Klebsiella infection is one of the most common diseases that has a wide clinical picture from mild symptoms to septic manifestations. The microorganism belongs to the category of conditionally pathogenic, that is, those that can live on the mucous membranes without causing the development of pathology.
Klebsiella in urine, feces or other body fluids is an important diagnostic factor requiring a complete examination and treatment regimen.
What kind of microorganism?
Klebsiella is a representative of enterobacteria, which is part of the microflora of the human intestinal tract. Has the following features:
- gram negative rod;
- small size;
- fixed;
- located singly, in pairs or as a chain;
- anaerobic (reproduces in the absence of oxygen, but can live with itstock);
- has the ability to encapsulate in order to endure adverse conditions.
Klebsiella pneumoniae, Klebsiella oxytoca, Frisch-Volkovich stick, Abel-Lavenberg stick, Klebsiella terrigen, Klebsiella planticol are distinguished by appearance. Most often, the first two types of bacteria are involved in the defeat of the body.
Causes of disease
An infected person becomes a source of the spread of the disease. Pathology can manifest itself in the form of inflammatory processes in the lungs. In this case, the bacteria enter the body with inhaled contaminated air when talking, coughing, sneezing. The fecal-oral route of infection is typical for pathological strains to enter the gastrointestinal tract. This happens through unwashed hands, food.
The following populations are at increased risk of disease:
- children from birth and toddlers;
- older people;
- patients with chronic pathologies;
- transplant patients in history;
- suffering from chronic alcoholism, drug addiction.
Klebsiella can exist for a long time after ingestion as a safe strain. But there are a number of provocative factors that cause the transition of bacteria into a pathological state through active growth and reproduction:
- low level of immune protection (HIV infection, prematurity, weakening of the body after an infectious disease);
- unsanitary conditions andviolation of hygiene standards - unwashed hands, animal hair and even breast milk can cause Klebsiella to be found in the urine;
- prolonged use of antibacterial agents;
- respiratory viral infections;
- systemic pathologies (e.g. diabetes mellitus);
- bad habits (drug addiction, alcoholism).
Pneumonia
Depending on the way the microorganism enters, there are lesions of various systems: respiratory, genitourinary, circulatory, gastrointestinal tract, nose and upper respiratory tract. Patients are concerned about a sharp rise in temperature, weakness, increased sweating, chills. A dry cough appears, which later turns into a wet one with streaks of blood and pus in the discharge. The sputum has a smell of rot, shortness of breath appears even at rest. On x-ray, infiltrates of various sizes are visible, which can be single or merge with each other. The lack of timely therapy leads to a generalization of the infectious process with damage to other organs (brain, liver, kidneys).
This is how Klebsiella manifests itself. Pneumonia in the urine can be detected when it enters the bloodstream into the organs of the genitourinary system.
Rhinoscleroma and upper respiratory disease
Granulomas appear on the mucous membranes, in which bacteria are localized. The patient complains of constant congestion, which is not relieved by vasoconstrictor drugs. Scabs appear in the nasal cavity, emit a fetid odor and bleed when removed.
Later, the mucous membrane atrophies, the person ceases to perceive smells sufficiently. A small amount of viscous thick sputum is formed, which is difficult to pass. Accompanied by a sensation of a lump in the throat, perspiration, low-grade fever.
Gastrointestinal infection
The disease is most often caused by two types of sticks: Klebsiella pneumonia and oxytoca. Depending on where the bacteria are localized, gastritis, enterocolitis, enteritis can develop. The patient has the following symptoms of infection:
- stomach pain;
- heartburn attacks;
- nausea and vomiting;
- lack of appetite;
- weakness;
- high body temperature;
- loose frequent stools streaked with blood, mucus, green patches, rotten smell.
Klebsiella oxytoca in the urine, like the pneumonia bacterium, is determined against the background of infection by an ascending or hematogenous route. This is typical for newborns and infants, as well as older people who, for medical reasons, cannot serve themselves.
Urinary system damage
Klebsiella in the urine of a child or an adult can also speak of a primary infection of the urinary tract and reproductive system. The disease can occur in the form of acute or chronic pyelonephritis, cystitis, inflammation of the prostate gland. Clinical manifestations of infection do not differ in specificity, therefore, they require a properly conducted differential diagnosis.
