Klebsiella pneumoniae or K.pneumoniae is a kind of bacteria that usually lives in your feces and intestines.
There are harmless bacteria until they are present in your intestines. But, as they spread to other body parts, it can result in serious infections. If you are sick, the risk doubles.
Klebsiella pneumoniae can infect your lungs, brain, bladder, blood, wounds, liver and eyes.
It is generally the site of infection that determines your symptoms, reactions and treatment. Healthy individuals do not get infected by these bacteria. The ones who have a weak immune system are on the risk of getting infected by Klebsiella pneumoniae.
The infections from these bacteria are treated using antibiotics. However, some of its strains are now drug resistant, which makes it difficult to treat using normal antibiotics.
Before we move to the symptoms and treatment of Klebsiella pneumonia infections, let us know about its history and etiology.
History of Klebsiella pneumoniae
The first person to talk about Klebsiella pneumoniae was Carl Friedlander in 1882. He described the bacteria as an encapsulated bacillus after isolating it from the lungs of a people who died because of pneumonia. It was originated called Friedlander’s bacillus, until 1886 when it got the name Klebsiella pneumoniae. It is a gram-negative, non-mobile, encapsulated bacterium found in the environment and is associated with pneumonia in the diabetic and alcoholic population. The bacterium is known to colonize human musical surfaces of the gastrointestinal tract (GI tract) and oropharynx.
Once it enters the body, it can lead to a high level of antibiotic resistance and virulence. In the present world, k.pneumoniae pneumonia is one of the most common causes of hospital-acquired pneumonia in the US. The organism is responsible for 3-8% of nosocomial bacterial infections
Klebsiella pneumoniae belongs to the enterobacteriaceae family and is described as encapsulate, gram-negative, non-mobile bacterium. Virulence of these bacteria is a result of different factors that leads to infection and antibiotic resistance. One of the most significant virulence factors is the organism’s polysaccharide capsule, which allows the bacterium to evade opsonophagocytosis and serum killing. Almost 77 various types of capsules have been studied and the species of the organism that doesn’t contain a capsule are proven to be less virulent.
Another virulence factor is lipopolysaccharides that cover the outer surface of the klebsiella pneumonia bacterium. The lipopolysaccharides release a kind of inflammatory cascade in a human body (host) and are the main culprit of the septic shock and sequel in sepsis. The third virulence factor is fimbriae that allow the bacterium to attach itself to the host cells. The fourth possible virulence factor is siderophores that the organism requires to cause several infections. This virulence factor absorbs iron from the host’s body allowing the movement of the infecting plant.
K. pneumoniae is one of the bacteria that is facing a lot of antibiotic resistance, secondary to the changes in the organism’s core genome. In 1929, Alexander Fleming became the first person to discover the strength of beta-lactam antibiotics in gram-negative organisms. It was from 1929 that K.pneumoniae is being studied and shown producing a beta-lactamase that leads to hydrolysis of the beta-lactam ring in the antibiotics. In 1983, Europe saw the extended beta-lactamase (ESBL) k.pneumoniae, which was seen later in United States in the year 1989.
ESBLs can hydrolyze oxyimino cephalosporins dividing third-gen cephalosporins ineffective to treatment. It was because of this resistance that carbapenems became the treatment option for extended beta-lactamase (ESBL).
Causes of Klebsiella pneumoniae infection
A klebsiella infection is a result of K.pneumoniae bacteria. It occurs when the bacteria enters your body directly. It is mainly because of person-to-person contact.
The bacteria can flight against the defense mechanism of your immune system and cause infection.
Symptoms of Klebsiella pneumoniae
As K.pneumoniae can infect various body parts, it can lead to different infections and each infection type has different symptoms.
K. pneumonia causes bacterial pneumoniae or lung infection when the bacteria enters your respiratory tract.
Community-acquired pneumonia is the lung infected when you get infected in a community setting, such s subway or mall, Hospital-acquired pneumonia happens when you get infected at a nursing home or hospital.
In the Western countries, K. pneumoniae causes 3-5% of community-acquired pneumonia and almost 11.8% of hospital-acquired pneumonia.
The common pneumonia symptoms:
- Chest pain
- Cloudy or yellow mucus
- Shortness of breath
Urinary tract infection
It is the infection of your urinary tract when the bacteria enter the urinary tract. Also called UTI, the urinary tract includes organs like uterus, urethra, kidneys and urinary bladder.
Klebsiella UTIs can also happen using a urinary catheter after a long time. Typically, the condition occurs in older women.
UTIs do not show any particular symptoms. Some of the possible symptoms include:
- frequent urge to urinate
- pain and burning when urinating
- bloody or cloudy urine
- strong-smelling urine
- passing small amounts of urine
- pain in the back or pelvic area
- discomfort in the lower abdomen
If your kidneys get affected, you will experience:
- Pain in the upper back and sides
Skin or soft tissue infection
It is a kind of infection that occurs when K. pneumoniae enters breaking into your skin. The bacterial infection damages your soft tissue or skin. It commonly happens due to wounds from surgery or injury.
The K.pneumoniae would infections are:
- Necrotizing fasciitis
Based on the type of infection, you might see symptoms like:
- Flu-like symptoms
In the rarest of cases, K. pneumoniae can lead to bacterial meningitis or inflammation of the several membranes covering your spinal cord and brain. It occurs if the bacteria infect the fluid around the spinal cord and brain.
More often, the cases of K. pneumonia meningitis occur in medical settings like nursing homes, hospitals, etc.
