|Acute Severe Asthma
|Exacerbation of COPD
|Cardiogenic Pulmonary Oedema
|Respiratory (Chest) infections Pneumonia
Considered the most common cause of hospital-acquired pneumonia in the United States. Antibiotic resistance is a major issue
- Originally named Friedlander's bacillus,
- Lactose fermenting Enterobacteriaceae
- Large polysaccharide capsule is it main source of virulence
- Klebsiella species without a capsule tend to be less virulent.
- Found in gut and upper respiratory tract
- High degrees of virulence and antibiotic resistance.
- Gram negative rods
- Aerobic and Facultative anaerobe
- Glucose fermenting
- Oxidase negative catalase-positive
- Reduce nitrates to nitrites
- Ferments lactose to produce pink colonies on MacConkey's agar
- Fever, Dyspnoea, Consolidation, Sepsis
- Affects Alcoholics and Diabetics and on ventilators
- "Currant jelly” sputum is a hallmark of infection with Klebsiella pneumoniae.
- Pneumonia often in those who have underlying pulmonary disease or alcoholism. Lobar pneumonia with thick jelly-like bloody sputum
- Urinary tract infections especially with catheters
- Pyogenic liver abscess
- Beta-lactamase that causes hydrolysis of the beta-lactam ring in antibiotics
- Also some resistance to Carbapenems
- ABC, chest physio, Oxygen HDU support if needed. Antibiotics
- Klebsiella pneumonia usually signals a grim prognosis. Even with optimal therapy, mortality is 30 to 50%. The prognosis is usually worse in diabetics, the elderly, and those who are immunocompromised.
- Speak to Microbiology about optimal antibiotics. May include Gentamicin and a cephalosporin or Chloramphenicol or co-trimoxazole.