Klebsiella pneumoniae - what is it? Bacteria Klebsiella pneumoniae: a description

Klebsiella pneumoniae - what is it? It is a bacterium that can cause serious inflammatory diseases of the respiratory, digestive and genitourinary systems. Such cases require serious treatment and careful medical care. And the nosocomial infections caused by it practically do not give in to therapy because of a considerable quantity of kinds of the originator.

Biological properties

A simple person can not imagine what Klebsiella pneumoniae looks like, what it is. Morphologically, it is a small fixed sticks, which can be arranged either singly or in groups. This gram-negative bacterium, that is, when stained with hematoxylin-eosin, it becomes pink (indicating the presence of a capsule).

It prefers to reproduce in places with limited access to oxygen, but also does not lose its cultural properties in its presence. In the laboratory, the bacterium Klebsiella pneumoniae grows on dense and liquid nutrient media, forming beautiful grayish-white colonies. Its name was given by the name of the pioneer - pathologist Edwin Klebs.

Types of Klebsiella

Microbiologists have identified six types of Klebsiella since the discovery of the microorganism:

- Klebsiella pneumoniae (Friedlander's stick).
- Klebsiella oxytoca.
- Klebsiella rhinoscleromatis (Frish-Wolkowicz wand).
- Klebsiella ozaenae (Abel-Lavenberg wand).
- Klebsiella terrigena.
- Klebsiella planticola.

In humans, the first two diseases are most often caused, but with a decrease in immunity, other types become pathogenic. In healthy people, the intestine also contains Klebsiella pneumoniae, its norm should not exceed 105 bacteria per gram of chyme. In addition, these microorganisms are constantly present in the skin and mucous membranes of the bronchial tree. They are able to maintain their properties on food, water and soil long enough for infection to occur.

Sources of infection

Among many others, Klebsiella pneumoniae can also be referred to anthropo- nous infections. What it is? This means that the source of the disease can be either diseased people, or carriers of the pathogen, which have no symptoms. Inside the body klebsiella gets along with dirty food or from dirty hands. If the infection affects the bronchopulmonary system, the spread of the bacteria will be predominantly airborne (through coughing and sneezing). All people are susceptible to klebsiella, but small children, the elderly, and those with immunodeficiency belong to the group at high risk, since the multiplication of the obligate intestinal microflora is endogenously virtually uncontrolled.

Getting into the body, the bacterium produces endotoxin, which is released only after the death of the microbe-carrier. It causes fever and intoxication. There are two more exotoxins: enterotoxin and membrane toxin. The first affects the mucosa of the small intestine, and the second destroys the erythrocytes, causing anemia.

Pneumonia

Called pneumonia, as you might guess, Klebsiella pneumoniae. A characteristic feature of this type of inflammation is the appearance of many small foci of inflammation, which can merge with each other, throughout the surface of the lungs. Patients experience a high fever (up to thirty-nine degrees), weakness, lethargy, sweating. At the beginning of the disease, cough is dry, but in the midst it becomes wet, with an admixture of phlegm and pus, there may be blood veins. Dyspnoea is characteristic, and in advanced cases - respiratory failure and pulmonary edema.

At physical examination on the party of an inflammation damp rales are audible, and also at a palpation - shortening of a percussion sound. On the roentgenogram of chest organs in the direct and lateral projection, focal shadows that are prone to unification are visible.

If the disease is diagnosed on time and proper treatment is prescribed, then there is a high probability that the inflammatory process can be interrupted at the very beginning, until it spread across the entire surface of the lungs. But in case of incorrect treatment or late treatment in the hospital, most likely, the patient will already have a picture of sepsis (generalized inflammation), and in this case the lethality is very high.

Disorders of the digestive system

This disease is also caused by Klebsiella pneumoniae. Unfortunately, it is "masked" for gastroenterological pathology, making it difficult to diagnose and treat. The patient first turns to the gastroenterologist with complaints of pain in the stomach and navel, heartburn, nausea, loss of appetite, but FGDS (fibrogastroduodenoscopy) shows a normal or slightly inflamed gastric mucosa. This can not possibly lead a doctor to think about klebsiella. Rather, he will deliver gastritis and prescribe appropriate treatment.