Klebsiella cystitis is characterized by:
- increased painful urination;
- Itching and burning sensation;
- urine becomes cloudy, drips, may contain blood;
- subfebrile condition;
- nausea;
- Klebsiella in urine determined by bacteriological research method.
Pyelonephritis is manifested as follows:
- high body temperature;
- aching pain in the lumbar region;
- dysuria accompanied by soreness;
- dyspeptic manifestations in the form of nausea and vomiting;
- signs of organism intoxication;
- Klebsiella in urine determined by bacteriological research method.
Prostatitis symptoms:
- dysuria;
- Feeling like your bladder is constantly full;
- pain in the groin and abdomen;
- disorders of sexual function;
- nervousness, depression;
- Klebsiella in urine bacteriologically detected.
Features of infection in pregnant women
Infection of the lung tissue of pregnant women is fraught with serious consequences for the fetus, since bacteria tend to form infiltrates, which are later replaced by connective tissue. Such a process reduces the amount of oxygen supplied not only to the mother's body, but also to the child.
How is Klebsiella treated? Pneumonia in the urine during pregnancy requires the use of antibacterial agents, and onearly stages of embryogenesis, this is fraught with the development of congenital anomalies and mutations. In order to reduce the risk of developing such pathologies, pregnant women are prescribed bacteriophages instead of antibiotics. They are also effective against Klebsiella, but are less traumatic for the baby's body.
Infection of newborns and infants
The disease is typical for premature babies who have symptoms of damage to the central nervous system and muscular apparatus. Gram-negative rods can affect any organs up to the development of blood poisoning. Against the background of severe toxicosis, newborns can lose up to 0.5 kg of their already small weight for 2-3 days from the onset of the manifestations of the disease. The skin becomes gray with signs of acrocyanosis. The following clinic appears:
- convulsive seizures;
- high body temperature;
- hemodynamic disorders;
- damage to the heart muscle;
- acidosis.
Klebsiella in the urine of infants and newborns may appear due to its ingestion by the hematogenous or ascending route when the urinary organs come into contact with feces.
Methods for determining Klebsiella in urine
The following diagnostic methods are used:
- Bacterioscopy - apply the material to the Petri dish, carry out Gram staining.
- Bacteriological method - the material is sown on a nutrient medium and the growth rates of microorganisms are evaluated.
- Serological method - determine the presence and level of antibodies in serumthe patient's blood to the causative agent of the disease.
- General clinical tests, coprogram, instrumental methods.
Features of therapy
Klebsiella in the urine, the treatment of which should be timely and comprehensive, requires the appointment of etiotropic, pathogenetic and post-syndromal therapy. Mild manifestations of the disease allow outpatient treatment, in other cases, hospitalization in the infectious diseases department is necessary.
For outpatient therapy use:
- Probiotics - drugs that restore normal microflora. Representatives - "Bifiform", "Lactobacterin", "Bifikol", "Lineks". Accepted for 10-14 days.
- Bacteriophages can be used from birth. The dosage is selected by the doctor depending on the age of the patient.
The principle of such a treatment regimen is also used if Klebsiella is detected in the urine during pregnancy.
Children under adolescence and people with severe illness require mandatory hospitalization. In such cases, antibacterial agents are prescribed with a mandatory determination of the sensitivity of pathogens to drugs. Depending on age, the following groups of antibiotics are selected:
- penicillins - "Ampicillin", "Ampioks";
- aminoglycosides - "Streptomycin", "Monomycin";
- cephalosporins - "Cefotaxime", "Ceftriaxone";
- tetracyclines -"Tetraolean", "Tetracycline";
- fluoroquinolones - Ciprofloxacin, Ofloxacin.
Pathogenetic therapy requires the use of antipyretic, detoxifying drugs, as well as rehydration agents. The specialist can prescribe antiemetic and expectorant medicines, herbal preparations. A vaccine has not been developed to prevent Klebsiella infection. Preventive measures are hygienic education of children, strengthening of immunity and timely treatment of chronic foci of infection in the body.
