When is Klebsiella normal?
The bacterium belongs to the opportunistic flora: it is present in the intestines of many healthy people and does not cause disease as long as the balance of the microflora and normal immunity are maintained. Therefore, its detection in stool culture in the absence of complaints, normal stool and good health does not require either antibiotics or bacteriophages. The same applies to a finding in a throat swab from an asymptomatic person. A separate common situation is the so-called asymptomatic bacteriuria, when the microbe is found in the urine without any complaints: in most adults it is not treated, exceptions are determined by the doctor.
- Detection in stool without symptoms is not a disease
- A throat swab in a healthy person does not need to be treated
- Asymptomatic bacteriuria does not require antibiotics in most people
- The concept of dysbiosis as a diagnosis is not used
- The decision about treatment is made according to the clinic, and not according to the number on the form
What infections does it cause?
Klebsiella most often causes urinary tract infections, especially in people with a catheter, kidney stones, prostate adenoma and diabetes. In second place is pneumonia, which usually develops in weakened and elderly patients, with alcoholism and chronic lung diseases, and is severe, with thick viscous sputum. The bacterium also causes suppuration of postoperative wounds, infections due to venous catheters and sepsis. In newborns and children in the first months, the infection can be severe and require hospital treatment.
- Cystitis and pyelonephritis
- Pneumonia, including hospital-acquired
- Wound infection and abscesses
- Catheter-associated bloodstream infections
- Sepsis in weakened patients
- Infections in newborns
Symptoms
Manifestations depend on the organ, and not on the microbe itself. With a urinary tract infection, this is pain and frequent urination, pain in the lower abdomen, and when the infection rises, it is fever and pain in the lower back. Pneumonia causes fever, cough with thick sputum, shortness of breath and chest pain. A wound infection produces redness, swelling, pain and purulent discharge. Common warning signs for any form are high fever with chills, severe weakness, drop in blood pressure and confusion: they indicate the possible spread of infection into the blood.
- Pain and frequent urination, lower back pain
- Fever with chills
- Cough with thick sputum, shortness of breath
- Purulent discharge from a wound
- Weakness, low blood pressure, confusion
- In infants - lethargy, refusal to eat, fever
Diagnostics
The key study is bacteriological culture of material from the lesion: urine, sputum, wound discharge, blood. It is important not only to identify the microbe, but also to determine its sensitivity to antibiotics, because Klebsiella is often resistant to standard drugs. Urine is collected correctly, in a medium portion after toileting the external genitalia, otherwise the result will be false. The picture is completed by a general analysis of urine and blood, C-reactive protein, and if pneumonia is suspected, a chest x-ray. For repeated urinary tract infections, a kidney ultrasound and examination by a urologist are performed.
- Culture of urine, sputum, wound fluid, or blood
- Mandatory antibiotic sensitivity testing
- Correct urine collection in medium portions
- General analysis of urine and blood, C-reactive protein
- Chest X-ray for cough and shortness of breath
- Ultrasound of the kidneys for repeated infections
Treatment and prevention
The antibiotic is chosen based on the culture result, and not empirically, if the condition allows. The course is carried out completely, in the prescribed dose and duration: the untreated infection returns and contributes to the emergence of resistant strains. Bacteriophages, probiotics and plant uroseptics are not a substitute for antibacterial therapy for confirmed infection. An important part of treatment is eliminating the cause: removing or replacing the catheter, treating urolithiasis, controlling diabetes. Prevention comes down to hand hygiene, judicious use of antibiotics, catheter care, and timely treatment of chronic diseases.
- Antibiotic based on culture and sensitivity results
- Full course without self-cancellation
- Elimination of the catheter and other provoking factors
- Control of diabetes and chronic diseases
- Hand hygiene and wound care
- Avoiding self-medication with antibiotics
- Physician supervision for repeated episodes