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    Klebsiella

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    Klebsiella organisms were named for Edwin Klebs, the noted German bacteriologist. Klebsiella species are Gram-negative, non-motile bacilli that belong to the family of Enterobacteriaceae. The genus Klebsiella includes several species, some of which are human and animal pathogens. Klebsiella species are natural inhabitants of many water environments. They are known to colonize washers in taps, and they can grow in water distribution systems. These organisms are reasonably sensitive to disinfectants.1 Most Klebsiella species can be isolated from diverse mammals, birds, reptiles, and insects.

    Klebsiella species may cause severe infections of the urinary, respiratory tract, biliary tract, and bloodstream. In hospital environments, transmission sources include hands, contaminated blood pressure monitoring equipment, ventilator traps, dialysate, ultrasonography gel, dextrose solution, and hand disinfectant. Some strains are resistant to beta-lactam antibiotics. Klebsiella species are second only to E. coli as causes of sepsis.2

    Klebsiella species are common in forest environments, vegetation, soil, and water. They are also commonly associated with wood and sawdust, and can be isolated from nasal cavities of workers in the pulp, paper, and wood mills. Klebsiella species have been shown to grow rapidly on surfaces of potatoes and lettuce with counts exceeding 103 per g of surface. K.variicola has been isolated from banana plants, sugar cane, rice, and corn. Luffa sponges made from vegetable gourds and used in exfoliative beauty aids contained Klebsiella species that could be transmitted to the skin during use.3

    K. pneumoniae frequently colonizes the nose and throat of alcoholics in rates as high as 30%; that is why community acquired pneumonia occurs more often in alcoholics than in normal hosts. Certain debilitating diseases also predispose to Klebsiella pneumonia.4

    In animals, Klebsiella bacteria are an important cause of metritis and infertility in horses, mastitis in bovines, hematogenous osteomyelitis originating in pulmonary lesions in cattle, and accumulation of pus in the chest (pyothorax) in horses. K.oxytoca has been frequently isolated from insects. Klebsiella species have been isolated from the tissues of farmed crocodiles with hepatitis and/ or sepsis as well as from oral cavities and cloacae of both healthy and diseased snakes.7

    Luffa sponges made from vegetable gourds and used in exfoliative beauty aids may contain Klebsiella species that could be transmitted to the skin during use.

    Bacterial bronchopneumonia or pneumonia caused by Klebsiella species is a common lung disease, particularly in dogs. Affected dogs and cats usually have immunosuppression resulting from drugs, malnutrition, stress, endocrine diseases, and other infections, including feline leukemia virusfeline immunodeficiency virus infection, and canine distemper. Signs of bacterial pneumonia in dogs include productive and soft cough, nasal discharge, and exercise intolerance. Cats rarely have a cough. 5,6

    Klebsiella species are responsible for approximately 7% of urinary tract infections in dogs.

    Rhinoscleroma is a chronic granulomatous infection that affects the upper respiratory tract from the nose down to the trachea. This disease is found primarily in impoverished areas of the Middle East, Eastern Europe, Africa, and Central and South America. It is reported uncommonly in the USA, where cases are seen in immigrants from endemic countries. The bacterium implicated as the causative agent of this infection is Klebsiella rhinoscleromatis. However, Klebsiella ozaenae, typically associated with primary atrophic rhinitis, has also been reported as a cause of rhinoscleroma. Rhinoscleroma predominantly affects the nose; other areas of the respiratory tract such as the larynx or oropharynx are affected.8

    References

    1. World Health Organization – Guidelines for Drinking-water Quality: Recommendations
    2. James Cherry, Gail J. Demmler-Harrison, Sheldon L. Kaplan, William J. Steinbach, Peter J Hotez – Textbook Of Pediatric Infectious Diseases
    3. J. Michael Janda, Sharon L. Abbott – The Enterobacteria
    4. Richard A. Bordow, Andrew L. Ries, Timothy A. Morris – Manual Of Clinical Problems In Pulmonary Medicine
    5. Lila Miller, Stephen Zawistowski – Shelter Medicine For Veterinarians And Staff
    6. Richard W. Nelson, C. Guillermo Couto – Small Animal Internal Medicine
    7. Virginia P. Studdert, Clive C. Gay, Kenneth W Hinchcliff – Saunders Comprehensive Veterinary Dictionary Third Edition
    8. Zamora et al. – Rhinoscleroma With Pharyngolaryngeal Involvement Caused By Klebsiella Ozaenae – Journal ListCase Rep Infect Disv.2016; 2016

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