Klebsiella infection is one of the 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 inhabit 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 determination of a treatment regimen.
What kind of microorganism?
Klebsiella is a representative of enterobacteria, which is part of the microflora of the human intestinal tract. It has the following features:
- gram-negative bacillus;
- small size;
- motionless;
- located singly, in pairs or in the form of a chain;
- anaerobic (multiplies in the absence of oxygen, but can live in its presence);
- has the ability to encapsulate in order to tolerate adverse conditions.
In appearance, Klebsiella pneumonia, Klebsiella oxytoku, Frisch-Volkovich stick, Abel-Lavenberg stick, Klebsiella terrigen, Klebsiella plantikola are distinguished. Most often, the first two types of bacteria are involved in the defeat of the body.
Causes of the disease
An infected person becomes a source of the spread of the disease. Pathology can manifest itself in the form of inflammatory processes of 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 characteristic of pathological strains entering the gastrointestinal tract. This happens through unwashed hands, food.
The risk of the disease is increased for the following population groups:
- babies from birth and infants;
- aged people;
- patients with chronic pathologies;
- a history of transplant patients;
- suffering from chronic alcoholism, drug addiction.
Klebsiella may be present for a long time after ingestion in the form of 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 defense (HIV infection, prematurity, weakening of the body after a previous infectious disease);
- unsanitary conditions and violation of hygiene standards - unwashed hands, animal hair, and even breast milk can cause Klebsiella 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 route of entry of the microorganism, there are lesions of various systems: the 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 becomes wet with the presence of blood and pus in the separated veins. Sputum has the smell of rot; shortness of breath appears even at rest. X-rays show infiltrates of various sizes, 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 appears. Pneumonia in the urine can be detected when it is introduced with a blood stream into the organs of the genitourinary system.
Rhinoscleroma and upper respiratory tract damage
Granulomas appear on the mucous membranes, in which bacteria are localized. The patient complains of constant congestion, which is not removed by vasoconstrictor drugs. In the nasal cavity, crusts appear, emitting a fetid odor and bleeding when removed.
Later, the mucous membrane atrophies, a person ceases to perceive odors to a sufficient extent. A small amount of viscous thick sputum forms, which is difficult to leave. It is accompanied by a sensation of a lump in the throat, tickling, subfebrile condition.
Digestive tract infection
The disease is often caused by two types of rods: Klebsiella pneumonia and oxytocia. Depending on where the bacteria are located, gastritis, enterocolitis, enteritis may develop. The patient has the following symptoms of infection:
- stomach ache;
- heartburn attacks;
- nausea and vomiting;
- lack of appetite;
- weakness;
- high body temperature;
- liquid frequent stools with streaks of blood, mucus, green spots, has the smell of rot.
Klebsiella oxytok in urine, like the bacterium pneumonia, is determined against the background of infection by the ascending or hematogenous route. This is characteristic of newborns and infants, as well as elderly people who, for medical reasons, cannot service themselves on their own.
Genitourinary system
Klebsiella in the urine of a child or adult can also talk about 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. The clinical manifestations of infection do not differ in specificity, therefore, they require correctly conducted differential diagnosis.
Klebsiella cystitis is characterized by:
- frequent painful urination;
- sensation of itching and burning;
- urine becomes cloudy, excreted dropwise, may have blood impurities;
- subfebrile condition;
- nausea;
- Klebsiella in the urine, determined by the bacteriological method of research.
Pyelonephritis is manifested as follows:
- fever;
- aching pain in the lumbar region;
- dysuria accompanied by soreness;
- dyspeptic manifestations in the form of nausea and vomiting;
- signs of intoxication;
- Klebsiella in the urine, determined by the bacteriological method of research.
Symptoms of prostatitis:
- dysuria;
- the feeling that the bladder is constantly full;
- pain in the groin and stomach;
- sexual dysfunction;
- nervousness, depression;
- Klebsiella in the urine, detected by a bacteriological method of research.
Features of infection of 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 replaced in the future by connective tissue. A similar process reduces the amount of oxygen supplied not only to the mother's body, but also to the baby.
How is Klebsiella treated? Pneumonia in the urine during pregnancy requires the use of antibacterial agents, and in the early 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 less traumatic for the baby's body.
Infection of newborns and infants
The disease is characteristic of premature babies who have symptoms of damage to the central nervous system and muscle system. Gram-negative bacilli 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 light weight for 2-3 days from the onset of the manifestations of the disease. The skin turns 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 an infant and a newborn can appear due to its ingestion by the hematogenous or ascending route when the urinary organs come in contact with feces.
Methods for the determination of Klebsiella in urine
The following diagnostic methods are used:
- Bacterioscopy - apply the material to a Petri dish, carry out Gram staining.
- Bacteriological method - the material is sown on a nutrient medium and microbial growth indicators are evaluated.
- Serological method - determine the presence and level of antibodies in the patient's blood serum to the causative agent of the disease.
- General clinical tests, coprogram, instrumental methods.
Therapy Features
Klebsiella in the urine, the treatment of which should be timely and comprehensive, requires the appointment of etiotropic, pathogenetic, and syndromic therapy. Mild manifestations of the disease allow outpatient treatment, in other cases, hospitalization in the hospital of the infectious department is necessary.
For outpatient therapy use:
- Probiotics are 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 in urine is determined during pregnancy.
Children under adolescence and people with a severe form of the disease require mandatory hospitalization. In such cases, antibacterial agents are prescribed with the mandatory determination of the sensitivity of pathogens to drugs. The following groups of antibiotics are selected depending on age:
- penicillins - "Ampicillin", "Ampioks";
- aminoglycosides - "Streptomycin", "Monomycin";
- cephalosporins - "Cefotaxime", "Ceftriaxone";
- tetracyclines - "Tetraolean", "Tetracycline";
- fluoroquinolones - Ciprofloxacin, Ofloxacin.
Pathogenetic therapy requires the use of antipyretic, detoxification drugs, as well as rehydration agents. A specialist can prescribe antiemetic and expectorant medicines, herbal preparations. A vaccine for the prevention of Klebsiella infection has not been developed. Preventive measures include hygienic education of children, strengthening immunity and timely treatment of chronic foci of infection in the body.