Children's immune system is weak and the body is often attacked by pathogenic bacteria. Laboratory tests allow to identify them and prescribe adequate treatment. The most common bacteria found in young patients are various types of cocci. Sometimes the analysis reveals Klebsiella in children. What is this bacterium and why is it dangerous for a child, let's try to figure it out.
What is Klebsiella?
Klebsiella are opportunistic prokaryotic microorganisms. They are part of one large family of enterobacteria such as Escherichia coli, Salmonella and others. The bacteria are gram-negative single capsular rods. They have the shape of an irregular oval with a size of 0.3-1.25 microns.
Klebsiella decompose almost all carbohydrates, grow in a medium with potassium cyanide. They remain viable after treatment with bactericidal soap and preparations.disinfectants. Due to resistance to many antibacterial drugs, these enterobacteria are ranked among the most dangerous. They die when heated for an hour to a temperature of 65 degrees. Sensitive to the action of solutions of chloramine, phenol.
Microorganisms are widespread. They are found in human feces, skin, mucous membranes of the respiratory tract. They can be found in soil, water, plant products.
In adults and children, the Klebsiella bacterium causes pneumonia, rhinoscleroma, lakes, lesions of the genitourinary organs, and intestinal infections. Pathogens are often isolated in the composition of the microflora of newborns immediately after birth. Infection of infants can lead to the formation of severe lesions of the lung tissue, intestinal infections, toxic and septic conditions with a fatal outcome.
Classification
The Klebsiella capsular genus is divided into biochemical species. Bacteria are classified into three main and several additional types. The main ones are:
- Klebsiella pneumonia or Friedlander's stick. A small coccobacillus that does not form spores. It can be located singly, in pairs or form whole colonies (on agar nutrient media). It mainly affects the mucous membranes of the lower respiratory tract, is one of the main causative agents of pneumonia. It also causes urinary tract infections, purulent inflammation of the liver parenchyma, spleen. Occurs in mixed infections. With intestinal infections in children, staphylococcus aureus and Klebsiella are found most often. But the most common pathogencauses bronchitis and bronchiopneumonia.
- Klebsiella ozena (Abel-Levenberg stick). Causes diseases of the upper respiratory tract. Inflammation is accompanied by dry, sticky secretions that emit a fetid odor, atrophy of the nasal mucosa and skeleton. Ozena is most often diagnosed at the age of 8-16 years. The pathological process can spread to the larynx, trachea. Often leads to loss of smell.
- Klebsiella rhinoscleroma (Frisch-Volkovich stick). It affects the mucous membranes of the respiratory tract. Hard white nodules with viscous sputum appear in the nose and larynx. Infiltrates appear in the bronchi, which later scar.
- Klebsiella oxytoca. It affects the joints, eyes, membranes of the brain, organs of the genitourinary system. Sticks cause septicopyemia and cause blood poisoning.
In young patients, Friedlander's wand is most often detected. But Klebsiella oxytoca is rarely found in children.
How a pathogen enters a child's body
Pathogenic rods are considered the causative agent of nosocomial infections. The pathogen can get from the hands of infected personnel, poorly treated catheters. Out-of-hospital conditions, Klebsiella is found on the surface of vegetables, frozen fish, and in dairy products. Enterobacteria survive and even multiply in the refrigerator.
The reason for the appearance of Klebsiella in the feces of a child is not always an infectious disease. Enterobacteria can stay in the body of a child for a long time without causing pathological changes. The pathogen can become activated as a result of prolonged use of antibiotics, poor nutrition, and digestive problems.
But still more often Klebsiella in children appears due to the following actions:
- consumption of contaminated, unboiled water;
- child eats raw, often not well washed fruits and vegetables;
- child's failure to follow simple hygiene rules: not washing hands after going to the toilet, before eating, after walking;
- Inadequate maternal hygiene: does not wash her breasts well before and after feeding, does not clean her hands well enough;
- close contact with a sick person: Klebsiella is transmitted by airborne droplets, during sneezing, when coughing;
- Using objects of a sick person: young children put toys used by a sick child into their mouths.
Despite the fact that capsular bacteria are highly survivable, certain conditions are necessary for their active growth. The risk group includes:
- infants;
- premature;
- having genetic or congenital malformations;
- children from asocial families: mother suffers from alcoholism or drug addiction, badly monitors the child;
- HIV-positive;
- frequently ill and undergoing treatment in a hospital.
In some children, the presence of allergies becomes a favorable environment for the reproduction of Klebsiella.
Clinical picture
After the entry of capsular bacteria intobody enters an incubation period. Its duration depends on the type of pathogen, the state of immunity and a number of other individual characteristics. The period from the moment of penetration into the body to the appearance of the first symptoms can be from several hours to several days.
