Dr. Kennedy

There are millions of bacteria in the intestinal tract, primarily in the colon. They are important for normal bowel health and function. Klebsiella is the name for one of these bacteria. When Klebsiella bacteria get outside of the gut, however, serious infection can occur. Klebsiella infections tend to occur in people with a weakened immune system and many of these infections are contracted when a person is in hospital for some other reason. Klebsiella pneumonia is the most common infection caused by Klebsiella bacteria outside the hospital. Klebsiella pneumonia usually affects people with underlying diseases, such as diabetes, alcoholism, and chronic lung disease. Usually Klebsiella pneumonia causes a severe, rapid-onset illness that often causes areas of destruction in the lung. An infected person usually get high fever, chills, flu-like symptoms and a cough productive of a lot of mucous. The mucous coughed up is often thick and blood tinged and has been referred to as “currant jelly” sputum due to its appearance.

Mortality (death rate) in Klebsiella pneumonia is fairly high due to the debilitating effect of the underlying diseases that tends to be present in affected persons. While regular pneumonia frequently resolves without complication, Klebsiella pneumonia more frequently causes lung destruction and pockets of pus (abscesses) in the lung. There may also be pus surrounding the lung (“empyema”), which can be very irritating to the delicate lung tissue and can result in scar tissue. Surgery may be needed to save a lung that is trapped in irregular pockets of pus and scar tissue.

Klebsiella can also cause less serious garden-variety bronchitis, which is usually acquired in a hospital. Also Klebsiella can cause surgical wound infections, urinary tract infections, and infection of the blood (“bacteremia”). All of these infections can progress to shock and death if not treated early and aggressively.

Klebsiella bacteria are generally resistant to many antibiotics, for example penicillin. Often two or more powerful antibiotics are used to help eliminate a Klebsiella infection. A culture of the suspected infection site is required before a Klebsiella can be diagnosed wity certainty. This may involve getting sputum samples, blood or urine specimens or a swab of a surgical wound. Once the samples are obtained, they are taken to a laboratory and “cultured.” If bacteria grow, the lab can determine which type of bacteria it is. If the bacteria are Klebsiella, the lab will need to run special tests to determine which antibiotics are best to treat the infection (sensitivity testing). This is important because different Klebsiella bacteria are resistant to different antibiotics, so what works for one Klebsiella infection may not work for another. These culture and sensitivity tests may take two to three days to complete. A doctor may choose not wait for the test results to begin antibiotics. Usually a powerful antibiotic or perhaps two are begun immediately once an infection is suspected. The antibiotic can be switched a few days later if the results of the culture and sensitivity tests suggest a more effective drug to treat the infection.

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