Klebsiella pneumoniae

Klebsiella pneumoniae is a Gram-negative, non-motile, encapsulated, lactose fermenting, facultative anaerobic, rod shaped bacterium found in the normal flora of the mouth, skin, and intestines. It is the most important member of the Klebsiella genus of Enterobacteriaceae. It is naturally occurring in soil and about 30% of strains can fix nitrogen in anaerobic conditions.

Hans Christian Gram developed the technique now known as Gram staining in 1884 to discriminate between K. pneumoniae and Streptococcus pneumoniae. The bacteria were named after the German bacteriologist Edwin Klebs.

Klebsiella pneumoniae have been killed in vivo. This treatment has been available for some time but a greater danger of bacterial resistance exists to phages than to antibiotics. Resistance to phage may cause a bloom in the number of the microbes in the environment as well as among humans. Phage therapy is only used in conjunction with antibiotics.

Research has implicated molecular mimicry between HLA-B27 and two Klebsiella surface moleculars as the cause of ankylosing spondylitis. Infections generally tend to occur in people with weakened immune system from improper diet. Many infections happen when a person ends up in the hospital. Antibiotic resistance strains are appearing.
It ranks second to E. coli for urinary tract infections in older people. Patients with chronic pulmonary disease, enteric pathogenicity, nasal mucosa atrophy, and rhinoscleroma are easy targets for Klebsiella. Feces are the most common cause of infection.
CRKP is resistant to almost all available antimicrobial agents, and infections with CRKP have cause high rates of morbidity and mortality. Carbapenem is often used as a drug of last resort when battling resistant bacterial strains. CRKP most important mechanism of resistance is its production of a carbapenemase enzyme.

The encoding gene of the enzyme is carried on a mobile piece of genetic material. CRE is difficult to detect due to some strains harboring blakpc have minimal inhibitory concentrations. These strains are susceptible to carbapenems.

Patients infected are put on contact precautions. Acute care facilities establish a protocol in conjunction with the guidelines of the Clinical and Laboratory Standards Institute.

Effective sterilization and decontamination procedures are important to keep the infection rate of this antibiotic resistant strain, CRKP as low as possible.