During the period of active development of Klebsiella, the symptoms in a child are slightly different and depend on the localization of enterobacteria. If the pathogen has hit the respiratory tract, then the clinical picture will be as follows:
- a sharp rise in temperature;
- feverish, chills;
- difficulty in nasal breathing, the appearance of mucous discharge with a fetid odor;
- redness, swelling of the larynx;
- cough appears first daytime dry, then wet more at night;
- the child does not get enough sleep, cries and is naughty;
- violation of the frequency and depth of breathing.
When the gastrointestinal tract is affected by Klebsiella in children, the following clinical manifestations are observed:
- first paroxysmal, then intense abdominal pain;
- gas formation increases;
- nausea, not always accompanied by vomiting;
- child refuses food, even favorite foods;
- the stool is disturbed: it becomes liquid, frequent, mucus visible to the eye, streaks of blood appear in the feces;
- due to frequent stools, the anus is irritated, hyperemia occurs, sometimes a small rash;
- fever is observed in debilitated children or with prolonged lack of medical care.
Klebsiella in throatbaby
Microflora of the mouth includes a huge number of different microorganisms. Bacteria get not only with food, but also by inhalation, conversation. Normally, Klebsiella in a child at 3 years old or at any other age should be absent. The presence of enterobacteria indicates that an inflammatory process is taking place in the body.
Most often in the pharynx, Klebsiella pneumonia, oxytoca, ozena, rhinosleroma are detected in a child. The bacteria cause severe respiratory diseases. According to statistics, 35.7% of them are fatal. Different types of Klebsiella cause certain diseases.
- Klebsiella rhinoscleroma is the causative agent of scleroma. This is an inflammatory process that affects the walls of the respiratory tract with the formation of connective tissue nodules (granulomas). The danger of the disease is that it begins to develop 2-3 years after the Frisch-Volkovich stick enters the body. The symptoms are the same as with a cold. Parents begin to treat the child on their own, which complicates the situation.
- Klebsiella ozena causes the disease of the same name. It is characterized by an atrophic process of the structures of the nose (mucosa, cartilage, etc.). Ozena occurs infrequently 1-3% of all nasal diseases. Most often, girls aged 7-8 years are ill. Pathology can cause complications: sinusitis, sphenoiditis, conjunctivitis, keratitis, chronic otitis media.
- Klebsiella pneumonia, despite its name, causes inflammation of the lung tissue in 2-4% of all patients with pulmonary pathologies. But the disease is very dangerous, especially if it occurs in a child. The main reasons for the development of Klebsiella pneumoniae in children are too weak immunity and frequent pathologies of the respiratory tract. Friedländer's pneumonia often causes pulmonary and extrapulmonary complications: exudative pleurisy, abscesses, sepsis.
Klebsiella in feces
Klebsiella pneumonia, oxytoca and others are representatives of the normal intestinal flora, provided that their number is less than 10⁴. At higher levels, the capsular bacterium causes gastroenterological diseases.
In a child, Klebsiella enters the feces from the intestines. In the digestive organ, enterobacteria produce enterotoxins. These are polypeptide bacteria that disrupt the ability to absorb nutrients from the intestinal lumen. This pathological condition significantly increases the risk of imbalance of the intestinal flora and the development of other pathogens. The main sign of the presence of enterotoxin in the intestines is loose, watery stools in a child.
In addition to enterotoxin, Klebsiella produces membranotoxin. They increase the permeability of the cell membrane for hydrogen, potassium, sodium ions. This leads to the destruction of cells and a violation of the pH of the blood.
Dysbacteriosis in children most often develops due to the fact that Klebsiella pneumonia “hosts” the intestines. Other pathogenic bacteria may also be present in the feces of a child during testing. This is usually due to the fact that capsular enterobacteria greatly weakens the immune system, which contributes to the attachment of secondary infections. Children often get sick with colds, viraldiseases. A weak body is the best breeding ground for Klebsiella.
Klebsiella in newborns
The best favorable background for the development of Klebsiella is a weak organism. Therefore, most often the bacterium affects young children, whose immunity is just beginning to form.
Children born prematurely are more prone to infectious diseases than others. The danger is that the pathological process in weak children progresses at an accelerated pace. Infection usually occurs immediately after discharge. The sterility of the hospital abruptly changes to normal conditions, it is difficult for the body to resist such a number of microbes. In premature babies, Klebsiella can simultaneously cause intestinal disorders and pneumonia.
But Klebsiella is often found in children who were born at term. The symptoms of capsular bacteria are the same as for intestinal disorders:
- Baby begins to defecate frequently, with looser stools each time.
- The color of the feces changes, it becomes a yellow-green hue. Mucus, fragments of undigested food (if the baby is already on complementary foods), streaks of blood are observed. A specific sour smell appears.
