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WorksheetsRapid Lactose Fermenters - Klebsiella
Total questions: 20
Worksheet time: 11mins
- A.k.a. Friedlander's Bacillus (2022 trans)
- Present normally in nasopharynx and feces (5%)
Escherichia coli
Klebsiella
Enterobacter
- Common isolates of Klebsiella
- Responsible for Community-acquired pneumonia (CAP), Hospital-acquired pneumonia (HAP), UTI, wound infections, bacteremia, sepsis
K. pneumonia
K. oxytoca
K. granulomatis
Klebsiella Pneumoniae
Gram-positive
Gram-negative
Encapsulated
Non-capsulated
Klebsiella Pneumoniae
Coccobacillus bacteria which __________
ferments lactose
does not ferment lactose
VIRULENCE FACTORS
- Clone, community-acquired pyogenic liver abscess seen mostly among Asian males
- Phenotypically appears hypermucoviscous
K1-encapsulated strain
Capsule with K antigens
VIRULENCE FACTORS
Phagocytosis resistant, cover O-H antigens
K1-encapsulated strain
Capsule with K antigens
VIRULENCE FACTORS
- Expresses extended spectrum β-lactamases
- Confers resistance to a broad range of penicillins and
cephalosporins
- Still remains susceptible to carbapenems
K. pneumoniae sequence type 16
K. pneumoniae sequence type 258
VIRULENCE FACTORS
- Multidrug-resistant strain
- “Carbapenamase producer”
- Resistant to all β-lactam antibiotics, including broad spectrum carbapenem agents
K. pneumoniae sequence type 16
K. pneumoniae sequence type 258
CLINICAL MANIFESTATIONS
Autoimmune disease that is thought to be a possible sequelae of Klebsiella infection
Ankylosing spondylitis
K. pneumoniae
K. granulomatis
CLINICAL MANIFESTATIONS
- Lobar pneumonia with hemorrhagic necrotizing consolidation of the lung
Features:
- Upper lobe affectation
- "Currant jelly" sputum due to associated hemoptysis
- Abscess formation
K. pneumoniae
K. granulomatis
CLINICAL MANIFESTATIONS
Causes chronic genital ulcerative disease (granuloma inguinale)
Diagnosis: visualization of "Donovan bodies" is tissue smears/biopsy
Treatment: azithromycin
K. pneumoniae
K. granulomatis
CLINICAL MANIFESTATIONS
- Inflammatory UR isolated from nasal mucosa
- Cause of ozena (atrophic rhinitis)
- Commonly seen in tropical regions
- Spread by person-to-person transmission
K. pneumonia subspecies ozaenae
K. pneumonia subspecies rhinoscleromatis
CLINICAL MANIFESTATIONS
- Causes rhinoscleroma
-- A granulomatous disease of nasal passages
-- Extend to pharynx, larynx, and even the trachea® Commonly seen in tropical regions
- Spread by person-to-person transmission
K. pneumonia subspecies ozaenae
K. pneumonia subspecies rhinoscleromatis
LAB DIAGNOSIS
Serology test
Gram's stain
Culture
Biochemical test
CULTURE
Large pink mucoid colonies on MAC or EMB
Lactose fermenter colonies
Non-lactose fermenter colonies
Hemolytic colonies
Non-hemolytic colonies
BIOCHEM TEST
Lysine Decarboxylase (_)
+
-
BIOCHEM TEST
Urease (_)
+
-
BIOCHEM TEST
Ornithine (_)
+
-
BIOCHEM TEST
IMViC ( _ / _ / _ / _ ) (similar with Enterobacter)
- Indole (_)
- Methyl Red (_)
- Voges Proskauer (_): red solution
- Citrate (_): blue solution
( - / - / + / + )
( + / + / - / - )
TREATMENT
Aminoglycoside
3rd gen Cephalosporin
Ampicillin
Tetracycline
