Klebsiella Pneumoniae Bacteria

Klebsiella pneumoniae is a gram-negative bacillus that lives in the normal bacterial flora of the human body. So it is an enteric bacteria.

General Situation in Hospitals

All over the world in the intensive care units of hospitals, 30% of the infections seen in patients receiving Ventilator-Related treatment are seen as the agent responsible for infection [1].

Hospital Floor
Hospital Floor

Problems Caused by Intensive Care Settings

When the weekly sputum and lung secretions of patients who are hospitalized in intensive care units and whose respiration is maintained with ventilator support are examined by taking microbiological culture samples, the most common bacteria are Pseudomonas aeroginosa, Acinetobacter baumanii, Klebsiella pneumoniae, Staphylococcus aureus, Enterobacter cloacae and Escerichia coli. It is said that these bacteria colonize from the gastro-intestinal system upwards through the esophagus, throat and trachea, and you have a gastro-tracheal spread. On the other hand, it is emphasized that the same bacteria that were present in the environment before are contaminated by the workers during the aspiration of the mouth and tracheal tracts, and the bacteria are made to reach the respiratory tract [3]. As a result, the pictures of Nosocomial Pneumonia (Pneumonia Developing in Hospital Environment) are mentioned in these colonization patients.

Nosocomial pneumonia is one of the biggest problem in intensive care patients. They increase the mortality rate by causing multiple organ failure and sepsis.

In a study, it was found that 56.4% of intensive care patients had ARDS (Acute Respiratory Distress) due to Nosocomial Pneumonia and could lead to death [3].

This is a grave situation in intensive care practice. For this purpose, both intensive care healthcare professionals and suppliers of medical products and antiseptics that supply the needs of hospitals should put their hats in front of them and think again. Let’s go into more detail about beer.

First, let’s get to know Klebsiella pneumonia bacteria with its general characteristics.

Klebsiella pneumonia is an enteric bacillus that is not motile and is abundantly found in the intestinal tract. It does not have a cell capsule, it continues its life by breaking down lactose found in milk and dairy products and foods into ferment. It has an anaerobic metabolism thanks to its ability to survive in an anaerobic (without oxygen) environment [2] [4].

Subtypes of Klebsiella pneumoniae [4]

  • Klebsiella pneumoniae subsp ozaenae
  • Klebsiella pneumoniae subsp pneumoniae
  • Klebsiella pneumoniae subsp rhinoscleromatosis

It is found in normal flora, skin and gruel in the mouth. [4] It causes devastating damage to the human lung and lungs in animals. It is a bacterial group that has come to the fore in hospital infections in recent years [4].

It becomes prominent as the predominant infectious agent especially in patients with diabetes melltus, alcoholism, chronic obstructive pulmonary disease, liver disease, renal failure or intensive cortisone use [4]. In addition, it is seen in urinary tracts, bile ducts and surgical wounds.

It causes thrombophlebitis (vascular inflammation), urinary tract infections, biliary tract infections, diarrhea, upper respiratory tract infections, wound infections, osteomyelitis (bone infection) meningitis and bacteremia (spreading bacteria in the blood) or sepsis. It is also transmitted during implants, catheters and interventional procedures applied to the body [4].

Newborns are also at risk due to the same procedures [4].

Klebsiella pneumoniae causes bronchopneumonia, bronchitis, abscesses, empyema or pleural effusions in people outside the hospital with low body resistance or uncontrolled use of intensive antibiotics, which in spite of antibiotic treatments, the mortality rate of such patients increases up to 50% [4].

How is Klebsiella pneumoniae transmitts to patients?

For a person to be exposed to Klebsiella pneumoniae infection, the bacteria must either enter the patient’s airways or enter the bloodstream. Accordingly, contamination: Klebsiella does not show contamination by flying air [4].

  • It is transmitted by person-to-person contact in intensive care settings (for example, it is transferred from patient to patient with contaminated hands) [4]
  • Through patient-to-patient direct contact [4].
  • In the form of contamination to every patient who enters the patient with the contamination of the environment where the patients are located [4].
  • Patients who are hospitalized in the intensive care unit connected to the ventilator are infected by the ventilator system [4].

Finally, transmission occurs in cases of deep vein or long-term use of vascular access in an intensive care patient [4].

What is Klebsiella Resistance to Antibiotics?

Klebsiella group bacteria are already resistant to many antibiotics due to their natural structure. This is due to the bacteria’s genetic makeup. Therefore, almost all Beta Lactam Antibiotics are ineffective because they are resistant to Broad Spectrum Beta Lactamase [4].

For this reason, if Klebsiella pneumoniae infection is observed in a patient in intensive care units, it is transferred to other patients with to the employees and this situation becomes a fearful dream of the judges.

