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Laboratory Diagnosis of Klebsiella pneumoniae
- In the setting of pneumonia, infection with K. pneumoniae is confirmed by either sputum culture analysis, blood culture analysis or midstream urine depending upon the illness.
- The presence of gram-negative rods in Gram-stained smears suggests Klebsiella; they maybe capsulated and non-sporing.
- Material is inoculated into blood agar and Mac Conkey agar medium and incubated aerobically.
- Blood Agar: Mucoid, non-hemolytic colonies
- MacConkey Agar: Mucoid, lactose-fermenting (pink colored) colonies
- After pure cultures have been obtained by selecting colonies from aerobically incubated plates, they are identified by biochemical reactions and colony morphology.
Image Source: Microbiology In Pictures
|Indole Production Test||Negative (K. oxytoca is Indole positive)|
|Citrate Utilization Test||Positive|
|Hydrogen Sulfide Production
|Urea Hydrolysis Test||Positive|
|Lysine Decarboxylase Test||Positive|
|Arginine Dihydrolase Test||Negative|
|Ornithine decarboxylase test||Negative|
|Motility at 36 °C||Non-motile|
|Acetate Utilization Test||Positive|
Treatment of Klebsiella pneumoniae
- Given the low occurrence of K. pneumoniae pulmonary infections in the community, treatment of pneumonia should follow standard guidelines for antibiotic therapy.
- Once infection with K. pneumoniae is either suspected or confirmed, antibiotic treatment should be tailored to local antibiotic sensitivities.
- Current regimes for community-acquired K. pneumoniae pneumonia include a 14-day treatment with either a third or fourth generation cephalosporin as monotherapy or a respiratory quinolone as monotherapy or either of the previous regimes in conjunction with an aminoglycoside.
- For nosocomial infections, a carbapenem can be used as monotherapy until sensitivities are reported.
- Surgery may be needed for patients who experience empyema, lung abscess, pulmonary gangrene, or respiratory tract obstruction following a Klebsiella infection.
- Correction of posterior urethral valves in patients with reoccurring UTIs is a possibility or other abnormalities influenced by infection.
- Nosocomial isolates of K. pneumoniae often display multidrug-resistance phenotypes that are commonly caused by the presence of extended-spectrum β-lactamases or carbapenemases, making it difﬁcult to choose appropriate antibiotics for treatment.
Prevention of Infection
- Klebsiella infections are most well-known in hospitals spread through person-to-person contact by contaminated hands of surrounded people in the hospitals, whether it be an employee or a patient.
- Nurses who look after these patients should maintain strict infection control protocols to prevent the spread of the organism.
- Hand washing is crucial for both medical personnel and visitors.
- Nurses should only ensure that only devices are only used once to minimize transmission from contaminated devices.
- The pharmacist should ensure that empirical antibiotic prescribing is not carried out, as this only leads to the development of drug resistance.
- Murray, P. R., Rosenthal, K. S., & Pfaller, M. A. (2013). Medical microbiology.
- Philadelphia: Elsevier/Saunders.