Table of contents:
- Klebsiella: what is it
- Factors for the development of klebsiellosis
- Causes of Klebsiella infection
- Diagnostics of the Klebsiella infection
- The main symptoms
- Klebsiella pneumoniae in the taxonomy of bacteria
- Klebsiella pneumoniae (Friedlander's stick) in feces
- Klebsiella - intestinal infection
- Stool analysis for Klebsiella
- When treatment of Klebsiella in feces in an adult is not necessary
- Features of the course of Klebsiella infection in pregnant women
Video: Klebsiella In Feces In Adults: Symptoms And Treatment
Klebsiella in feces. Klebsiella belongs to a conditionally pathogenic type of microorganisms and is considered an element of healthy human microflora. For a long time, Klebsiella may not manifest itself in the body, but when exposed to certain factors, for example, with a weakened immune system, Klebsiella begins to be dangerous. Klebsiella infection is spread from person to person, as well as through contaminated food. In case of infection, Klebsiella is diagnosed in the feces of the patient. In moderate quantities, it is necessary for the full functioning of the digestive system, but sometimes, under the influence of certain factors, the number of bacteria increases, causing pathological processes. Klebsiella in feces is most often found in excess of the norm in disorders of the digestive tract.
The content of the article:
- 1 Klebsiella: what is it
- 2 Factors for the development of klebsiellosis
- 3 Causes of Klebsiella infection
- 4 Diagnosis of Klebsiella infection
- 5 Main symptoms
- 6 Klebsiella pneumoniae in the taxonomy of bacteria
- 7 Klebsiella pneumoniae (Friedlander's bacillus) in feces
- 8 Klebsiella - intestinal infection
- 9 Stool analysis for Klebsiella
- 10 When treatment of Klebsiella in feces in an adult is unnecessary
- 11 Features of the course of Klebsiella infection in pregnant women
Klebsiella: what is it
The klebsiella bacterium belongs to the Enterobacteriaceae family, outwardly looks like a stick, covered with a strong membrane that protects it from external negative influences. It is an anaerobic microorganism that can live without oxygen. Only high temperatures have a detrimental effect on Klebsiella - it dies at 60 degrees Celsius. Klebsiella are conditionally divided into 7 subspecies, however, pathological processes in the human body most often cause only 2 - pneumonia and oxytoca. Klebsiella (Klebsiella) is a conditionally pathogenic microorganism, which is a member of the Enterobacteriaceae family. It received its name from the name of the German scientist, bacteriologist and pathologist who discovered it - Edwin Klebs.
Klebsiella in feces. Microbiologically, these are gram-negative rods (when stained according to Gram they do not have a specific purple coloration) of small size (1.0 * 6.0 microns), motionless, located both in pairs and alone, as well as in chains.
They are facultative anaerobes (capable of multiplying in the absence of oxygen, however, with its presence, they do not lose their vitality). Klebsiella are able to form a capsule, thanks to which they are resistant to the environment. They have O-antigens (about 11) and K-antigens (about 70), which differ within the genus.
Klebsiella are gram-negative bacilli at the biological level (that is, Gram staining does not give a violet color), the size of this microorganism is 1x6 microns. Klebsiella shape resembles a stick, they are absolutely motionless, can be arranged in pairs or alone, often line up in a chain.
The conditionally pathogenic microorganism in question belongs to the class of facultative anaerobes. It is well known that these microorganisms multiply in the absence of oxygen, but even if there is the presence of this gas, Klebsiella do not lose their viability.
Under normal physiological conditions, Klebsiella is not something pathological, since this microorganism is part of the intestinal microflora and the entire digestive system.
In addition, the conditionally pathogenic microorganism under consideration may be present in the mucous membrane of the respiratory tract and on the skin. The vital activity of Klebsiella is preserved in the soil and in water, in dust and in food that is stored in the refrigerator.
Factors for the development of klebsiellosis
Klebsiella belong to the same family with bacteria of the genus Serratia and Enterobacter. These pathogens, especially Serratia, which has the highest drug resistance, cause outbreaks of infection in hospitals, due to the contamination of a number of medications, medicinal solutions used in the therapy of the respiratory system.
They are difficult, but it is possible to differentiate only with the help of special tests. Klebsiella Enterobacter and Serratia, which cause nosocomial pneumonia, urinary tract infection, bacteremia, have different sensitivity to antimicrobial drugs.
