focus on the role of the accessory genome is all the pathotypes.

To combat these rare but severe infections, it is essential to understand how the emerging Klebsiella species and strains are identical and how they vary from each other.

An opportunistic hospital-acquired infection

  1. K. Pneumoniae is a Gram-negative pathogenic bacterium having a phenotype conferred by polysaccharide capsule. The capsule is connected with the outer membrane of the bacteria and ferments lactose. K. Pneumoniae is a part of the Enterobacteriaeceae family composed of different familiar pathogens like Escherichia coli, Salmonella species, Yersinia species and Shigella species.
  2. K. Pneumoniae is a prominent cause of hospital-acquired infections in America and is considered as an opportunistic pathogen. It is because the bacteria cause infections in a hospital setting or individuals with a compromised immune system. As the demographic characteristics of patients and virulence of the bacteria shifts, understanding the transmission process and parameters causing pathogenicity is essential to treat the infected patients.

The Klebsiella species is the third main cause of HAIs in the USA after Staphylococcus aureus and Clostridium difficile. K. pneumoniae results in severe infections like UTIs, pneumonia and bloodstream infections. It is the cause of hospital-acquired pneumonia, a pneumonia infection caused after hospitalization. The bacteria is also a prominent cause of VAP (Ventilator-associated pneumonia) in patients in the ICUs (Intensive Care Units). VAP is the reason behind 83% of HA pneumonia. The mortality rate of this type of pneumonia is more than 50% in the United States.

Cause of Bloodstream infections

K, pneumonia causes bloodstream infections (BSI), a condition caused by the Gram-negative bacteria, after E- coli. One of the diseases associated with HA bloodstream infections is cancer, while diabetes mellitus and liver disease is community-acquired bloodstream infections by K. Pneumoniae. BSI is the primary infection that doesn’t have a particular identifiable source.

BSI is a secondary infection that leads to dissemination into our bloodstream through a known source, the main causes of the secondary bloodstream infections are the gastrointestinal tract, urinary tract, respiratory sites and urinary or intravenous catheters. The mortality rate of K. pneumonia BSI is around 20-30% in the United States

What are the symptoms of K. pneumoniae infections?

The most common type of infection due to K. pneumoniae bacterium is pneumonia. It is a lung infection that shows symptoms like chills, fever, shortness of breath, coughing, a sense of running down and fatigue.

When infected by the bacteria, you may experience chest discomfort caused by coughing. One of the many characteristics of this lung infection is thick, blood sputum in a productive cough, which is termed as ‘currant jelly sputum’.

Other infections due to K. pneumonia and their symptoms include:

Meningitis: It is a kind of disease of the meninges, the protective layers of the brain. It causes neck or back pain, headache, a stiff neck, fatigue and fever. There are rare cases of meningitis causing seizures.

Wound infections: it is a kind of infection that causes slow wound healing, pus, fevers, pain and redness in the affected area.

Urinary tract infection (UTI): The condition affects your urinary frequency causes burning during urination, incontinence and bladder urgency. Some other associated symptoms are abdominal pain, fever or discomfort.

Sepsis: It is a kind of blood infection due to K, pneumoniae that causes fever, chills, fatigue, muscle aches and lethargy. You may also experience its effects on consciousness.

Subtypes of Klebsiella Pneumonia

You will find subspecies or subtypes of K, pneumoniae bacteria that cause severe sickness, such as:

  • The first subset Klebsiella rhinoscleromatis, which leads to rhinoscleroma , a serious nodular inflammation of the throat and nose.
  • Klebsiella ozanae infections is the second type of subsets that results in atrophy (malodorous wasting away) of your nasal mucous membranes.

Klebsiella pneumoniae is an organism that evades your body’s natural protective mechanisms. It not just attacks the organs such as urinary bladder and lungs but also causes an inflammatory response that aggravates the symptoms of chills and fever.

What are the causes of K. pneumoniae infections?

The K. pneumoniae bacteria resides in the respiratory tract and the gut of our body. The infections are rarely seen in individuals having a healthy immune system.

The conditions that increase the risk of Klebsiella infections include prolonged antibiotic use, illness or a weakened immune system. It is a leading cause of nosocomial infection among individuals or all age groups, from infants to older people. This type of infection mostly occurs in a hospital setting.

Community-acquired Klebsiella pneumoniae is the kind of Klebsiella infection that occurs in a public setting and not at the hospital. However, it is a rare case. CA K. pneumoniae infections affect individuals with a weak immune system, specifically people who are alcoholic or diabetic.

The bacteria spreads through direct contact, mainly through the contamination of equipment likes catheters or other elements in the healthcares. The bacterial infection can also spread from one person to another by direct touch but doesn’t transmit in the air.

What are the risk factors of Klebsiella pneumoniae infections?

If you have a weakened immune system, you are at a higher risk of a weakened immune system.

Some other risk factors include:

  • Growing age
  • Hospitalization
  • Taking corticosteroids
  • Prolonged usage of antibiotics
  • Wounds
  • Surgery
  • Diabetes
  • Using a ureter or intravenous catheter
  • Using a ventilator
  • Chemotherapy
  • Dialysis
  • Kidney failure
  • Alcoholism
  • Chronic liver disease
  • COPD (Chronic Obstructive Pulmonary Disease)
  • Cancer
  • Solid-organ transplantation

Most of these health problems can weaken your immune system, thus putting you at risk of K. pneumoniae infection.

