Klebsiella Infections Follow-up

Updated: Jun 10, 2019
  • Author: Shahab Qureshi, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Follow-up

Transfer

Transfer patients with serious infections to a tertiary care facility.

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Deterrence/Prevention

Follow hospital protocols for infection control to limit the spread of infection and resistant organisms. Restricting certain antibiotic use for specific indications and duration may help prevent the spread of resistant organisms.

Proper hand washing is crucial to prevent transmission from patient to patient via medical personnel. Contact isolation should be used for patients colonized or infected with highly antibiotic–resistant Klebsiella strains, such as ESBL-producing organisms.

Single-use devices may minimize transmission from contaminated equipment.

Contaminated nebulizers are a major source of hospital-acquired infection; this source has been eliminated through the use of disposable devices.

Use of protective isolation is generally not recommended. Outbreaks of diarrhea associated with Klebsiella infection in neonatal nurseries should necessitate isolation of affected infants.

Other suggested measures to prevent nosocomial infections include the following:

  • Remove medical devices (eg, catheters, tubes) when no longer needed.

  • Use nonalkalinizing gastric cytoprotective agents.

  • Place intubated patients in a semirecumbent position.

  • When possible, consider decreasing the duration and intensity of immunosuppression in patients who are immunocompromised.

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Complications

Lung abscesses can occur days to weeks after Klebsiella infection. A lung abscess in a patient with a non–community-acquired pneumonia strongly suggests K pneumoniae infection.

Pulmonary gangrene leading to necrosis involves rapid destruction of part of the lung. This is believed to follow vascular compromise. Fortunately, this is rare.

Other pulmonary complications include cavitation, empyema, bronchopulmonary fistula, and pleural adhesions.

Superinfections can occur while patients are treated for K pneumoniae infection; likewise, K pneumoniae infection can be a superinfection that develops during inpatient treatment for another type of pneumonia.

Sepsis can complicate bacteremia and can result in shock and disseminated intravascular coagulopathy.

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Prognosis

K pneumoniae pneumonia has a 50% mortality rate, even with adequate therapy. The prognosis is worse in patients with alcoholism and bacteremia. Preventive strategies and early diagnosis/treatment help to reduce morbidity.

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