🚣🏿 🍥 🧔🏻 Klebsiella in children: symptoms, treatment and consequences 🙎🏽 💇🏼 🦌

The children's immune system is weak, and the body is often exposed to the negative effects of pathogenic bacteria. Laboratory tests can identify them and prescribe adequate treatment. The most common bacteria detected in young patients are various types of cocci. Sometimes the analysis reveals Klebsiella in children. What is this bacterium and what is it dangerous for a child, let's try to figure it out.

What is klebsiella?

Klebsiella (Klebsiella) - opportunistic prokaryotic microorganisms. They are part of one large family of enterobacteria such as Escherichia coli, Salmonella and others. Bacteria are gram-negative single capsule sticks. They have the form of an irregular oval with a size of 0.3-1.25 microns.

Klebsiella decompose almost all carbohydrates, grow in an environment with potassium cyanide. They remain viable after treatment with bactericidal soap and disinfectant preparations. Due to the 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. 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, the lake, urogenital organs, intestinal infections. Pathogens are often isolated in the microflora of newborns immediately after birth. Infection of infants can lead to the formation of severe lesions of the lung tissue, intestinal infections, toxicoseptic conditions with a fatal outcome.

Classification

The genus of capsule sticks Klebsiella is divided into biochemical species. Bacteria are classified into three main and several additional species. The main ones include:

Klebsiella pneumonia or Friedlander’s wand. Small coccobacillus, not forming a spore. It can be located singly, in pairs or form entire colonies (on agarized nutrient media). It affects mainly 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. It occurs in mixed infections. With intestinal infections in children, staphylococcus and Klebsiella are most often found. But most often the causative agent causes bronchitis and bronchiopneumonia.
Klebsiella ozena (Abel-Levenberg wand). Causes diseases of the upper respiratory tract. Inflammation is accompanied by dry, sticky secretions that emit a fetid odor, atrophy of the mucous membrane and skeleton of the nose. Most often, ozena is 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 wand). It affects the mucous membranes of the respiratory tract. Dense white nodules with viscous sputum appear in the nose and larynx. Infiltrates appear in the bronchi, which are later scarred.
Klebsiella oxytoc. It affects the joints, eyes, membranes of the brain, organs of the genitourinary system. The sticks cause septicopyemia and cause blood poisoning.

In young patients, Friedlander’s wand is most often detected. But Klebsiella oxytok in children is detected infrequently.

How a pathogen enters a child’s body

Pathogenic sticks are considered the causative agent of nosocomial infections. The pathogen can get from the hands of infected personnel, poorly processed catheters. In community-acquired conditions, Klebsiella is found on the surface of vegetables, frozen fish, and dairy products. Enterobacteria survive and even breed in the refrigerator.

The reason for the appearance of Klebsiella in the feces in a child is not always an infectious disease. Enterobacteria can be in the body of a child for a long time without causing pathological changes. The pathogen can be activated as a result of prolonged use of antibiotics, poor nutrition, digestive problems.

But still, more often than not, Klebsiella in children appears as a result of the following actions:

the use of contaminated, unboiled water;
the child eats raw, often not well-washed fruits and vegetables;
child's non-observance of simple hygiene rules: does not wash his hands after using the toilet, before eating, after walking;
improper hygiene of the mother: she does not wash her breast well before and after feeding, does not handle her hands well enough;
close contact with a sick person: Klebsiella is transmitted by airborne droplets, during sneezing, and when coughing;
use of objects of a sick person: young children drag toys that a sick child played in their mouths.

Despite the fact that capsular bacteria are highly survivable, certain conditions are necessary for their active growth. The risk group includes:

infants;
Born earlier than the deadline;
having genetic or congenital malformations;
children from asocial families: the mother suffers from alcoholism or drug addiction, and she does not follow the child well;
HIV infected
often ill and undergoing treatment in a hospital setting.

In some children, allergies become a favorable breeding ground for Klebsiella.