What is the transmission process of Klebsiella pneumoniae?

The bacteria, K. pneumoniae spreads through one person to another by direct contact. So, if you touch a person already infected with the bacterial infection, you might also suffer from a K. pneumoniae infection.

Surprisingly, even when you don’t have Klebsiella infection, you can still carry the bacteria and transmit to another person through direct contact.

The bacteria might also contaminate medical equipment such s

  • Ureter catheters
  • Ventilators
  • Intravenous catheters

How doctors diagnose a K. pneumoniae infection?

The diagnosis of Klebsiella pneumonia depends on the physical exam, your medical history, laboratory testing and diagnostic testing.

In most cases, symptoms of meningitis, pneumonia, wound infection of other Klebsiella infections make you fall sick. The medical evaluation focuses on understanding the root cause of the condition and identifying any signs of complications like an abscess.

Medical History

Your doctor will ask you about your symptoms like cough, fever, body ache, nausea, difficulty in breathing and discomfort. The medical team on board will also ask about your energy levels and duration of sleep. They will also ask about getting in contact with a person having a Klebsiella infection.

Physical examination

Your physician will conduct various assessments for your throat, body temperature, breathing sound, and a checkup of your abdomen. In case of wounds, the doctor examines the painful areas for warmth, swelling and redness.

Diagnostic Tests

The K. pneumoniae bacteria mainly affect your right upper lungs and create a cavity and pus-producing tissue. On doing an X-ray as one of the diagnostic tests, the presence of K. pneumoniae in the lungs, form a distinct appearance.

Along with X-ray, there are other imaging tests that your doctor may prescribe to diagnose the condition better. It includes imaging tests of the urinary bladder, abdomen, bone or brain, based on your symptoms and results of the physical examination.

The doctor can take samples for testing, based on the suspected infection. The samples include:

  • Blood sample: The doctor takes your blood sample in case of any symptoms of sepsis.
  • Sputum sample: This sample helps to identify bacterial pneumoniae
  • Lumbar puncture: it detects bacterial meningitis infection.

In the same way, if you have got a wound, the doctor takes the sample of the wounded area to detect the type of infection.

Doctors send these samples to a laboratory for culture to identify the infectious organism.

What is the treatment of K. Pneumonia infections?

Generally, doctors prescribe a high dose of antibiotics to treat a Klebsiella pneumoniae infection. You can get it orally or IV (intravenously).

The possible antibiotics your healthcare expert can prescribe are:

  • Azactam (aztreonam)
  • Carbapenems, like Primaxin (imipenem/cilastatin)
  • Quinolones, like Avelox (moxifloxacin)
  • Third- or fourth-generation cephalosporins, like Rocephin (ceftriaxone)
  • Aminoglycosides, like Gentak (gentamicin) or Amikin (amikacin)

He can also suggest some antibiotic combinations or switch a drug which doesn’t show any positive effect. The treatment time of a Klebsiella Pneumoniae infection depends on the degree of infection, but usually ranges from a couple of days to up to two weeks.

Note: If you are allergic to penicillin, tell your doctor beforehand.

Antibiotic Resistance

Klebsiella pneumonia is a gram-negative rod, encased in a capsule of thick polysaccharide. The structure indicates that the bacteria can easily escape the protective immune response of your body. This also makes it hard to treat a Klebsiella infection with antibiotics.

Some specific evolved K. pneumoniae strains have now become resistant to treatments using conventional antibiotics. When diagnosing and treating a Klebsiella infection, doctors should check the bacterial resistance profiles.

For instance, certain strains develop beta-lactamase, which is an enzyme that turns it resistant to cephalosporins and penicillins.

Bacteria resistant to several antibiotics are called ‘superbugs’.

How to prevent Klebsiella pneumoniae infection?

As K. pneumoniae spreads from one person to another, the ideal way to prevent the infection from spreading is to keep your hands clean all the time.

You must maintain good hand hygiene to ensure the germs don’t spread. You must wash your hands:

  • After using the washroom
  • Before touching your nose, eyes or mouth
  • After and before preparing food
  • Before and after eating food
  • After sneezing or coughing
  • Before and after dressing a wound

If you work in the hospital, you should always wear gloves and gowns while touching people having Klebsiella infection. On hospitalization, the same rule applies.

What is the recovery time of Klebsiealla pneumoniae infection?

Recovery and prognosis of the Klebsiella infection depend on many factors like:

  • Age type of infection
  • Health condition
  • Strain of K.pneumoniae
  • Severity of infection

There are cases when the infection can cause lasting permanent effects, like Klebsiella pneumoniae can impair lung functioning permanently.

On-time treatment of Klebsiella pneumoniae makes the prognosis turn out better. However, the recovery time ranges from a couple of days to several months, based on the symptoms and type of infection.

Note: Take all the antibiotics as prescribed and keep up with your doctor’s appointments.

In a nutshell

Bacterial infections due to organisms like Klebsiella Pneumoniae include pneumonia, bloodstream infection, urinary tract infection and some other types. It is vital to diagnose and get the treatment on time to avoid serious complications.

 

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