If the protection of the human body is weakened for some reason: general immunity is reduced, often influenza, SARS, the use of antibiotics, the use of contaminated, low-quality products, diabetes mellitus, alcoholism, etc., Klebsiella begins to actively multiply, release toxins, causing endotoxemia and inflammatory processes in different organs.
Diseases such as pneumonia, inflammatory diseases of the urinary tract, meningitis, conjunctivitis, intestinal infections, sepsis, and quite rare diseases such as ozena (fetid rhinitis), rhinoscleroma develop.
Klebsiella in feces. The most common cause of Klebsiella is pneumonia and intestinal damage. Pneumonia caused by Friedlander's bacillus is more common in adults. Due to the peculiarity of the immunity of newborns and their lack of normal microflora on the skin, in the respiratory tract and especially in the intestines - Klebsiella - Klebsiella oxytoca - often causes damage to the gastrointestinal tract - the large intestine.
Causes of Klebsiella infection
The source of infection is a person with Klebsiella infection and a carrier of Klebsiella. Klebsiella gets into the intestines with poor personal hygiene - from dirty hands, fruits and vegetables, and so on.
The susceptibility to infection is general, but the risk group for the occurrence of this infection: newborns and infants due to imperfect immune system; elderly persons with age-related immunodeficiency; persons with acquired immunodeficiency (chronic diseases, diabetes mellitus, oncology, blood diseases, patients after organ and tissue transplantation); persons suffering from chronic alcoholism.
Klebsiella in feces. Transmission factors - contaminated food most often (milk, meat products, vegetables, fruits). A patient with pneumonia is able to infect others by airborne droplets (when coughing and sneezing).
In the human body, Klebsiella form endotoxin (lipopolysaccharide of the Klebsiella capsule), which is formed when the microbe is destroyed and is the cause of an infectious-toxic reaction (fever, intoxication); thermostable enterotoxin, causing damage to the intestinal epithelium and effusion of fluid into its lumen (liquid watery stool); membranotoxin that damages cells and has hemolytic activity.
Diagnostics of the Klebsiella infection
Klebsiella in feces. The preliminary diagnosis is always clinical. There are no specific symptoms characteristic of this particular infection, therefore, a preliminary diagnosis is made without etiological decoding.
The final diagnosis is after a laboratory examination. The material for research is stool, sputum, mucus of the nasopharynx, oral cavity, cerebrospinal fluid, urine, bile, infiltrates and crusts from the nose, sectional material. The choice of material depends on the clinical form of the infection.
Research methods for Klebsiella infection:
- bacterioscopy (smears are stained according to Gram): under microscopy, thick gram-negative rods are visible, located singly, in pairs or in chains;
- bacteriological method (leading): sowing the material on nutrient media (K-2 selective medium, Endo and Ploskirev medium and others) with subsequent analysis of growing colonies of microorganisms. After 24 hours, growth of greenish-yellow and blue colonies with a metallic sheen is visible;
- serological methods (rarely used): agglutination reaction (RA) and indirect hemagglutination (RNGA) with the patient's blood serum. Diagnostic titer 1: 160 and higher. It is recommended to study paired sera taken 2 weeks later with a 4-fold increase in antibody titer;
- additional diagnostic methods: blood analysis, urine analysis, coprogram, instrumental diagnostic methods.
The main symptoms
Klebsiella in feces. After the harmful Klebsiella enters the body or its pathologization in the intestine, the incubation period begins, which can last from several hours to 2-3 days, depending on the intensity of infection. Symptoms usually start abruptly and are intense. If the pathological process develops in the gastrointestinal tract, when analyzing Klebsiella is found in feces, with the following signs of infection prevailing:
- acute abdominal pain;
- sharp jumps in temperature;
- liquefaction of feces;
- bloody spots and mucus in the stool;
- feeling unwell.
If the respiratory organs are affected, the following symptoms occur:
- increased sweating;
- general weakness;
- cough (immediately dry, then sputum with bloody impurities begins to separate);
- weak breathing;
- wheezing in the chest;
- the X-ray image clearly shows the confluence of infiltration foci.
Klebsiella pneumoniae in the taxonomy of bacteria
The species Klebsiella pneumoniae is included in the genus Klebsiella (lat.Klebsiella), the family of enterobacteria (lat.Enterobacteriaceae), the order of enterobacteria (lat.Enterobacteriales), the class of gamma-proteobacteria (lat. γ proteobacteria), type of proteobacteria (lat.the kingdom of bacteria), …
The outdated name for Klebsiella pneumoniae is Friedlander's bacillus. Karl Friedländer (German Carl Friedländer, 1847-1887) is a German microbiologist who isolated a pure culture of Klebsiella pneumoniae in 1882.