- Abundant regurgitation "fountain". Such a symptom should alert parents, it occurs only when the intestines are affected by pathogenic microbes.
- Bloating. When completing the construction, the baby starts to cry, is constantly naughty.
- When Klebsiella occurs in a child, a rise in temperature is often observed in a year. itevidence that there is already immunity and the body is trying to fight the pathogen.
How the diagnosis is made
With symptoms similar to the development of respiratory diseases or pathologies of the housing and communal services, it is necessary to immediately show the child to the pediatrician. Self-medication, especially for infants, can be fatal.
The doctor first of all takes an anamnesis. By the symptoms, you can understand which system is affected by enterobacteria. After the physical examination, the doctor orders various laboratory tests:
- Sowing on nutrient media. In the feces of a child, Klebsiella for pneumonia is detected using an analysis for dysbacteriosis. The test also shows the presence of resistance to certain antibacterial drugs. The results are the basis for determining the antibiotic with which therapy will be carried out.
- Gram stain. The method allows classifying bacteria depending on the structure and cell wall into gram-positive and gram-negative. The method allows to differentiate Staphylococcus pneumococcus from Klebsiella pneumonia.
- Serological methods allow you to determine the type of pathogen and the presence of antibodies to it. The studied biomaterial is blood from a vein. In very young children, such a study is rarely done.
- Coprogram. With the help of the method, the disease is diagnosed, the features of the infectious process. Analysis is prescribed at any age.
When confirming the presence of Klebsiella in the body in children, treatment is prescribed taking into account the typebacteria, the age of the child. Antibacterial therapy is carried out under the strict supervision of a pediatrician. In some cases, it is carried out permanently.
Klebsiella in a child: how to treat?
Therapeutic tactics depend on the age of the patient, the characteristics of the course and the stage of the disease. In most cases, treatment is carried out on an outpatient basis, with the exception of infants with congenital pathologies or very weak immunity.
Treatment is carried out with the help of antibacterial drugs. But infants should not use antibiotics because they have a large number of side effects. they are replaced by bacteriophages. Features of Klebsiella therapy with bacteriophages:
- the drug is taken three times a day before meals (for 20-30 minutes), if the child is breastfed, you can drink the medicine before feeding;
- maximum single dose for children from birth to six months is 5 ml;
- 6-12 months - 10 milliliters;
- from one to three years - 15 ml;
- three to seven - 20 ml;
- For children over seven years of age, a single dose is calculated based on weight.
Klebsiella in a child 2 years of age or older is treated with safe antibacterial drugs. The most effective are cephalosporins ("Cefazolin", "Cefalexin") and fluoroquinolones ("Ciprofloxacin"). Penicillins (Amoxiclav) may also be prescribed, but they are considered less effective.
Probiotics are shown to restore and strengthen the natural microflora: Bifiform, Bifidumbacterin,"Linex for children", "Acipol", "Probifor" and others. Probiotics are drunk during antibiotic therapy and two weeks after it ends.
Pathogenetic treatment is being carried out:
- NSAIDs (antipyretics): Paracetamol, Nurofen;
- immunomodulators: "Kipferon", "Genferon Light";
- antihistamines: Zodak, Zyrtec.
Symptomatic treatment:
- for vomiting, "Motilium" is prescribed in suspension, children from 12 years old can be in tablets;
- with diarrhea take "Stopdiar", "5-NOC", "Enterofuril";
- in case of dehydration, the child is given water and electrolyte balance regulators Regidron, Hydrovit.
Consequences
With timely and adequate treatment of Klebsiella in children, the prognosis is favorable. With late presentation or lack of therapy, the infection spreads rapidly and causes sepsis, a dangerous condition, especially for a child. In addition to the systemic inflammatory response, there may be other severe consequences:
- One of the common complications of capsular bacteria in the intestine is chronic dyspepsia. The disease is accompanied by nausea, vomiting, constant pain in the epigastrium, bleeding in different parts of the intestine.
- In newborns with inadequate Klebsiella therapy, hemorrhagic diathesis may develop. The disease is characterized by vomiting of blood, tarry stools, internal hemorrhages.
- Meningitis and cerebral edema.
- Acute pulmonary failure.
Even after well-conducted therapy, they are greatly weakenedprotective functions of the body. young children are often re-infected. The danger lies in the fact that the pathogen is widespread and highly resistant. To avoid recurrence, it is necessary to carefully monitor hygiene, wash vegetables and fruits, and it is better to subject them to heat treatment. At first, protect the child from large crowds of people, contact with carriers of infections transmitted by airborne droplets.
To date, vaccines against Klebsiella have not been developed. The main preventive measure is hygiene and strengthening the child's immunity.