Recently, Antibiogram Tests show resistance against all antibiotics tested in Klebsiella pneumoniae medium, which leaves no antibiotic option in treatment.

Klebsiella Pnomonia Lab Result Pic1
Klebsiella Pnomonia Lab Result Pic1
Klebsiella Pnomonia Lab Result Pic2
Klebsiella Pnomonia Lab Result Pic2
Klebsiella Pnomonia Lab Result Pic3
Klebsiella Pnomonia Lab Result Pic3

As seen in all three tests, Klebsiella pneumoniae is resistant to almost all antibiotics tested in the antibiogram. More effective antibiotics have not yet been developed on how to treat such patients. This problem is now seriously considered in intensive care clinics.

Klebsiella peumoniae is only one of the bacteria that we encounter as a cause of infection in intensive care patients.

Here, physicians and intensive care workers should focus on and be open to much more effective technologies.


  1. Emergence of carbapenem-resistant Acinetobacter baumannii as the major cause of ventilator-associated pneumonia in intensive care unit patients at an infectious disease. Kop Nguyen Thi Khanh Nhu, Nguyen Phu Huong Lan, James I Campbell, Christopher M Parry, Corinne Thompson, Ha Thanh Tuyen, Nguyen Van Minh Hoang, Pham Thi Thanh Tam, Vien Minh Le, Tran Vu Thieu Nga, Tran Do Hoang Nhu, Pham Van Minh, Nguyen Thi Thu Nga, Cao Thu Thuy, Le Thi Dung, Nguyen Thi Thu Yen, Nguyen Van Hao, Huynh Thi Loan, Lam Minh Yen, Ho Dang Trung Nghia, Tran Tinh Hien, Louise Thwaites, Guy Thwaites, Nguyen Van Vinh Chau, Stephen Baker. Journal of medical microbiology 63 (Pt 10), 1386, 2014
  2. Epidemiological and microbiome associations between Klebsiella pneumoniae and Vancomycin-resistant Enterococcus colonization in Intensive Care Unit patients Abigail Collingwood1 , Freida Blostein2 , Anna M. Seekatz4 , Christiane E. Wobus3 , Robert J. Woods4 , Betsy Foxman2 , and Michael A. Bachman1 1Department of Pathology, University of Michigan, Ann Arbor, MI 2University of Michigan School of Public Health, Ann Arbor, MI 3Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI 4 Internal Medicine-Division of Infectious Disease, University of Michigan, Ann Arbor, MI . http://creativecommons.org/licenses/by-nc-nd/4.0/
  3. Oropharyngeal or gastric colonization and nosocomial pneumonia in adult intensive care unit patients: a prospective study based on genomic DNA analysis. Maïté Garrouste-Orgeas, S Chevret, G Arlet, O Marie, M Rouveau, N Popoff, B Schlemmer
    a) American journal of respiratory and critical care medicine 156 (5), 1647-1655, 1997.
  4. Klebsiella pneumoniae; From Wikipedia, the free encyclopedia; https://en.wikipedia.org/wiki/Klebsiella_pneumoniae

General Status of Hospitals

During this epidemic period, some known troublesome situations about the general condition of hospitals have developed. As you know, the epidemic has restricted many branches in a categorical manner and made it difficult to work. The most important of these is the increase in the patient population density seen in surgical clinics. In this process, the general intensive care units, which are deemed necessary after surgical interventions, serve patients struggling with the epidemic rather than providing services to the relevant surgical branches. For this reason, this situation has affected all branches as a chain. In addition to the patients who will be operated only, the surgical personnel’s service to combat the epidemic also creates different problems. The confusion created by the patients who cannot receive service and their relatives is the most irresponsible.

Hospital Floor
General Status of Hospitals

The main element of taking this process under control is that the hospitals are well disinfected and the spread of the epidemic is prevented. For this, correct and harmless disinfection processes must be done. This passes through new generation disinfection products and techniques. The more accurately the use of disinfection in hospitals and the regular controls, the faster the epidemic is brought under control.

The most risky group of the process is the Infection Specialists, who are intensely fighting the infection, and the Intensive care staff working with it. It is the most sacred duty of these two groups to fight by serving the people with one-to-one contact under the most difficult conditions.

Considering the risky branches in hospitals, not every hospital has the status of a pandemic hospital. However, they are at the forefront of emergency response needs in the process. From the emergency entrance to the intensive care, the patient must be under the control of the infectious diseases specialist at the stage of referral. Sufficient capacity intensive care beds are also an important factor at this point.

