Klebsiella pneumoniae is an important multidrugresistant mdr pathogen affecting humans and a major source for hospital infections associated with high morbidity and mortality due to limited treatment options. Klebsiella pneumoniae infection causes mastitis in pigs. Klebsiella pneumoniae is considered an urgent health concern due to the emergence of multidrugresistant strains for which vaccination offers a potential remedy. In humans, the bacteria are often present in parts of the digestive tract where they do not generally cause problems. Klebsiella infection genetic and rare diseases information. Outcomes of carbapenemresistant klebsiella pneumoniae infection and the impact of antimicrobial and adjunctive therapies volume 29 issue 12 gopi patel, shirish huprikar, stephanie h. Invasive klebsiella pneumoniae with hypermucoviscosity phenotype hmv k. Klebsiella pneumoniae, a member of the fa mily enterobacteriac eae, is a rodshap ed, gramnegative, lactosefermentin g bacillus wit h a prominent capsule. Frontiers colonization, infection, and the accessory genome. Besides lungs, infections in the urinary tract and intraabdominal parts are also reported. Mortality due to nosocomial infection with klebsiella. Vaccines based on surface polysaccharides are highly promising but need to address the high diversity of surfaceexposed polysaccharides, synthesized as oantigens lipopolysaccharide, lps and kantigens capsule polysaccharide, cps. This organism is also surrounded by a capsule, which increases its virulence by acting as a physical barrier to evade the hosts immune response.
Klebsiella is a genus of enterobacteriaceae that has emerged as a significant nosocomial pathogen in neonates. Epidemiology of klebsiella pneumoniae bloodstream infections in a teaching hospital. Blood bacteremia or septicemia brain meningitis heart endocarditis skin cellulitis urinary tract utis. For example, your surgical wound could be infected. Invasive klebsiella pneumoniae infections, california, usa. Antibiotic resistance related to biofilm formation in. This hospital study was conducted retrospectively and covered a 3 months period. Antibiotic use and the risk of carbapenemresistant extendedspectrum lactamaseproducing klebsiella pneumoniae infection in hospitalized patients. Multidrug resistance associated with extendedspectrum betalactamase esbl and klebsiella pneumoniae carbapenemase kpc among k. Chan yr, liu js, pociask da, zheng m, mietzner ta, berger t, et al. Klebsiella pneumoniae is a bacterium that causes different types of infections, including pneumonia, meningitis, and cellulitis.
Klebsiella pneumoniae is a gramnegative bacterium that is frequently found in the flora of the mouth, skin and intestines as well as in natural environments. The four recognized species include klebsiella pneumoniae, klebsiella oxytoca, klebsiella terrigena, and klebsiella planticola. Klebsiella is second only to escherichia coli in nosocomial gramnegative bacteremia 32, as well as in urinary tract infections utis, affecting catheterized patients 16% and 70%, respectively 33. Oct 02, 2014 multidrug resistance associated with extendedspectrum betalactamase esbl and klebsiella pneumoniae carbapenemase kpc among k. We summarize the wide resistome of this pathogen, which encompasses plentiful chromosomal and plasmidencoded antibiotic resistance. All consecutive patients with kpckp bsis between may 2008 and. In contrast to the usual health careassociated epidemiology of ckp infections, hvkp has the ability to cause serious infection in otherwise healthy individuals in community settings. Increasingly, klebsiella has been found to be resistant to the class of antibiotics known as carbapenems. Clinical epidemiology of klebsiella pneumoniae carbapenemases. Klebsiella pneumoniae endophthalmitis has a characteristic disease phenotype and a particularly aggressive course with poor visual outcomes observed in most cases. Some important virulence factors have been elucidated in klebsiella pneumoniae infections. The signs and symptoms of a klebsiella infection will vary with the site of infection.
In the united states, klebsiella pneumoniae and klebsiella oxytoca are the two strains responsible for most human illnesses. Klebsiella pneumoniae is a gramnegative pathogenic bacterium. Klebsiella species are examples of enterobacteriaceae, a normal part of the human gut bacteria, that can become carbapenemresistant. Klebsiella pneumoniae is second to escherichia coli the most common gramnegative pathogen associated with a wide spectrum of infections, such as urinary tract infection uti, pneumonia, intraabdominal infection, bloodstream infection bsi, meningitis and pyogenic liver abscess pla 14. A casecontrol study comprising 7 cases and 14 controls was. The disease is usually seen only in patients with underlying medical. Klebsiella pneumoniae, the name itself suggests that this strain of klebsiella species causes pneumonia in humans, and the disease is called klebsiella pneumonia. It appears as a mucoid lactose fermenter on macconkey agar. Klebsiella pneumoniae is a gramnegative bacterium that belongs to the family enterobacteriaceae and that has become a wellrecognized cause of nosocomial infections. Klebsiella pneumoniae is a gramnegative pathogen responsible for a wide range of infections, including pneumonia and bacteremia, and is rapidly acquiring antibiotic resistance.
