WordNet

respiratory disease characterized by inflammation of the lung parenchyma (excluding the bronchi) with congestion caused by viruses or bacteria or irritants
a genus of nonmotile rod-shaped Gram-negative enterobacteria; some cause respiratory and other infections

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肺炎

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/02/13 10:16:31」(JST)

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Klebsiella pneumonia is a form of bacterial pneumonia associated with Klebsiella pneumoniae.

It is typically due to aspiration by alcoholics, though it is more commonly implicated in hospital-acquired urinary tract and wound infections, particularly in immunocompromised individuals and diabetics.

Presentation[edit]

Patients with Klebsiella pneumonia tend to cough up a characteristic sputum that is said to resemble "red-currant jelly".

Klebsiella pneumonia tends to affect people with underlying diseases, such as alcoholism, diabetes and chronic lung disease.

Treatment and resistance[edit]

Treatment for Klebsiella pneumonia is by antibiotics such as aminoglycosides and cephalosporins, the choice depending upon the patient’s health condition, medical history and severity of the disease.^[1]

However, Klebsiella possesses a chromosomal class A beta-lactamase giving it resistance to ampicillin. Many strains have acquired an extended-spectrum beta-lactamase with additional resistance to carbenicillin, amoxicillin, and increasingly to ceftazidime. The bacteria remain largely susceptible to aminoglycosides and cephalosporins. Varying degrees of inhibition of the beta-lactamase with clavulanic acid have been reported. Infections due to multidrug-resistant Gram-negative pathogens in the ICU have invoked the re-emergence of colistin, an antibiotic that had rarely been used for decades. However, colistin-resistant strains of K. pneumoniae have been reported in Greek ICUs.^[2] In 2009, strains of K. pneumoniae with gene called New Delhi metallo-beta-lactamase (shortened NDM-1) that even gives resistance against intravenous antibiotic carbapenem, were discovered in India and Pakistan.

Klebsiella cases in Taiwan have shown abnormal toxicity, causing liver abscesses in patients with diabetes mellitus (DM). Treatment consists of third generation cephalosporins.^[3]

Spread of resistant strains[edit]

Klebsiella resistant strains have been recorded in USA with a roughly threefold increase in Chicago cases,^[4] Brazil ^[5] with 15 deaths per 163 cases, quarantined individuals in Israel,^[6] United Kingdom and parts of Europe. Possible ground zero, or location of emergence, is the India-Pakistan border.^[7]

A strain known as Carbapenem-Resistant Klebsiella pneumonia (CRKP) was estimated to be involved in 350 cases in Los Angeles County between June and December 2010.^[8]

Eponym[edit]

Community-acquired pneumonia caused by Klebsiella pneumoniae may be called Friedländer's Pneumonia, after Carl Friedländer.

References[edit]

^ Buzzle --> Klebsiella Pneumoniae By Ningthoujam Sandhyarani. Published: 16 December 2008
^ Antoniadou A, Kontopidou F, Poulakou G, et al. (April 2007). "Colistin-resistant isolates of Klebsiella pneumoniae emerging in intensive care unit patients: first report of a multiclonal cluster". J. Antimicrob. Chemother. 59 (4): 786–90. doi:10.1093/jac/dkl562. PMID 17307769.
^ Liu YC, Cheng DL, Lin CL (October 1986). "Klebsiella pneumoniae liver abscess associated with septic endophthalmitis". Arch. Intern. Med. 146 (10): 1913–6. doi:10.1001/archinte.1986.00360220057011. PMID 3532983.
^ Bigongiari J (October 26, 2010). "Chicago sees drug-resistant bacteria spreading". VaccineNewsDaily.com.
^ http://www.google.com/hostednews/canadianpress/article/ALeqM5iGkjXXk7Wqvs8dTt7CVYVSpFEZXA?docId=4944703
^ Siegel-Itzcovich J (26 October 2010). "Israelis hospitalized in India to be checked for 'bugs'". The Jerusalem Post.
^ Ogundipe S (October 25, 2010). "New ‘superbug’ scare emerges from India, Pakistan". Vanguard.
^ Moisse K (March 25, 2011). "Deadly Antibiotic-Resistant Superbug Spreads in Southern California". ABC News.

UpToDate Contents

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1. 肺炎桿菌（肺炎クレブシエラ）感染症の臨床的特徴、診断、および治療 clinical features diagnosis and treatment of klebsiella pneumoniae infection
2. 成人における院内感染性／人工呼吸器関連／医療関連肺炎の治療 treatment of hospital acquired ventilator associated and healthcare associated pneumonia in adults
3. 入院を要する成人における市中肺炎の治療 treatment of community acquired pneumonia in adults who require hospitalization
4. 肺炎桿菌感染症の微生物学および病因 microbiology and pathogenesis of klebsiella pneumoniae infection
5. 小児における肺炎：入院治療 pneumonia in children inpatient treatment

English Journal

Monitoring of multiple drug-resistant pathogens in a selected stretch of Bay of Bengal, India.

Panda SK, Patra AK, Kar RN.SourceInstitute of Minerals and Materials Technology, Bhubaneswar, 751013, Orissa, India.
Environmental monitoring and assessment.Environ Monit Assess.2012 Jan;184(1):193-200. Epub 2011 Mar 22.
The present work aims at identification of multiple drug-resistant pathogenic bacteria in a selected stretch, namely, Puri on the Bay of Bengal, India. Six stations at the coast of Puri were selected and samples of water and sediment were collected during the winter of 2008 and 2009 for this study.
PMID 21424669

High Prevalence of Multidrug-Resistant Nonfermenters in Hospital-acquired Pneumonia in Asia.

