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 |
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.
Contents
- 1 Presentation
- 2 Treatment and resistance
- 2.1 Spread of resistant strains
- 3 Eponym
- 4 References
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.
- Infectious diseases
- Bacterial disease: Proteobacterial G−
- primarily A00–A79, 001–041, 080–109
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α |
Rickettsiales |
Rickettsiaceae/
(Rickettsioses) |
Typhus |
- Rickettsia typhi
- Rickettsia prowazekii
- Epidemic typhus, Brill–Zinsser disease, Flying squirrel typhus
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Spotted
fever |
Tick-borne |
- Rickettsia rickettsii
- Rocky Mountain spotted fever
- Rickettsia conorii
- Rickettsia japonica
- Rickettsia sibirica
- Rickettsia australis
- Rickettsia honei
- Flinders Island spotted fever
- Rickettsia africae
- Rickettsia parkeri
- Rickettsia aeschlimannii
- Rickettsia aeschlimannii infection
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Mite-borne |
- Rickettsia akari
- Orientia tsutsugamushi
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Flea-borne |
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Anaplasmataceae |
- Ehrlichiosis: Anaplasma phagocytophilum
- Human granulocytic anaplasmosis, Anaplasmosis
- Ehrlichia chaffeensis
- Human monocytotropic ehrlichiosis
- Ehrlichia ewingii
- Ehrlichiosis ewingii infection
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Rhizobiales |
Brucellaceae |
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Bartonellaceae |
- Bartonellosis: Bartonella henselae
- Bartonella quintana
- either henselae or quintana
- Bartonella bacilliformis
- Carrion's disease, Verruga peruana
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β |
Neisseriales |
M+ |
- Neisseria meningitidis/meningococcus
- Meningococcal disease, Waterhouse–Friderichsen syndrome, Meningococcal septicaemia
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M- |
- Neisseria gonorrhoeae/gonococcus
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ungrouped: |
- Eikenella corrodens/Kingella kingae
- Chromobacterium violaceum
- Chromobacteriosis infection
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Burkholderiales |
- Burkholderia pseudomallei
- Burkholderia mallei
- Burkholderia cepacia complex
- Bordetella pertussis/Bordetella parapertussis
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γ |
Enterobacteriales
(OX-) |
Lac+ |
- Klebsiella pneumoniae
- Rhinoscleroma, Klebsiella pneumonia
- Klebsiella granulomatis
- Klebsiella oxytoca
- Escherichia coli: Enterotoxigenic
- Enteroinvasive
- Enterohemorrhagic
- O157:H7
- O104:H4
- Hemolytic-uremic syndrome
- Enterobacter aerogenes/Enterobacter cloacae
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Slow/weak |
- Serratia marcescens
- Citrobacter koseri/Citrobacter freundii
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Lac- |
H2S+ |
- Salmonella enterica
- Typhoid fever, Paratyphoid fever, Salmonellosis
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H2S- |
- Shigella dysenteriae/sonnei/flexneri/boydii
- Shigellosis, Bacillary dysentery
- Proteus mirabilis/Proteus vulgaris
- Yersinia pestis
- Yersinia enterocolitica
- Yersinia pseudotuberculosis
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Pasteurellales |
Haemophilus: |
- H. influenzae
- Haemophilus meningitis
- Brazilian purpuric fever
- H. ducreyi
- Chancroid
- H. parainfluenzae
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Pasteurella multocida |
- Pasteurellosis
- Actinobacillus
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Aggregatibacter actinomycetemcomitans |
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Legionellales |
- Legionella pneumophila/Legionella longbeachae
- Coxiella burnetii
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Thiotrichales |
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Vibrionaceae |
- Vibrio cholerae
- Vibrio vulnificus
- Vibrio parahaemolyticus
- Vibrio alginolyticus
- Plesiomonas shigelloides
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Pseudomonadales |
- Pseudomonas aeruginosa
- Moraxella catarrhalis
- Acinetobacter baumannii
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Xanthomonadaceae |
- Stenotrophomonas maltophilia
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Cardiobacteriaceae |
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Aeromonadales |
- Aeromonas hydrophila/Aeromonas veronii
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ε |
Campylobacterales |