Infection Risks in Hospitals

At this stage, intensive work is taking place in the treatment branches. In recent years, as if hospitals had no problems, the fight against the Covid-19 epidemic has also entered a risky period. This situation can be seen as a very good improvement in terms of patient circulation of a hospital. It can be seen as good in terms of financial returns in the early days. However, we do not want to and will not stop recommending that you pay more attention to infection control, which you encounter over time and will increase its incidence rates.

In addition to these developments, there are some problems that attract our attention, like many hospital staff doctors. These problems are situations that may affect your patient care and treatment times, drug use times, and hospital stays. As your patients continue to stay in the hospital, your patient circulation rate will slow down. This will give your institution the appearance of both financial loss and failure.

Notable matters

Infectious Diseases Specialist

Some of the hospitals do not have an Infectious Disease Specialist. Naturally, the Infection Committee cannot continue its activities under the supervision of an expert. For this, committees affiliated to the provincial health directorate serve.

Use of Antibiotics

Therefore, the use of antibiotics in many hospitals is exhaustive and common. It should be remembered that bacteria (microbes) like wet (moist), warm (hot) and nutritious (protein or sugar) environment. In addition, they are divided into two every 24 hours and multiply very easily in places where there is no hygiene. The unhygienic place should also be seen as a garbage dump, and we cannot clean and get rid of the garbage dump with antibiotics or antiseptics. It makes Hygiene Teams under the control of these and infectious diseases specialist.

Hospital Quarantine System

Most hospitals do not have a quarantine system. It is necessary to detail the quarantine system a little.

30-40 years ago, there was not that much variety of antibiotics available to hospitals. For this reason, patients to be admitted to the hospital were observed in the quarantine department and admitted to the hospital before being admitted to the clinics. What would be done in this quarantine department. Patients were given all their clothes with a removable bag to be taken away from the hospital. Then, all jewelery, earrings and rings on the patient are removed. Hair shaving of the patients was done if necessary, the nails were cut and the patients were thoroughly washed from head to toe. After this cleaning process, the patient is taken to the clinic room. 1 person is allowed to stay as an accompaniment. In cases where it was deemed necessary and the patient’s condition was suspicious, patients were kept in the quarantine department for 24 hours, and after the results of the laboratory tests were obtained, the transition to the clinical environment was provided. The quarantine system would allow the patient to be isolated from bacteria that might be brought from outside. This practice should be considered both economically and as a serious measure against infections.

Chemical Use

Using large amounts of chemicals in hospitals does not work except that a much larger amount of bacteria causes resistance to chemicals and antibiotics. Instead, new generation disinfectants should be preferred.


The following infection tables are common in our patients hospitalized in hospital intensive care units.

Lung Infections

The methods used in tracheal aspirations should be reviewed.

Urinary Infections

It may be necessary to improve the methods used in Foley catheter follow-up.


It is necessary to review superficial venous routes and the use of deep venous routes. Patients with multi-lumen routes or multiple vascular accesses at the same time should be reviewed. Intravenous nutrition, intravenous hypertonic solutions, use of intravenous blood and blood products, application frequencies, densities, rates, and intravenous antibiotic treatments should be reviewed. Almost all of the causes of sepsis are due to contamination during IV treatment, prolonged deep vein catheters or multiple vascular access. Almost all of the sepsis cases are atrogenic.

Skin infections

Skin infections, pressure sores, thrombophlebitis of superficial veins, skin abrasions, edematous tissue abrasions, plaster allergy and scraping are important. This can be caused by sharp and sharp objects remaining in the mattress, and abrasions from shaving and cleaning. There are dozens of reasons such as cuts, abrasions, and fluid leakage under the skin. Continuous training of care staff on these is required.

Surgical wound infections

Surgical wound infections require a direct review of operating room conditions. Patients’ wounds should be regularly reviewed daily for wound infection.


In addition, the most striking issue in terms of hygiene is the lack of liquid soap in the liquid soap reservoirs in polyclinics and toilets. The clothes of the polyclinics are hanging behind the doors, there are many unnecessary materials, bottles, glasses, covers, etc. in the middle. In hygiene care, there are no paper towels at the beginning of the sinks to dry after hand washing. Tables and items used with computers should be regularly wiped with clean and wet cloths. Antiseptic material is not necessarily required. Water is the best cleaning material. The stains on the seats remain so for months. Cleaning is not just about mopping floors.


Hygiene and disinfectant products used in hospitals and other health institutions are generally obtained from chemicals. After the use of these products, bacteria that can survive in the environment gain resistance. To break the resistance of these bacteria, a stronger disinfectant must be used in the next process. With this application, an even stronger chemical is exposed every time.

In this process, people who are trapped have to use next generation antibiotics constantly.

Alcohol-free disinfection products are now produced with new generation technologies. Pure Anti-B is a good example of these. The product, developed with nano technology, is a disinfectant that is alcohol-free and does not leave any chemical residue.