Klebsiella Pneumoniae and Antibiotic Resistance

Klebsiella pneumoniae cause a wide range of infections. It is a common source of hospital-acquired infections, which are a dangerous problem for some patient populations, particularly newborns, the elderly, and those who are immunocompromised. Healthy people do not normally get Klebsiella infections, though community spread is becoming more common in some areas.

Klebsiella pneumoniae spreads through contact. In healthcare settings, it is commonly spread from person to person through contaminated hands. It can also be passed to patients through essential medical devices, like a catheter into the bladder, IV into the vein, or endotracheal tube into the lungs. Klebsiella pneumoniae does not spread through the air.

Hypervirulent strains of klebsiella pneumoniae have emerged that make more people susceptible to infection, including healthy people. Klebsiella pneumoniae is resistant to many antibiotics, making it very difficult to treat. Recent studies have identified some strains that are resistant to multiple drugs and capable of causing untreatable infections. Microbiology labs can test the bacteria causing the infection to determine what, if any, treatment is available.

Urinary tract infections (UTIs) commonly arise from Klebsiella pneumonia, from the GI tract. Symptoms include blood in the urine, increased frequency and need to urinate, and painful urination. Normally, UTIs can be treated with antibiotics, but if the infection stems from a drug-resistant strain, treatment is difficult. Hospital stays are lengthened, and, if the infection spreads into the blood, it can be fatal.

If Klebsiella pneumoniae gets into the blood, it causes bacteremia, which may lead to sepsis. Klebsiella pneumoniae is the second leading cause of bacteremia for both hospital- and community-acquired infections. Most Klebsiella pneumoniae bacteremia infections originate in the lungs, and studies show that the mortality rate is as high as 37 percent.

Some patient populations have a higher risk of developing Klebsiella pneumoniae bacteremia, including patients with a history of solid-organ transplant, dialysis, chronic liver disease, immunodeficiency diseases, and cancer. Taking medications that suppress the immune system, such as chemotherapy, corticosteroids, and anti-rejection medication, also increases the risk. Having diabetes is another significant risk factor, and about half of community-acquired Klebsiella pneumoniae bactermia cases occur in this population.

Klebsiella pneumoniae infections in the lung can cause pneumonia. This is often the result of mechanical ventilation, as the device bypasses some of the body's natural defenses and allows the bacteria to enter directly into the airway. Klebsiella pneumonia is most common among people with alcohol addiction or diabetes. It presents with red-currant or dark brown secretions and can cause abscesses or empyema.

Since most Klebsiella pneumoniae infections are hospital-acquired, prevention relies largely on healthcare personnel. Contact precautions must be used for patients with a confirmed Klebsiella infection, and all staff needs to practice diligent hand-washing and equipment cleaning. Patients can help prevent the spread by washing their hands before they eat and after using the restroom, coughing, sneezing, or blowing their nose.

Klebsiella pneumoniae infections are diagnosed through bacterial cultures of infected sputum, blood, or urine to confirm the organism causing the infection. Sensitivity testing helps identify an effective course of treatment. Other tests — such as x-rays, CT scans, and ultrasounds — can determine the extent of the infection.

Caring for a family member with a Klebsiella pneumoniae infection can be troubling, but for otherwise healthy people, there is a very low risk of transmission. It is still very important to follow strict hand hygiene to limit the spread. People being treated for a Klebsiella pneumoniae infection must adhere to their treatment plan, including taking the full course of prescribed antibiotics.