Chung DR, Song JH, Kim SH, Thamlikitkul V, Huang SG, Wang H, So TM, Yasin RM, Hsueh PR, Carlos CC, Hsu LY, Buntaran L, Lalitha MK, Kim MJ, Choi JY, Kim SI, Ko KS, Kang CI, Peck KR; on behalf of the Asian Network for Surveillance of Resistant Pathogens Study Group.SourceDivision of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Asia Pacific Foundation for Infectious Diseases, Irwon-dong, Gangnam-gu, Seoul 135-710, Korea. songjh@skku.edu.
American journal of respiratory and critical care medicine.Am J Respir Crit Care Med.2011 Dec 15;184(12):1409-1417. Epub 2011 Sep 15.
Rationale: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) remain important causes of morbidity and mortality. Increasing antimicrobial resistance has aroused the concern of the failure of antibiotic treatment. Objectives: To determine the distribution of the bacterial is
PMID 21920919

Japanese Journal

口腔日和見細菌の気管内チューブ・カフへの付着

TOLEDO Andreia de,北田勝浩,山口泰平,於保孝彦
口腔衛生学会雑誌 61(1), 57-64, 2011-01-30
… 題である.長期にわたる気管内チューブの挿管は,ヒト口腔に常在する日和見細菌の上部気道での集落化をしばしばまねく.本研究では口腔日和見細菌の唾液被覆気管内チューブ・カフへの付着能を調べ,さらにKlebsiella pneumoniaeが唾液被覆カフへ付着する機序を調べた.8株の口腔日和見細菌の唾液被覆チューブおよびカフへの付着能を調べた.またK.pneumoniaeの付着機序を調べるため,付着抑制実験と菌体凝集実験を行った.調べた …
NAID 110008440562

A comparative study of induction of pneumonia in mice with planktonic and biofilm cells of Klebsiella pneumoniae

Sharma Sonica,Mohan Harsh,Sharma Saroj [他]
Microbiology and immunology 55(5), 295-303, 2011-05
NAID 40018823242

「クレブシエラ肺炎」

Klebsiella pneumoniae
	Classification and external resources
	; K. pneumoniae on a MacConkey agar plate.
ICD-10	B96.1, J15.0
ICD-9	041.3, 482.0
DiseasesDB	7181
eMedicine	med/1237
MeSH	D007710

　　[★]

英: Klebsiella pneumonia
同: Klebsiella肺炎、肺炎桿菌肺炎、フリートレンダー桿菌肺炎 Friedlaender bacillus pneumonia
関: 肺炎桿菌 Klebsiella pneumoniae、クレブシエラ感染症

肺炎桿菌性肺炎は劇症化しやすい。(095B016)

病原体

Klebsiella pneumoniae

「Klebsiella肺炎」

　　[★]

英: Klebsiella pneumonia
関: クレブシエラ肺炎

「Klebsiella pneumoniae」

　　[★]

同: 肺炎桿菌
関: 細菌、クレブシエラ属、肺炎、クレブシエラ肺炎

概念

グラム陰性桿菌
通性嫌気性
腸内細菌科クレブシエラ属
厚い莢膜
運動能なし

肺炎の原因菌。日和見病原菌として院内感染も多い。
老人や小児の肺炎死亡例の原因菌であることが多い。
肺炎レンサ球菌(Streptococcus pneumoniae)による肺炎よりも劇症
喀痰は粘稠性
ペニシリン系薬に自然耐性

治療

[1] Buzzle --> Klebsiella Pneumoniae By Ningthoujam Sandhyarani. Published: 16 December 2008

[2] Antoniadou A, Kontopidou F, Poulakou G, et al. (April 2007). "Colistin-resistant isolates of Klebsiella pneumoniae emerging in intensive care unit patients: first report of a multiclonal cluster". J. Antimicrob. Chemother. 59 (4): 786–90. doi:10.1093/jac/dkl562. PMID 17307769.

[3] Liu YC, Cheng DL, Lin CL (October 1986). "Klebsiella pneumoniae liver abscess associated with septic endophthalmitis". Arch. Intern. Med. 146 (10): 1913–6. doi:10.1001/archinte.1986.00360220057011. PMID 3532983.

[4] Bigongiari J (October 26, 2010). "Chicago sees drug-resistant bacteria spreading". VaccineNewsDaily.com.

[5] ttp://www.google.com/hostednews/canadianpress/article/ALeqM5iGkjXXk7Wqvs8dTt7CVYVSpFEZXA?docId=4944703

[6] Siegel-Itzcovich J (26 October 2010). "Israelis hospitalized in India to be checked for 'bugs'". The Jerusalem Post.

[7] Ogundipe S (October 25, 2010). "New ‘superbug’ scare emerges from India, Pakistan". Vanguard.

[8] Moisse K (March 25, 2011). "Deadly Antibiotic-Resistant Superbug Spreads in Southern California". ABC News.

リンク元	「クレブシエラ肺炎」「Klebsiella肺炎」
拡張検索	「Klebsiella pneumoniae」

匿名

検索

案内

案内

Klebsiella pneumonia