The immediate symptoms of meningitis are:
- High fever
- Stiff neck
Additional symptoms such as:
- Photophobia (sensitivity to light)
If K. pneumonia enters your blood, it tends to spread to your eye, causing endophthalmitis. It is a type of infection that results in inflammation in the white area of the eye.
Some common symptoms include:
- Eye pain
- Blurred vision
- Yellow or white discharge
- Cloudiness on the cornea
Pyogenic liver abscess
There are situations when K. pneumoniae bacteria infect your liver, causing a pyogenic liver abscess or a type of pus-filled lesion.
This infection commonly occurs in people having diabetes or individuals who are taking antibiotics for a prolonged time.
Some of the common symptoms include:
- Pain in the right upper abdomen
It is a kind of Klebsiella pneumoniae infection when the bacteria enters your blood stream, causing bacteremia. It indicates that there are bacteria present in your blood.
In case of primary bacteremia, K. pneumoniae infects your bloodstream directly, while in secondary bacteremia, it spreads to your blood through an infection caused in some other part of the body.
A study estimated that about 50% of Klebsiella blood infections occur due to Klebsiella lung infections.
The immediate symptoms include:
The condition of bacteremia should be treated quickly. When left untreated, it turns into sepsis, becoming life-threatening.
Note: Bacteremia indicates a medical emergency. Reach out to your closest hospital or a local emergency nearby. You can recover easily if treated on time, it lowers the risk of serious complications.
Risk factors of Klebsiella pneumoniae
People having a weak immune system are at a higher risk of K. pneumoniae. The common risk factors of Klebsiella infection include:
- Being hospitalized
- Growing age
- Taking corticosteroids
- Taking antibiotics regularly for long
- Kidney failure
- Lung disease
- Chronic liver disease
- COPD (Chronic Obstructive Pulmonary Disease)
- Solid-organ transplantation
Many of these health problems can weaken your immune system, specially if left untreated
Transmision of Klebsiella Pneumoniae
Klebsiella pneumoniae usually spreads by person-to-person contact. You might get infected if you come in direct contact with a person who is already infected with the condition.
In some cases, a person who is not infected with the bacteria can also be carrying it from one individual to another.
Moreover, there are chances of the bacteria contaminating medical objects such as
- Ureter Catheters
- Intravenous Catheters
The bacterial condition doesn’t spread through the air.
Diagnosis of a Klebsiella infection
Your doctor will perform various kinds of tests to diagnose a disease of K. pneumoniae, based on your symptoms.
Some of the leading medical tests include:
Fluid samples: Your doctor will take samples of your urine, blood, mucus or cerebral spinal fluid. The samples will be sent to a laboratory to check the presence of bacteria.
Physical exam: In case of a wound, the doctor will see for any signs of infection. They will also examine your eye to check for any eye-related symptoms.
Imaging tests: In case your doctor suspects pneumoniae, he will take a PET scan or chest X-ray to examine your lungs. In the case of suspecting a liver abscess, they may perform CT scan or ultrasound.
If you have recently used a catheter or ventilator, the doctor might also test these objects for the presence of any bacteria.
Treatment of Klebsiella pneumoniae infection
K. pneumoniae infections are usually using antibiotics. However, sometimes it gets difficult to treat the bacteria. Some of the strains are resistant to antibiotics. In case you have got a drug-resistant infection, the doctor will prescribe some lab tests to check which antibiotics works best for your condition.
Note: Follow your doctor’s instructions strictly. If you discontinue the dose of antibiotics soon, there are chances of the infection attacking back.
Right time to see a doctor
If you notice any of the symptoms mentioned above, know that it is time to see your doctor. Get immediate medical assistance if you experience sudden fever or have problems breathing.
Klebsiella pneumoniae infections tend to spread very quickly in your body, so medical help is essential.
Preventing a Klebsiella infection
As the infection usually spread from one person to another, the most critical thing to do for its prevention is washing your hands regularly.
Good hand hygiene is essential to prevent the germs from spreading. You should strictly wash your hands:
- Before and after cooking or eating
- After using the bathroom
- Before touching your mouth, nose or eyes
- After sneezing or coughing
- Before and after changing the dressings of a wound
If you work in a hospital, you must wear gowns and gloves before touching a patient with Klebsiella infection. You should also do a handwash after touching the surfaces of the hospital building.
If you are at a higher risk of Klebsiella infection, your doctor will recommend you some more safety tips.
Prognosis and recovery from a Klebsiella infection
Prognosis and recovery of the infection vary from person to person, depending on various factors such as:
- type of infection
- health status
- severity of infection
- the strain of K. pneumoniae
There are cases when the infection can lead to lasting effects. In rare instances of Klebsiella pneumonia, it can permanently affect the functioning of lungs.
The earlier you seek treatment, the better is the prognosis. On time treatment of a Klebsiella infection also reduces the risks of serious complications
Recovery can take a few weeks to a few months or even more.
It is recommended that you take all the prescribed antibiotics and go for regular follow-ups to your doctor.
The Bottom Line
- Pneumoniae bacteria are usually harmless. They live in your feces and intestines, but can be harmful when reaches other body parts.
It can cause serious infection in your bladder, brain, lungs, liver, blood, wounds and eyes. The signs and symptoms depend on the type of infection.
Klebsiella infection spreads from direct contact with an infected person. A person not having the infection might also carry the bacteria. If you are sick, the risk of getting infection doubles. Usually, healthy people do not get infected by the bacteria.
If Klebsiella Pneumoniae infects you, your doctor will prescribe you antibiotics. Some bacterial strains are drug resistant, but your doctor can help you get the right antibiotic that works for your condition. Recovery takes a few weeks to several months, depending on the time you get the treatment.