But most often klebsiella manifests itself in the gastrointestinal tract (gastrointestinal tract) in the form of enteritis or enterocolitis. The patient goes to an infectious hospital with complaints of high fever, weakness, nausea, cramping abdominal pain and stool disorder (profuse diarrhea with blood, mucus and unpleasant odor). This state can last from two to five days.

Diseases of the genitourinary system

Most often Klebsiella pneumoniae in the genitourinary system manifests itself in the form of pyelonephritis, cystitis and prostatitis. Depending on the level of damage, patients complain of pain in the lumbar region, difficulty with urination and with erectile function.

If the immune system works well, then the disease is acute, and with proper treatment a person is cured completely. But in case of inferiority of the body's defenses (elderly or child's age, immunodeficiency), the disease takes a chronic or recurrent course.

Complications

During the severe course of Klebsiella infections, such complications are not excluded:

- pulmonary edema;
- ITH (infectious-toxic shock);
- hemorrhagic syndrome;
- edema of the brain.

These are life-threatening conditions, each of which can end up lethal. And if they combine, the probability of a fatal outcome increases. After the infection, the patient develops a specific unstable immunity, that is, speaking in the usual language, after a while a person can get sick again.

Features of the disease in children and pregnant women

Klebsiella pneumoniae during pregnancy is not a rare phenomenon. The organism experiences a double load, the immunity decreases, and the probability of an increase in the obligate microflora increases. Since the situation is delicate, to take or not take antibiotics, the doctor decides. It all depends on the gestational age, the amount of Klebsiella pneumoniae in the smear from the genital tract and the level of leukocytes. The dose is also selected individually. In no case should not be treated at home.

There is often a situation where a pregnant woman asks questions not to the doctor, but to her friends about the bacteria Klebsiella pneumoniae. What it is, she can not find out. And then mistakes in treatment are inevitable, in addition, it can harm the child.

Because of the weakened immunity, newborns and small children also often suffer from conditionally pathogenic microflora. Klebsiella pneumoniae in infants causes severe intoxication, generalization of the inflammatory process and sepsis. Most often it is a dysbacteriosis with characteristic symptoms (belching, giving up breast, losing weight and breaking stool).

Diagnostics

It is rather difficult to clinically diagnose that the infection is caused by Klebsiella pneumoniae, since there are no specific symptoms indicating this. Therefore, the diagnosis is made syndromally and only then is confirmed bacteriologically. As the material suits blood, urine, sputum, cerebrospinal fluid, bile and sectional material.

Klebsiella pneumoniae in the urine is detected by bacteriological or bacterioscopic examination. For this, the material is sown on a nutrient medium or dripped onto a slide and studied under a microscope.

The same methods can detect Klebsiella pneumoniae in feces, but only the material intake is somewhat different. For qualitative research, you need to deliver the material to the laboratory within half an hour after its collection.

Two weeks after the onset of the disease, you can send blood to a serological study. It allows you to assess the severity of the process and the work of the immune system.

Treatment

The doctor chooses the tactics of treatment for each specific case. It depends on the form of the disease, its severity and the characteristics of the patient's body. Most patients receive out-patient treatment.

In the first place, specific bacteriophages are assigned. They need to be taken three times a day before meals. In addition to the oral variant, it is possible to administer the medication through the enema. The course of treatment can vary from five to ten days. The next stage is the probiotics needed to restore normal intestinal flora. They need to drink at least ten days, and preferably two or three weeks.

Of antibiotics, cephalosporins and third-fourth generation fluoroquinolones, aminoglycosides and tetracyclines are chosen.

In hospital, patients are hospitalized for the following indications: worsening of the condition, high fever, sepsis. Symptomatic and pathogenetic therapy is mandatory, aimed at eliminating the symptoms of the disease and alleviating the patient's condition.

Nonspecific prevention for Klebsiella infections is not carried out, since there is no vaccine. Therefore, everything comes down to hygienic education of children and adults, tempering and timely and full-fledged treatment of infectious diseases.