KLEBSIELLA PNEUMONIAE

MICROORGANISMS INVOLVED IN THE RESPIRATORY TRACT (BACTERIA I)

Enterobacteriaceae

Family of Klebsiella Pneumoniae

oropharynx and gastrointestinal tract

Klebsiella pneumoniae can normally colonize the

Hospital-acquired infections

Klebsiella pneumoniae causes various — like pneumonia

UTIs

Third common cause of —-

negative

Klebsiella pneumoniae is gram

rod-shaped

What is the shape of Klebsiella pneumoniae?

non-motile

Motility of Klebsiella pneumoniae

FALSE.

TRUE OR FALSE. Klebsiella pneumoniae is spore forming.

lungs
throat
respiratory airways
ventilators in the ICU

Since Klebsiella pneumoniae is facultative anaerobe, it prefers paces like:

positive

Klebsiella pneumoniae urease

carbon dioxide and ammonia

Klebsiella pneumoniae can produce an enzyme called urease that dissociates urea into —

bright pink

In the case of Klebsiella pneumoniae, urease makes urea dissociate into carbon dioxide and ammonia which makes the mixture of urea agar broth and phenol red turn from orange yellow to —-

MacConkey Agar

Klebsiella pneumoniae grows on

Lactose

Klebsiella pneumoniae ferments

very mucoid and viscous pink colonies

Klebsiella pneumoniae has an abundant polysaccharide capsule, which leads to the formation of —

TRUE

TRUE OR FALSE. Klebsiella pneumoniae is encapsulated.

Capsule
Pili
LPS
Siderophore
Urease

Virulence factors of Klebsiella pneumoniae

Capsule

○ Major virulence factor because of its anti-phagocytic ability.
○ It protects the bacteria against phagocytosis by macrophages and neutrophils, allowing Klebsiella to escape destruction.

Pili

Hair-like extensions located on the capsule that help the bacteria attach to host cells.

Lipopolysaccharides

Has the ability to avoid complement-mediated killing by inhibiting the formation of membrane attack complex and preventing membrane damage and bacterial cell death.
Located in the outer membrane, underneath the capsule

Siderophore

○ Group of small high affinity iron chelating compounds that snatch iron from the host cells.
○ Produced by Klebsiella as it needs iron to thrive and replicate.

Urease

In the urinary tract, Klebsiella can also use —- to convert the urea that is normally present in urine to ammonia and carbon dioxide.

alkaline

Ammonia can then combine with hydrogen to form ammonium which increases urine pH, so the urine becomes more —-

Phosphate
Calcium
Magnesium

Alkaline urine promote the precipitation of:

large staghorn renal calculi or kidney stones

Phosphate, Calcium, and Magnesium can combine with ammonium to form struvite stones that often form —-

Urinary stasis

starts a vicious cycle, promoting bacterial multiplication, urinary alkalinization, and deposition of new layers of struvite.

diabetes
Central venous catheters
Endotracheal tubes
Urinary catheters

Klebsiella Pneumoniae can cause various hospital-acquired infections in people with:

lobar pneumonia

For people with diabetes or alcohol dependence, kleb can cause

Lobar Pneumonia

Associated with the formation of lung abscesses due to aspiration of microbes from the oropharynx to the lower respiratory tract.

UTIs (Cystitis, pyelonephritis, prostatitis)

For people with urinary catheters, kleb can cause

bacteremia

for people with blood vessel catheters, The bacteria can be inoculated directly into the bloodstream, which leads to a bloodstream infection called

endocarditis

if bacteremia occurs and it spread to the heart, it can cause

meningitis

if bactermia spreads and goes to the brain it causes

Spontaneous Bacterial Peritonitis

For people with cirrhosis and ascites, it can infect the peritoneal fluid and cause

Lobar Pneumonia

● High fever
● Chills
● Chest pain
● Shortness of breath
● Productive cough with blood-tinge called red currant jelly sputum

Urinary Tract Infections (UTIs)

Dysuria
Urinary frequency
Urinary urgency

Cystitis

Suprapubic pain

Prostatitis

● Fever and chills
● Swollen, tender prostate on palpation

Pyelonephritis

● Flank pain
● Fever
● Nausea or vomiting

Bloodstream Infection

● Fever
● Tachycardia
● Hypotension

Spontaneous Bacterial Peritonitis

● Fever
● Chills
● Extreme Abdominal pain

Blood
Sputum
Urine

Specimen taken for Kleb

alkaline urine pH above 7

Specimen taken for urinalysis

WBCs in Urine

Specimen taken for pyuria

bacteria in urine

Specimen taken for bacteriuria

CBC

Can show leukocytosis

Chest x-ray

can be done in case of pneumonia because it shows cavitary lesions in upper lobes if there is abscess formation

multidrug

Klebsiella pneumoniae is a —- resistant bacterium

beta lactamases

Klebsiella pneumoniae produces —- which is resistant against ampicillin and amoxicillin

Cephalosporins
Aminoglycosides
Fluoroquinolones
Carbapenems

drugs for klebsiella pneumoniae

Carbapenems

For strains that produce extended spectrum beta lactamases (ESBL)

ESBL

Resistant to Cephalosporins, Aminoglycosides, and Fluoroquinolones

Colistin
Tigecycline
Fosfomycin

For strains that produce carbapenemases