Klebsiella pneumoniae siderophores induce inflammation. We retrospectively analyzed the impact of resistance on the appropriateness of empirical therapy and treatment outcomes of k. Klebsiella pneumoniae is one of such clinically significant organisms that have acquired much public health concern. In healthcare settings, klebsiella bacteria can be spread through persontoperson contact for example, from patient to patient via the contaminated. Management of kpcproducing klebsiella pneumoniae infections. A distinctive form of tissueinvasive communityassociated klebsiella pneumoniae infection, typi. Hypervirulent klebsiella pneumoniae hvkp is an evolving global pathotype that is more virulent than classical k. On agar media, it has a mucoid phenotype that is conferred by the polysaccharide capsule attached to the bacterial outer membrane, and ferments lactose.
People often develop klebsiella infections because they have impaired immunity from being sick or required medical interventions. Klebsiella pneumoniae kp is an important pathogen responsible for severe diseases such as septicemia, pneumonia, urinary tract infections, and soft tissue infections, and this pathogen is mainly associated with community and hospitalacquired infections. Prevalence of mcr1 in escherichia coli and klebsiella. Invasive infection caused by klebsiella pneumoniae is a. Virulence characteristics of klebsiella and clinical.
Communityacquired pneumonia and an invasive syndrome of liver abscess, meningitis, or endophthalmitis occurred only in taiwan and south africa. For example, klebsiella must enter the respiratory breathing tract to cause pneumoniae, or the blood to cause a bloodstream infection. Risk factors and clinical impact of klebsiella pneumoniae. Outbreak of infection with a multiresistant klebsiella. Klebsiella is a superbug that causes a range of diseases, depending on which part of the body it infects. Characteristics of bacteremia between communityacquired and nosocomial klebsiella pneumoniae infection. The first outbreak, diagnosed in early august, was typical and affected wellgrown preweaned pigs from two weeks old on an outdoor breeding herd. Association of these infections with a hypermucoviscous phenotype was. Klebsiella pneumoniae is a gramnegative, nonmotile, encapsulated, lactosefermenting, facultative anaerobic, rodshaped bacterium. Klebsiella pneumoniae is a gramnegative, lactosefermenting, nonmotile, aerobic rodshaped bacterium.
However, the frequency of gut colonization and its contribution to. From april 2004 through april 2012, a total of 120 k. Modeling klebsiella pneumoniae pathogenesis by infection. Intensive care unit icu patients are particularly at risk. Klebsiella pneumoniae is a bacterium that normally lives inside human intestines, where. Infections by k1 and k2 capsular serotype, the mucoid phenotype, and aerobactin production were important determinants of virulence. Klebsiella pneumoniae is a contagious bacteria that can cause infections such as pneumonia and sepsis. To get a klebsiella infection, a person must be exposed to the bacteria. Endophthalmitis, or infection of the vitreous or aqueous humour or both, is a medical emergency.
Klebsiella pneumoniae in healthcare settings hai cdc. Management of kpcproducing klebsiella pneumoniae infections clinical microbiology and infection. Potential antibiotic combination therapy algorithm for the treatment of carbapenemresistant klebsiella pneumoniae infections stratified to site of infection and antibiogram results. Klebsiella pneumoniae is a member of the klebsiella genus of enterobacteriaceae and belongs to the normal flora of the human mouth and intestine. Klebsiella pneumoniae is a ubiquitous gramnegative encapsulated bacterium that resides in the mucosal surfaces of mammals and the environment soil, water, etc. Risk of infection and carriage rates of klebsiella spp. Klebsiella pneumoniae can hit other parts of your body, too. Epidemiologic investigations revealed a short delay between an operation and the acquisition of the mrkp strain. Sometimes bacteria like klebsiella change so that certain antibiotics dont kill them anymore. Predictors of mortality in patients with bloodstream. Klebsiella pneumoniae an overview sciencedirect topics. Treatment of carbapenemresistant klebsiella pneumoniae. In fact, it is the second most common malignant pathogens, along with e. Klebsiella pneumoniae causes a wide range of infections, including pneumonias, urinary tract infections, bacteremias, and liver abscesses.
Pdf molecular pathogenesis of klebsiella pneumoniae. Other articles where klebsiella pneumoniae is discussed. Clinical outcomes of patients with klebsiella pneumoniae carbapenemaseproducing k. Klebsiella pneumoniae is a pathogenic strain of genus klebsiella of enterobacteriaceae and is present in the normal flora of the respiratory, intestinal, and urinogenital tracts of humans. Notice the pink color of colonies due to lactose fermentation and mucosal appearance. Bloodstream infections bsis caused by klebsiella pneumoniae carbapenemases kpcproducing k.