According to the results of the last revision of the Klebsiella taxonomy, two earlier separate species were assigned to the Klebsiella pneumoniae species as subspecies: Klebsiella pneumoniae subsp. ozaenae (formerly a separate species of Klebsiella ozaenae) Klebsiella pneumoniae subsp. rhinoscleromatis (formerly Klebsiella ozaenae), and the subspecies Klebsiella pneumoniae subsp. pneumoniae.
Klebsiella pneumoniae was originally identified as the microorganism causing pneumonia (hence its name). However, its role is not limited to infections of the respiratory system.
In general, Klebsiella pneumoniae is classified as a conditionally pathogenic microbe that is in a normal situation and in certain organs in a symbiotic relationship with the human body, and in other situations is the cause of infectious diseases.
Klebsiella pneumoniae (Friedlander's stick) in feces
In the modern world, there is an increase in infectious diseases caused by various opportunistic microorganisms, in particular, bacteria of the genus Klebsiella (lat. Klebsiella).
It is a rod-shaped microorganism of the Enterobacteriaceae family. There are four types of the Klebsiella genus. The most common is Friedlander's bacillus, which causes pneumonia and Klebsiella oxytoca - which affects the gastrointestinal tract - the large intestine.
Klebsiella lives in the body of perfectly healthy people, being one of the elements of the normal intestinal flora. Normally, klebsiella can be present on the skin, on the mucous membrane of the respiratory tract of humans and animals.
Diseases caused by Klebsiella are especially common in infants. This is due to the peculiarity of the immunity of babies and the failure at birth of normal microorganisms in the intestines, respiratory tract, and on the skin.
The bacterium can exist in soil, water, food, dust. It is one of the most common nosocomial infections. Klebsiella enters the gastrointestinal tract from poorly washed hands, vegetables and fruits, water, and soil.
When Klebsiella is in the body, it has a rod-like shape, but when it gets into the environment, it begins to change - it is rounded and covered with a special shell - a capsule! Thanks to this adaptation, Klebsiella are very resistant to environmental factors and high temperatures.
The symptoms of Klebsiella in infants are similar to those of dysbiosis. Therefore, for any stool disorder, it is imperative to donate the child's feces for analysis in order to accurately identify which bacteria caused a change in the child's condition.
In infants, Klebsiella can cause symptoms of a mild infectious disease, or, depending on the strength of the immune system, lead to a severe course: with fever, chills, fever, abdominal pain, diarrhea and severe dehydration.
Symptoms and signs of infections caused by Klebsiella, in particular infections of the genitourinary system, biliary tract and other organs of the gastrointestinal tract, are similar to those of infections caused by E. coli.
In addition, under the influence of Klebsiella, such serious illnesses as pneumonia, inflammatory diseases of the urinary tract, meningitis, conjunctivitis, or more rare diseases - ozena (fetid rhinitis), rhinoscleroma can develop.
Klebsiella are relatives of bacteria of the genus Serratia and the genus Enterobacter and they are difficult, but can only be differentiated using special tests. And this must be done because, Klebsiella, Serratia and Enterobacter have different sensitivity to antimicrobial drugs.
Intestinal diseases associated with Klebsiella are often caused by mixed flora.
When such symptoms appear, it is necessary to consult a doctor, and also donate the baby's feces for research. If Klebsiella was identified in the analysis, but the baby's disease is mild, then the treatment is carried out with probiotics, synbiotics - Normoflorins. Breastfeeding plays an important role in restoring immunity and normal microflora in a baby.
Comprehensive treatment of diseases caused by Klebsiella depends on the location and severity of the pathological process. Antibiotics are prescribed in severe cases according to sensitivity, with mild course or detection in analyzes, they are not used.
With a high contamination of Klebsiella and a severe form of the disease, complex therapy with antibiotics is prescribed. In some cases, a baby has an increased content of Klebsiella in the feces, but at the same time he feels normal. Then drugs with lacto- and bifidobacteria - biocomplexes Normoflorins are prescribed to displace excess Klebsiella, increase immunity and improve their own beneficial microflora.
Be sure to use drugs in the treatment that restore the intestinal microflora, because only in an organism with a normal healthy microflora, pathogenic flora will not be able to activate and develop! Antimicrobial therapy is generally recommended to start before culture and antibiotic susceptibility testing is available.