Clinical picture

After capsular bacteria enter the body, the incubation period begins. Its duration depends on the type of pathogen, state of immunity and a number of other individual characteristics. The period from the moment of penetration into the body to the onset of the first symptoms can range from several hours to several days.

During the period of active development of Klebsiella, the symptoms in the child are slightly different and depend on the localization of enterobacteria. If the pathogen affects the respiratory tract, then the clinical picture will be as follows:

a sharp increase in temperature;
fever, chills;
difficulty in nasal breathing, the appearance of mucous secretions with a fetid odor;
redness, swelling of the larynx;
cough appears first dry during the day, then wet longer at night;
the child does not get enough sleep, cries and is capricious;
violation of the frequency and depth of breathing.

With the defeat of the gastrointestinal tract by Klebsiella in children, the following clinical manifestations are observed:

first paroxysmal, then intense abdominal pain;
gas formation intensifies;
nausea, not always accompanied by vomiting;
the child refuses food, even favorite foods;
stool is broken: it becomes liquid, frequent, mucus visible in the eye, streaks of blood appear in the feces;
due to frequent stool, the anal opening is irritated, hyperemia occurs, sometimes a small rash;
an increase in temperature is observed in weakened children or with prolonged failure to provide medical care.

Klebsiella in the throat of a child

The microflora of the mouth includes a huge number of different microorganisms. Bacteria enter not only with products, 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 suggests that the body is undergoing an inflammatory process.

Most often, in the throat, Klebsiella pneumonia, oxytoku, ozena, rhinosleroma are detected in the child. Bacteria cause severe respiratory infections. 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 ingestion of the Frisch-Volkovich stick. Symptoms are the same as with a cold. Parents begin to independently treat the child, 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 and others). Ozena is not common 1-3% of all diseases of the nose. Most often, girls aged 7-8 are sick. Pathology can cause complications: sinusitis, sphenoiditis, conjunctivitis, keratitis, chronic otitis media.
Klebsiella pneumonia, despite its name, pneumonia causes 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. Friedlander’s pneumonia often causes pulmonary and extrapulmonary complications: exudative pleurisy, abscesses, sepsis.

Klebsiella in feces

Klebsiella pneumonia, oxytoka and others are representatives of the normal intestinal flora, provided that their number is less than 10⁴. With a higher content, the capsular bacterium causes gastroenterological diseases.

In a child, Klebsiella enters the feces from the intestines. In the digestive organ, enterobacteria produces enterotoxins. These are polypeptide bacteria that interfere with the ability to absorb nutrients from the intestinal lumen. This pathological condition significantly increases the risk of imbalance in the intestinal flora and the development of other pathogens. The main sign of the presence of enterotoxin in the intestine is liquid watery stool in a child.

In addition to enterotoxin, Klebsiella produces membranotoxin. They increase the penetration of the cell membrane for ions of hydrogen, potassium, sodium. 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 is "hosted" in the intestine. In the feces of the child, when passing tests, other pathogenic bacteria may be present. Usually this is 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, viral diseases. A weak organism 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 infects young children whose immunity is just beginning to form.

Premature babies are more prone to infectious diseases than others. The danger is that the pathological process in weak children is progressing at an accelerated pace. Infection usually occurs immediately after discharge. The sterility of the hospital changes dramatically to normal conditions, it is difficult for the body to withstand so many microbes. In premature infants, Klebsiella can simultaneously cause intestinal upsets and pneumonia.

But Klebsiella is often found in children who were born on time. Symptoms of capsular bacterial damage are the same as with intestinal disorders:

The baby begins to defecate often, while the stool becomes more fluid each time.
The color of feces changes, it becomes a yellow-green hue. There are mucus, fragments of undigested food (if the baby is already complementary), streaks of blood. A specific sour smell appears.
Abundant regurgitation "fountain". Such a symptom should alert parents, it occurs only with intestinal lesions by pathogenic microbes.
Bloating. When building the baby begins to cry, constantly naughty.
With the occurrence of Klebsiella in a child a year, an increase in temperature is often observed. This is evidence that there is already immunity and the body is trying to fight the pathogen.