Molecular epidemiological characteristics of klebsiella. Klebsiella pneumoniae is an opportunistic pathogen and leading cause of hospitalassociated infections. Related symptoms can include fever and a productive cough. When bacteria such as klebsiella pneumoniae produce an enzyme known as a carbapenemase referred to as kpcproducing organisms, then the class of antibiotics called carbapenems will not work to kill the bacteria and treat the infection. Klebsiella pneumoniae is a gramnegative, nonmotile, lactose fermenting, rodshape organism. The aim of this study was to evaluate nosocomial infections with k. Many klebsiella infections are acquired in the hospital setting or in longterm care facilities. Klebsiella bacteria are normally found in the human intestines and in human stool. Some klebsiella bacteria have become highly resistant to antibiotics.
Pdf klebsiella pneumoniae infection in a squirrel monkey. Invasive klebsiella pneumoniae infections, california, usa to the editor. Klebsiella pneumoniae infections treatment market global. Dec 18, 2018 klebsiella bacterial infections cause symptoms that vary depending on the site of the infection. Previously, we established an intranasal mouse model of klebsiella pneumoniae infection and validated its utility using a highly virulent wildtype strain and an avirulent capsular polysaccharide mutant.
The most common infection caused by klebsiella bacteria outside the hospital is pneumonia. In the united states, klebsiella pneumoniae and klebsiella oxytoca are the two strains responsible for most human. Klebsiella pneumoniae infections are usually hospital acquired and patients with compromised defense mechanisms are more prone to these infections. Aug 25, 2016 klebsiella pneumoniae is considered an urgent health concern due to the emergence of multidrugresistant strains for which vaccination offers a potential remedy. It has been a known human pathogen since it was first isolated in the late nineteenth century by edwin klebs. We studied 455 consecutive episodes of klebsiella pneumoniae bacteremia occurring in 7 countries.
This case highlights the risks of metastatic infection including bacterial endophthalmitis in. Vaccines based on surface polysaccharides are highly promising but need to address the high diversity of surfaceexposed polysaccharides, synthesized as oantigens lipopolysaccharide, lps and kantigens capsule. On august 2, 2018, maricopa county arizona department of public health mcdph identified two isolates of carbapenemaseproducing klebsiella pneumoniae kpckp, a type of carbapenemaseproducing carbapenemresistant enterobacteriaceae cpcre, from urine specimens collected on july 17 and july 23 from two residents of a ventilatorcapable. Multidrug resistance among enterobacteriaceae is a growing public health crisis that threatens to make many health careassociated infections untreatable with current antibiotics. Outcomes of carbapenemresistant klebsiella pneumoniae. Klebsiella pneumoniae is a member of the family enterobacteriaceae and is one of the most common pathogens causing pneumonia, abscess, bacteremia, and urinary tract infections 1, 2 over several decades, some virulence factors of k. We investigated the relationship between virulence factors and multilocus sequence types sts and assessed the risk factors for bacteremia in patients with pneumonia due to k. Klebsiella is a type of bacteria commonly found in nature.
Frontiers colonization, infection, and the accessory. Klebsiella pneumoniae, a common gut bacteria, causes problems when it moves outside the gut and causes infection. We retrospectively analyzed the impact of resistance on the appropriateness of. Klebsiella pneumoniae is part of the healthy human microbiome, providing a potential reservoir for infection. On the photo klebsiella pneumoniae strain on macconkey agar no. Clinical isolates of escherichia coli and klebsiella pneumoniae were collected from patients with bloodstream infections at 28 hospitals in china, then screened for colistin resistance by broth microdilution and for the presence of the mcr1 gene by pcr amplification. Infections produced by klebsiella pneumoniae are relatively rare, and hospital settings have the the highest prevalence of cases.
Klebsiella can cause infection in different parts of the body including the lungs, urinary tract, or the bloodstream. Klebsiella pneumoniae carbapenemase kpcproducing k. Klebsiella pneumoniae, also called friedlanders bacillus, was first described in 1882 by german microbiologist and pathologist carl friedlander. An outbreak with a multiresistant klebsiella pneumoniae mrkp strain among seven patients admitted to the adult intensive care unit icu of a regional teaching hospital in the netherlands was investigated. Gastrointestinal carriage is a major reservoir of klebsiella. The average annual incidence of endogenous bacterial endophthalmitis is estimated to be 5 per 10,000 hospitalised patients, and klebsiella pneumoniae is being increasingly recognised as a causative organism. During the last decades the rates of extendedspectrum cephalosporinresistant k. In the present study we compare the host responses to both infections by examining cytokine production, cellular infiltration, pulmonary histology, and intranasal immunization. We investigated outcomes, risk factors for mortality and impact of appropriate antimicrobial treatment in patients with bsis caused by molecularly confirmed kpckp. On august 2, 2018, maricopa county arizona department of public health mcdph identified two isolates of carbapenemaseproducing klebsiella pneumoniae kpckp, a type of carbapenemaseproducing carbapenemresistant enterobacteriaceae cpcre, from urine specimens collected on july 17 and july 23 from two residents of a ventilatorcapable unit in a skilled nursing. Feb 06, 2018 klebsiella is a type of bacteria commonly found in nature. Signs and symptoms the signs and symptoms of klebsiella infection depend on the location of infection.
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