In this case, probiotics are indispensable - the Normoflorins biocomplexes containing the waste products of live lacto- and bifidobacteria with an active antiseptic, anti-inflammatory effect, has a therapeutic effect in klebsiellosis, which has been proven by comparing many years of practice and scientific research, which have shown the maximum effectiveness of Normoflorins (L and B with other bifido- and lactose-containing preparations.
Klebsiella - intestinal infection
Klebsiella (mainly Klebsiella pneumoniae, but also Klebsiella oxytoca, Klebsiella aerogenes and others) is a representative of the normal microflora of the human intestine. At the same time, Klebsiella can cause a number of gastrointestinal diseases.
Klebsiella can cause acute gastritis - an acute inflammation of the gastric mucosa, which occurs due to the effect of an infectious factor directly on the gastric mucosa. Usually this is due to the use of poor quality food, improper storage of mixtures and products, non-compliance with hygiene rules.
Klebsiella can begin to develop intensively, causing a pathological process in the gastrointestinal tract, in particular, after therapy with antibacterial drugs, the side effect of which is the suppression of the main representatives of the normal microflora of the gastrointestinal tract (bifidobacteria and others), inhibiting the excessive growth of Klebsiella.
In most patients, klebsibellosis occurs in the form of an intestinal infection and is characterized by an acute onset, nausea, vomiting, abdominal pain, diarrhea, fever and general weakness. The duration of the disease is 1–5 days. Sources of the causative agent of infection are a sick person and a carrier of bacteria.
The most common routes of transmission are food, airborne and contact-household. Transmission also occurs through contaminated food, especially meat and dairy products. Klebsiellosis is one of the most common nosocomial infections.
Stool analysis for Klebsiella
The number of Klebsiella in the feces is calculated when analyzing for dysbiosis. This is usually a type of Klebsiella pneumonia. The norm is no more than 105 Klebsiella per 1 g of feces. The presence of Klebsiella in the intestine does not always require antimicrobial therapy.
According to the Helix laboratory service, the reference values of the Klebsiella content in feces during microbiological examination of feces, both for patients under one year old and for patients over one year old, are: Klebsiella pneumoniaе - less than 104; Klebsiella oxytoca - less than 104; Klebsiella aerogenes - less than 104.
When treatment of Klebsiella in feces in an adult is not necessary
Klebsiella in feces. Changes in the normal composition of the intestinal microflora can cause significant digestive problems and often require treatment. At the same time, the intestinal flora has a great regenerative potential and in some situations is able to independently recover to a normal state without any treatment.
Thus, when detecting deviations in the bacteriological composition of the feces of an adult or a child, it is not always necessary to carry out treatment. The main argument in favor of refusing to treat dysbiosis is the absence of any symptoms of dysbiosis.
Dysbiosis treatment does not need to be carried out in the following situations:
- an increase in the number of Escherichia coli with normal enzymatic activity of more than 3-4 x 106 / g;
- a decrease in the number of Escherichia coli to 10 6 / g in children under one year old and to 2 x 106 million / g in older children and adults;
- an increase in the number of enterococci by more than 25%;
- the presence of epidermal or saprophytic staphylococcus, streptococci up to 25%;
- the presence of hemolyzing Escherichia coli, Proteus, Klebsiella, lactose-negative enterobacteria, Staphylococcus aureus in an amount of no more than 10% (103);
- the presence of Candida mushrooms in the amount of 104;
- any increase in the number of bifidobacteria and lactobacilli or a decrease in the number of bifidobacteria and lactobacilli to 106.
Features of the course of Klebsiella infection in pregnant women
During the patient's pregnancy, the doctor should be especially careful about the diagnosis and the timely initiation of treatment for the disease, since Klebsiella can lead to a number of serious complications for both the mother and the unborn baby.
During pregnancy, bacteriophages are the drugs of choice as they do not have the side effects of antibiotics. Treatment with other drugs is prescribed by a qualified specialist, based on the minimal negative effects of medications on the fetus.
Early pregnancy in case of infection involves an abortion to avoid mutation of the fetus under the influence of toxins or antibiotics. Late pregnancy with klebsiella infection suggests treatment that can help mom and baby who may have become infected in utero.
Infection with klebsiella during pregnancy can cause premature birth and recurrent miscarriage. In cases of frequently recurring spontaneously interrupting pregnancies, an analysis should be made to identify klebsiella.
Find out more:
- Klebsiella: what is it, causes, symptoms and treatment
- Klebsiella in an adult: symptoms, causes and treatment
- Klebsiella in infants: causes, symptoms and treatment