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Klebsiella pneumoniae (Friedlander bacillus)

Gram negative bacilli. Etiology: (risk factors) 1) alcoholism 2) debilitation 3) diabetes mellitus 4) COPD Epidemiology: - more common in males - antibiotic-resistant strain of Klebsiella pneumoniae infected 19 people (7 deaths directly attributable to Klebsiella) at the NIH Clinical Center in Bethesda, Maryland Aug 2011-Sept 2012 Pathology: 1) community acquired lobar pneumonia 2) virulent, necrotizing pneumonia with lung abscesses & empyema 3) dependent lobes are affected more frequently Clinical manifestations: - current jelly sputum Laboratory: - Gram negative rod, oxidase negative - Klebsiella pneumoniae DNA - Klebsiella pneumoniae phoE gene - Klebsiella pneumoniae yggE gene Radiology: - chest X-ray may show bulging fissure(s) Complications: - carbapenem-resistant Klebsiella pneumoniae (CRKP) & other similarly resistant Enterobacteriaceae are resistant to most antimicrobial drugs, & are frequently fatal [4] - carbapenem-resistance (India, Pakistan) conferred by New Delhi metallo-beta-lactamase 1 (emergence in 2010) Management: - 3rd generation cephalosporin plus aminoglycoside - carbapenem for extended spectum beta-lactamase producing Klebsiella pneumoniae Comparative biology: - colistin-resistance in carbapenem-resistant Klebsiella pneumoniae identified in a mouse model [7] - in 3xTg-AD mice, Klebsiella pneumoniae can translocate from the gut to the bloodstream by penetrating the gut epithelial barrier & susequently infiltrate the brain by penetrating the blood-brain barrier [9]

Related

Klebsiella pneumoniae phoE gene

General

Klebsiella

Properties

KINGDOM: monera DIVISION: SCHIZOMYCETES

References

  1. Manual of Medical Therapeutics, 28th edition, Ewald & McKenzie (eds) Little, Brown & Co, 1995, pg 301
  2. Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook, Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 226-27
  3. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 797
  4. Lledo W et al Guidance for Control of Infections with Carbapenem-Resistant or Carbapenemase-Producing Enterobacteriaceae in Acute Care Facilities MMWR 2009 58(10);256-260 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5810a4.htm
  5. Vastag B and Sun LH NIH superbug claims 7th victim Washington Post. Sept 14, 2012 http://www.washingtonpost.com/national/health-science/nih-superbug-claims-7th-victim/2012/09/14/09b3742e-fe9b-11e1-b153-218509a954e1_story.html
  6. Petrosillo N, Giannella M, Lewis R, Viale P. Treatment of carbapenem-resistant Klebsiella pneumoniae: the state of the art. Expert Rev Anti Infect Ther. 2013 Feb;11(2):159-77. Review. PMID: 23409822
  7. Band VI, Satola SW, Burd EM et al Carbapenem-Resistant Klebsiella pneumoniae Exhibiting Clinically Undetected Colistin Heteroresistance Leads to Treatment Failure in a Murine Model of Infection. mBio. 6 March 2018 vol. 9 no. 2 e02448-17 PMID: 29511071 Free full text http://mbio.asm.org/content/9/2/e02448-17.full
  8. Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
  9. Park G, Kadyan S, Hochuli N et al An Enteric Bacterial Infection Triggers Neuroinflammation and Neurobehavioral Impairment in 3xTg-AD Transgenic Mice. J Infect Dis. 2024 Sep 10;230(Supplement_2):S95-S108. PMID: 39255397