klebsiella (friedlander’ bacillus) file/klebsiella by akram.pdf · introduction friendlander...

Klebsiella Klebsiella

(Friedlander Bacillus)(Friedlander Bacillus)

Professor Md. Akram HossainProfessor Md. Akram Hossain

12/25/201312/25/2013 11Prof. Muhammad Akram Hossain, Prof. Muhammad Akram Hossain, KlebsiellaKlebsiella

Review QuestionsReview Questions

Both Klebsiella & Esch coli are LF, How can you Both Klebsiella & Esch coli are LF, How can you differentiate?differentiate?

Why the colonies of Kelbsiella are mucoid ? How they Why the colonies of Kelbsiella are mucoid ? How they look like?look like?

Clinical importance of Klebsiella?Clinical importance of Klebsiella?

What are species of klebsiella?What are species of klebsiella?


IntroductionIntroduction

FriendlanderFriendlander firstfirst isolatedisolated thethe bacillusbacillusfromfrom lobarlobar pneumoniapneumonia inin 18831883..

IntestinalIntestinal flora,flora, causecause onlyonly extraintestinalextraintestinaldiseasesdiseases


TaxonomyTaxonomy

Five accepted species: Based on DNA hibridizationFive accepted species: Based on DNA hibridization

1.1. Klebsiella pneumoniaeKlebsiella pneumoniae

a)a) K.Pneumoniae pneumoniaeK.Pneumoniae pneumoniae

b)b) K.Pneumoniae aerogenesK.Pneumoniae aerogenesb)b) K.Pneumoniae aerogenesK.Pneumoniae aerogenes

c)c) K.Pneumoniae K.Pneumoniae oezaenaeoezaenae

d)d) K.Pneumoniae rhinoscleromatisK.Pneumoniae rhinoscleromatis

2.2. K.oxytocaK.oxytoca

3.3. K.platicolaK.platicola

4.4. K.terrigenaK.terrigena

5.5. K.group7K.group7


BiochemistryBiochemistry

Biochemistry:Biochemistry:

Ferment glucose, Lactose, Maltose, sucrose, Mannitol Ferment glucose, Lactose, Maltose, sucrose, Mannitol

by mixed acid fermentation by mixed acid fermentation

positive for Indole and methyl red reaction.positive for Indole and methyl red reaction. positive for Indole and methyl red reaction.positive for Indole and methyl red reaction.

do not produce H2S, phenylalaninedeaminase or urease, do not produce H2S, phenylalaninedeaminase or urease,

do not utilize citrate do not utilize citrate

LSS +++LSS +++

GMM +++GMM +++

IMViC IMViC -- -- ++++


KlebsiellaKlebsiella SerologySerology

Serology:Serology:

KlebsiellaKlebsiella can be types by Capsular can be types by Capsular antigensantigens

K 80 recognized types K 80 recognized types (1(1--6 are most 6 are most K 80 recognized types K 80 recognized types (1(1--6 are most 6 are most

frequent in Respiratory tract)frequent in Respiratory tract)

Detected by capsular swelling test, Detected by capsular swelling test,

agglutination, CFT& Fluorescent testagglutination, CFT& Fluorescent test

O 5 recognized typesO 5 recognized types

Bacteriocin typing Bacteriocin typing --klebocinklebocin12/25/201312/25/2013 66Prof. Muhammad Akram Hossain, Prof. Muhammad Akram Hossain,

KlebsiellaKlebsiella

Morphology & cultural Morphology & cultural

characters characters

Nonmotile with capsuleNonmotile with capsule

GNB 1GNB 1--3umx0.4 um3umx0.4 um

Lactose Fermenter . Lactose Fermenter . form pink mucoid form pink mucoid colonies in MA medium.colonies in MA medium.


Virulence factorsVirulence factors

1.1. Endotoxin like other GNB.Endotoxin like other GNB.2.2. CapsuleCapsule-- Interferers with phagocytosisInterferers with phagocytosis

What is theWhat is the Clinical significance of Clinical significance of capsule?capsule?capsule?capsule?

Capsule acts as virulence factorCapsule acts as virulence factor Helps in diagnosis by detecting the Helps in diagnosis by detecting the

capsulecapsule Due to antigenicityDue to antigenicity

Serotyping Serotyping epidemiological importanceepidemiological importance Vaccination Vaccination Therapeutics importanceTherapeutics importance


Summary of EndotoxinSummary of Endotoxin

LPS

LPS-LBP

CD14

TLR4

Circulation

Details of endotoxin

TLR4

TNF

Fever tissue damage IL6 IL8 IL1 PAF

Toxic shock

Macrophages


Structure of a GramStructure of a Gram--Negative Cell Negative Cell

WallWall


Clinical infections Clinical infections --11

Varies with different speciesVaries with different species

K.oezaenae K.oezaenae OezenaOezena-- a disesase charactrized a disesase charactrized by foul smelling nasal discharge with progressive by foul smelling nasal discharge with progressive by foul smelling nasal discharge with progressive by foul smelling nasal discharge with progressive atrophy of mucus membranesatrophy of mucus membranes

K. rhinoscleromatisK. rhinoscleromatis-- rhinoscleromarhinoscleroma-- a a chronic granulomatous disease of the nose and chronic granulomatous disease of the nose and pharynxpharynx


Clinical infections by Clinical infections by

K.pneumoniaeK.pneumoniae

1.1. PneumoniaPneumonia-- community acquired pneumonia community acquired pneumonia & also hospital acquired pneumonia& also hospital acquired pneumonia

2.2. Urinary tract infection (UTI)Urinary tract infection (UTI)-- 22ndnd common cause common cause 2.2. Urinary tract infection (UTI)Urinary tract infection (UTI)-- 22 common cause common cause especially in hospital acquired casesespecially in hospital acquired cases

3.3. Nosocomial infectionsNosocomial infections

4.4. Other infectionsOther infections

SepticemiaSepticemia

Wound infectionsWound infections


Other important causes of Other important causes of

UTIUTI

1.1. Esch coliEsch coli2.2. KlebsiellaKlebsiella3.3. ProteusProteus4.4. ProvidenciaProvidencia5.5. CitrobacterCitrobacter5.5. CitrobacterCitrobacter6.6. AcinatobacterAcinatobacter7.7. PseudomonasPseudomonas8.8. Staph saprophyticus & S. aureusStaph saprophyticus & S. aureus9.9. Streptococcus Gr. D & Streptococcus Streptococcus Gr. D & Streptococcus

pyogenespyogenes


Antimicrobial sensitivityAntimicrobial sensitivity

UTI UTI fluoroquinolonesfluoroquinolones-- (ciporofloxacin, (ciporofloxacin, levofloxacin, Gatifloxacin)levofloxacin, Gatifloxacin)

Sepsis Sepsis 33rdrd generation cephalosporingeneration cephalosporin Sepsis Sepsis 33rdrd generation cephalosporingeneration cephalosporin


12/25/201312/25/2013 Prof. Muhammad Akram Hossain, Prof. Muhammad Akram Hossain, KlebsiellaKlebsiella

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