How is the diagnosis

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 in infants, can lead to fatal consequences.

The doctor first conducts an anamnesis. By the symptoms, you can understand which system the enterobacteria affects. After a physical examination, the doctor prescribes various laboratory tests:

Sowing on nutrient media. In the feces of a child, Klebsiella for pneumonia is detected using an analysis of dysbiosis. The test also shows the presence of resistance to certain antibacterial drugs. The results are the basis for determining the antibiotic with which the therapy will be carried out.
Gram stain. The method allows you to classify 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 can 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 carried out.
Coprogram. Using the method, a disease is diagnosed, especially the infection process. The analysis is prescribed at any age.

When confirming the presence of Klebsiella in the body of children, treatment is prescribed taking into account the type of bacterium, the age of the child. Antibacterial therapy is carried out under the strict supervision of a pediatrician. In some cases, it is carried out stationary.

Klebsiella in a child: how to treat?

Therapeutic tactics depend on the age of the patient, the features of the course and stage of the disease. In most cases, treatment is carried out on an outpatient basis, with the exception of babies with congenital pathologies or very weak immunity.

The treatment is carried out using antibacterial drugs. But infants do not want to use antibiotics, because they have a large number of side effects. they are replaced by bacteriophages. Features of the treatment of Klebsiella bacteriophages:

the drug is taken three times a day before meals (for 20-30 minutes), if the baby while breastfeeding can drink the medicine before feeding;
the maximum single dose for children from birth to six months is 5 ml;
6-12 months - 10 milliliters;
from one to three - 15 ml;
from three to seven - 20 ml;
for children older than seven years, a single dose is calculated depending on the weight.

Klebsiella in a child 2 years of age and older is treated with safe antibacterial drugs. The most effective are cephalosporins ("Cefazolin", "Cephalexin") and fluoroquinolones ("Ciprofloxacin"). Penicillins (Amoxiclav) may also be prescribed, but they are considered less effective.

To restore and strengthen the natural microflora, probiotics are shown: Bifiform, Bifidumbacterin, Linex for Children, Acipol, Probifor and others. Probiotics are drunk during antibiotic therapy and two more weeks after its completion.

Pathogenetic treatment is carried out:

NSAIDs (antipyretic): Paracetamol, Nurofen;
immunomodulators: Kipferon, Genferon Light;
antihistamines: "Zodak", "Zirtek".

Symptomatic treatment:

in case of vomiting, Motilium is prescribed in suspension, for children from 12 years old it is possible in tablets;
with diarrhea take "Stopdiar", "5-NOC", "Enterofuril";
during dehydration, the child is given the Regidron and Hydrovit regulators of the water-electrolyte balance.

Effects

With timely and adequate treatment of Klebsiella in children, the prognosis is favorable. With late treatment or lack of therapy, the infection spreads rapidly and causes sepsis - a dangerous condition, especially for a child. In addition to a systemic inflammatory reaction, there may be other serious consequences:

One of the common complications of capsular bacteria in the intestines is chronic dyspepsia. The disease is accompanied by nausea, vomiting, constant epigastric pain, bleeding in different parts of the intestine.
With inadequate Klebsiella therapy, newborns may develop hemorrhagic diathesis. The disease is characterized by vomiting with blood, tarry stools, internal hemorrhages.
Meningitis and cerebral edema.
Acute pulmonary failure.

Even after correctly conducted therapy, the protective functions of the body are greatly weakened. young children are often re-infected. The danger is that the pathogen is widespread and has high resistance. In order to avoid relapse, it is necessary to carefully monitor hygiene, wash vegetables and fruits, and it is better to heat them. At first, to protect the child from a large crowd of people, contact with carriers of infections transmitted by airborne droplets.

To date, no vaccine against Klebsiella has been developed. The main preventive measure is compliance with hygiene rules and strengthening the child’s immunity.

Klebsiella in children: symptoms, treatment and consequences