- Campylobacter jejuni
- Campylobacteriosis, Guillain–Barré syndrome
- Helicobacter pylori
- Peptic ulcer, MALT lymphoma
- Helicobacter cinaedi
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gr+f/gr+a (t)/gr-p (c)/gr-o
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drug (J1p, w, n, m, vacc)
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Pathology of respiratory system (J, 460–519), respiratory diseases
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Upper RT
(including URTIs,
Common cold) |
Head
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- sinuses
- Sinusitis
- nose
- Rhinitis
- Vasomotor rhinitis
- Atrophic rhinitis
- Hay fever
- Nasal polyp
- Rhinorrhea
- nasal septum
- Nasal septum deviation
- Nasal septum perforation
- Nasal septal hematoma
- tonsil
- Tonsillitis
- Adenoid hypertrophy
- Peritonsillar abscess
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Neck
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- pharynx
- Pharyngitis
- Strep throat
- Laryngopharyngeal reflux (LPR)
- Retropharyngeal abscess
- larynx
- Croup
- Laryngitis
- Laryngopharyngeal reflux (LPR)
- Laryngospasm
- vocal folds
- Laryngopharyngeal reflux (LPR)
- Vocal fold nodule
- Vocal cord paresis
- Vocal cord dysfunction
- epiglottis
- Epiglottitis
- trachea
- Tracheitis
- Tracheal stenosis
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Lower RT/lung disease
(including LRTIs) |
Bronchial/
obstructive
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- acute
- Acute bronchitis
- chronic
- COPD
- Chronic bronchitis
- Acute exacerbations of chronic bronchitis
- Acute exacerbation of COPD
- Emphysema)
- Asthma (Status asthmaticus
- Aspirin-induced
- Exercise-induced
- Bronchiectasis
- unspecified
- Bronchitis
- Bronchiolitis
- Bronchiolitis obliterans
- Diffuse panbronchiolitis
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Interstitial/
restrictive
(fibrosis)
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External agents/
occupational
lung disease
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- Pneumoconiosis
- Asbestosis
- Baritosis
- Bauxite fibrosis
- Berylliosis
- Caplan's syndrome
- Chalicosis
- Coalworker's pneumoconiosis
- Siderosis
- Silicosis
- Talcosis
- Byssinosis
- Hypersensitivity pneumonitis
- Bagassosis
- Bird fancier's lung
- Farmer's lung
- Lycoperdonosis
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Other
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- ARDS
- Pulmonary edema
- Löffler's syndrome/Eosinophilic pneumonia
- Respiratory hypersensitivity
- Allergic bronchopulmonary aspergillosis
- Hamman-Rich syndrome
- Idiopathic pulmonary fibrosis
- Sarcoidosis
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Obstructive or
restrictive
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Pneumonia/
pneumonitis
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By pathogen
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- Viral
- Bacterial
- Atypical bacterial
- Mycoplasma
- Legionnaires' disease
- Chlamydiae
- Fungal
- Parasitic
- noninfectious
- Chemical/Mendelson's syndrome
- Aspiration/Lipid
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By vector/route
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- Community-acquired
- Healthcare-associated
- Hospital-acquired
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By distribution
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IIP
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Other
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- Atelectasis
- circulatory
- Pulmonary hypertension
- Pulmonary embolism
- Lung abscess
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Pleural cavity/
mediastinum |
Pleural disease
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- Pneumothorax/Hemopneumothorax
- Pleural effusion
- Hemothorax
- Hydrothorax
- Chylothorax
- Empyema/pyothorax
- Malignant
- Fibrothorax
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Mediastinal disease
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- Mediastinitis
- Mediastinal emphysema
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Other/general |
- Respiratory failure
- Influenza
- SARS
- Idiopathic pulmonary haemosiderosis
- Pulmonary alveolar proteinosis
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anat (n, x, l, c)/phys/devp
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noco (c, p)/cong/tumr, sysi/epon, injr
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proc, drug (R1/2/3/5/6/7)
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