In a message dated 4/29/2004 6:25:31 PM Eastern Standard Time, [EMAIL PROTECTED] writes:
klebsiella pneumoniae:
"Klebsiella pneumoniae can indeed be a serious infection! This mean
little bacteria can cause pneumonia, urinary tract infections, and
septicemia-a blood infection, sometimes mistakenly called âblood
poisoningâ.  K.pneumoniae actually commonly live, as normal flora, in
the respiratory tract, and the nasal passages of many people, with no
adverse effects. However, this germ is an aggressive opportunist,
known for attacking folks with an already weakened immune system, such
as diabetics, burn patients, post-surgical patients, and patients with
chronic lung disease.

People who have had surgery, or are suffering from another infection,
are more prone to K.pneumoniae, and itâs a common nosocomial
infection. (Acquired while in the hospital) Not only does this
bacteria cause infections, it produces a powerful enterotoxin, which
is a type of poison that can cause organ failure, shock, DIC (a
serious coagulation problem), and even death.

K. pneumoniae also like to take advantage of patients with an easy
port of entry! They often use tubing as a mode of
transportation-tubing such as a breathing tube, or a urinary catheter.

Under the microscope, Klebsiella pneumoniae appears as Gram-negative
rods. (Gram stain is how clinical scientists differentiate bacterial
species)
Hereâs how K. pneumoniae looks under the microscope-the small pink
cigar shapes are the bacteria.
http://www.vh.org/adult/provider/internalmedicine/PulmonaryCoreCurric/InvasivePneumonia/Slide5.html

Klebsiella bacteria are usually resistant to many antibiotics,
including  penicillin. Doctors will sometimes treat a patient with two
different antibiotics in an effort to stop a K.pneumoniae infection.
In order to determine which antibiotic is the best, a culture of the
infected area is taken with a sterile swab. Often, a catheter tip of a
piece of breathing tube is submitted for culture. Sputum and urine are
also samples that can be cultured.

The organisms are then âgrownâ in the lab, and looked at under the
microscope for identification.  Further chemical tests are run on the
cultured âbugsâ to confirm their identity.

The next test, and an important one, is called âsensitivitiesâ. This
tests the organism for resistance and susceptibility to antibiotics.
This very interesting test, called the Kirby-Bauer method, uses a
large agar plate, evenly streaked with the offending bacteria. Then
antibiotic coated discs are placed on the plate. The plate is allowed
to incubate 24-48 hours. The bacteria will grow up to the antibiotic
discs, if it is resistant(not killed) to that antibiotic. If the
organism is sensitive (can be killed by the antibiotic), there will be
a ring of no bacterial growth around the antibiotic disc. A report
goes to the doctor, with the source of the culture (urine, sputum,
etc.) and to which antibiotics the bacteria is resistant and sensitive
to. Sometimes the doctor will treat the patient with the antibiotic
that typically works on most people, however an antibiotic that treats
one patientâs K.pneumoniae may not be effective on another patient.
For this reason, a doctor will change the prescribed antibiotic to
another, after getting back the lab culture and sensitivity report.
See a picture of antibiotic sensitivity testing here
University of Maryland
Antibiotics of choice for K.pneumoniae are Amikacin,  cephalosporin
and  gentamicin, with cephalosporins being the most commonly
prescribed.
University of Florida, School of Medicine
http://www.medinfo.ufl.edu/year2/mmid/bms5300/bugs/klebpne.html


Here is a picture of K. pneumoniae growing on an agar plate,
formulated to grow K. pneumoniae and not other organisms.
http://www.cat.cc.md.us/courses/bio141/labmanua/lab13/xldkleb.html

It is very important for your mother-in-law to be treated properly for
this infection. If she is being treated while in the hospital, it is
imperative that she have culture and sensitivities run, then treated
with the appropriate antibiotics, even two antibiotics. If she is
treated on an outpatient basis, she MUST finish all the antibiotics
prescribed, at the correct times. Some antibiotic must be taken with
food, or NOT taken with dairy products. Your pharmacist can give you
advice as to how to best take prescribed antibiotics. If your
pharmacist does not explain, ask for the package insert, and read all
the advice for taking and completing all the medication.


patient will feel better a few days after starting an antibiotic
regimen, and quit taking the remaining medication. This causes the
weaker organisms to die off, but leaves the stronger ones to
reproduce, and become resistant to that antibiotic. What you get then
is a super-infection, one that is harder to fight. Good nutrition,
plenty of rest, and drinking a lot of water and juice will help your
mother-in-law fight off this K.pneumoniae infection.
Parent Soup http://www.parentsoup.com/experts/ped/qas/0,,200532_417026,00.html?arrivalSA=1&cobrandRef=0&arrival_freqCap=1&pba=adid=7530367"
 
good luck.

 


Thank you
Sincerely,
Marti Ann Benenfeld, RN
Educator and Consultant
Ombudsman Council, LTC
Miami, Fl
[EMAIL PROTECTED]
305-792-7979





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