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 .
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 . 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 .
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  .
Subtypes of Klebsiella pneumoniae 
- Klebsiella pneumoniae subsp ozaenae
- Klebsiella pneumoniae subsp pneumoniae
- Klebsiella pneumoniae subsp rhinoscleromatosis
It is found in normal flora, skin and gruel in the mouth.  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 .
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 . 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 .
Newborns are also at risk due to the same procedures .
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% .
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 .
- It is transmitted by person-to-person contact in intensive care settings (for example, it is transferred from patient to patient with contaminated hands) 
- Through patient-to-patient direct contact .
- In the form of contamination to every patient who enters the patient with the contamination of the environment where the patients are located .
- Patients who are hospitalized in the intensive care unit connected to the ventilator are infected by the ventilator system .
Finally, transmission occurs in cases of deep vein or long-term use of vascular access in an intensive care patient .
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 .
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.
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.
- 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
- 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/
- 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.
- Klebsiella pneumoniae; From Wikipedia, the free encyclopedia; https://en.wikipedia.org/wiki/Klebsiella_pneumoniae