‫بسم هللا الرحمن الرحيم‬

Enterobacteriaceae
Klebsiella

Dr. Abdelhakam Hassan Aldigeal

Assistant professor of Molecular
microbiology
Aldigeal007@gmail.com
Feb, 2021
 Taxonomy
• Domain = Bacteria
• Phylum = Proteobacteria
• Class = Gammaproteobacteria
• Order = Enterobacteriales
• Family = Enterobacteriaceae
• Genus = Klebsiella
• Species =K.pneumonia , K.ozaenae
K.rhinoscleromatis.
 Characteristics

1. gram-negative
2. Non motile
3. Lactose fermenting
4. Oxidase negative
5. Rod shaped organism
6. Facultative anaerobe
7. Surrounded by thick capsule
8. Act as opportunistic human pathogen
 Where it is found?

• 1)Found in the normal flora of the nose,

mouth, skin, GI tract and intestines.
• 2)It is also found in soil and water.
• Generally, Klebsiella infections are seen
mostly in people with a weakened immune
system.
 Diseases caused by Klebsiella

1) urinary tract infections

2)pneumonia
3) Specticaemia
4) nosocomial infections
5) soft tissue infections.
 transmission

1) spread through exposure to the bacteria via

respiratory tract which causes pneumonia.
2) Enters the blood to cause an infection in the
bloodstream.
3) Most well-known in hospitals spread through
person-to-person contact by contaminated hands
of surrounded people in the hospitals, whether it
be an employee or a patient.
 transmission

4) Klebsiella is spread very easily and rapidly, but not

through the air.
5)Healthcare settings are most vulnerable to Klebsiella
infections due to the nature of procedures that allow
easy access of bacteria into the body.

Patients who are on ventilators, catheters, or surgery

wounds are highly prone to catching this deadly
infection
 Symptoms
• The symptoms of a K. pneumoniae infection differ
depending on where the infection is located, and are
similar to symptoms of the same diseases caused by
other microbes.
• For instance, meningitis from K. pneumoniae
produces the hallmark symptoms of bacterial
meningitis,
• including fever, confusion, neck stiffness, and
sensitivity to bright lights.
 Symptoms
• Bloodstream infections (bacteremia and sepsis) from
Klebsiella cause fever, chills, rash, lightheadedness,
and altered mental states.
• Pneumonia from K. pneumoniae can result in:
• 1)Fevers and chills
• 2) Flu-like symptoms
• 3)Cough, which may produce mucus that's yellow,
green, or bloody
• 4) breathing issues
 Virulance Factors
• 1) Adhesions
• 2) Capsule
• Iron Capturing capability
 Pathophysiology
• When the defense mechanism in the respiratory system
is abnormal either due to illness , age or fatigue our
body loses fight against microbes then this microbes
will multiply rapidly & pass from the tube into the
alveoli .
• This will trigger an inflammatory reaction which will
generate a lot of infectious fluid that is composed from
– microbes ,
– dead antibodies
– & fluids from the edges in blood vessels .
 Pathophysiology
• Then this fluid will block the movement of gases
making it difficult to breath.
• This is mostly caused by klebsiella that invaded the
alveoli causing klebseilla pneumonia .
 The antibiotic resistance
• Some Klebsiella bacteria have become highly
resistant to antibiotics.
• Klebsiella pneumoniae produce an enzyme known as
a carbapenemase (referred to as KPC-producing
organisms).
• then the class of antibiotics called carbapenems will
not work to kill the bacteria and treat the infection.
• Klebsiella species are examples of
Enterobacteriaceae, a normal part of the human gut
bacteria, that can become carbapenem resistant.
 treatment
• 1) Klebsiella infections that are not drug resistant can be
treated with antibiotics.
• 2) Infections caused by KPC-producing bacteria can be
difficult to treat because fewer antibiotics are effective
against them.
• In such cases, a microbiology laboratory must run tests
to determine which antibiotics will treat the infection
• These drugs include:
• Aminoglycosides,Polymyxins,Tigecycline,Fosfomycin,
Temocillin.
 Laboratory diagnosis

• • Specimen (according to site of infections)

• • Sputum.
• • Urine.
• • pus.
• • CSF.
 Laboratory diagnosis

• • Gram stain: gram-negative rods

 Capsule visualization

Gram Stain of Sputum Specimen Showing Capsules

Surrounding a Gram Negative Bacillus
 Blood agar

• slimy appearance of the colonies

 MacConkey agar

• red/pink colonies
• Klebsiella pneumoniae
and Salmonella
enterica on
MacConkey agar:
• lactose + and -
• klebsiella
• salmonella
 EMB
• • Klebsiella species
• produces large,
mucoid, pink to
purple colonies with
no metallic green
sheen
• on EMB agar.
 CLED AGAR
• • Large, yellow mucoid colonies.
• due to lactose fermentation by bacterial growth.
 String test
• A colony that stretches more
than 5 mm using a standard
inoculation loop tests positive
for hypermucoviscosity.
• When colonies were
touched with a loop and the
loop lifted vertically from
the surface of the agar plate,
mucoid isolates adhered to
the loop as it was lifted
from the plate .
 India ink capsule stain
• India Ink Capsule Stain of Klebsiella pneumoniae showing white capsules
(Glycocalyx) surrounding purple cells
• -The background will be dark.
• -The bacterial cells will be stained purple.
• -The capsule (if present) will appear clear against the dark
background.
 Klebsiella API20E

• oxidase -ve
• indol –ve
• H2S –ve
• citrate +ve
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