Klebsiella Pneumoniae - Research Proposal Example

"Klebsiella pneumoniae" Classification Klebsiella pneumoniae belong to Kingdom- Bacteria; Phylum- Proteobacteria; Class- Gamma Proteobacteria; Order- Enterobacteriales; Family- Enterobacteriaceae (Todar). Characteristics It is a Gram-negative rod. The bacteria does not possess flagella and therefore not motile bacteria. It possess capsule and therefore it is encapsulated. Klebsiella is known to be lactose fermenting organism (Ryan, 2004). Habitat It is present as the natural microflora on the epidermal layers especially skin and oral cavity. It is also present in the intestine. It is also present in soil and around 30% of the species fix nitrogen under anaerobic conditions (Postgate, 1998). Research Background Klebsiella is becoming the topic of research as it is emerging as an impetrative pathogen in nosocomial infections. Klebsiella possess two different kinds of antigens one on its cell wall and other on its capsule. The O antigen is present as a cell wall component on the lipopolysaccharide (LPS) and possess 9 different kinds. The capsular antigen is known as K antigen and possess as many as 80 different kinds. These antigens are responsible for the virulence of the organism (Podschun, 1998). Clinical implications These virulence factors are responsible for disease called pneumonia. Pneumonia is the disease of lungs and results in inflammation of lungs. This results in necrosis of cells. It then produces thick, blood filled mucous or sputum. The causal organism is Klebsiella pneumoniae. The organism gains access into the lower part of respiratory tract and inhabit there as an oropharyngeal microbial population (Todar). If the immune system of the individual is compromised either due to poor nutrition or some condition of illness then the individual is likely to suffer with pneumonia. It is observed that Klebsiella pneumoniae affects individuals suffering from either diabetes, or display any kind of malignancy or witness liver disease or malfunction or if the individual is alcoholic. It is also reported that individuals with Chronic Obstructive Pulmonary Diseases (COPD) or suffer from renal failure, they also become victim of Klebsiella pneumoniae. Professional hazard in case of paper mill workers is also observed where personnel are likely to become soft targets for Klebsiella pneumoniae (Todar). Hospitalizations could also result in Klebsiella pneumoniae infestation and therefore the organism is becoming a source of nosocomial infections. Under these conditions, Klebsiella pneumoniae causes bronchopneumonia and also bronchitis. The patient may witness abscess of lungs, or cavitations in lungs, pus may get collected in the lung cavities resulting in empyema or pleural empyema, as a result of pneumonia, this are linked with parapneumonic effusions. This is a three phase ailment encompassing (Pothula, 1994). a. exudative phase where accumulation of pus takes place. b. fibrinopurulent stage where lot of pus pockets are being generated. c. the organizing stage which causes entrapment of lung(s) (Pothula, 1994). Pleural adhesion may be generated as a result of all the implications causing elevation in death rate. Klebsiella also affects the urinary tract, causing UTI. It also disrupts the intestinal lining and hence causes diarrhea. It is capable of colonizing in the upper respiratory tract and causes upper respiratory tract infection. It also causes infection of wounds, inflammation of gall bladder causing cholecystitis, as well as infection of bone and bone marrow leading to osteomyelitis. The most dreaded infection caused by Klebsiella pneumoniae is the inflammation of meninges leading to meningitis, it travels the blood stream leading to septicemia (Todar). The prevalence of Klebsiella pneumoniae in the invasive device or support equipments or catheters, not only contaminates the device but also position patients at an enhanced risk for Klebsiella infection. Thus sepsis as well as septic shock enables the bacteria to gain entry into the blood (Todar). Research The implications of Klebsiella are so wide that it can result into a condition called Rhinoscleroma, inflammation of nasal part of pharynx called as nasopharynx. It also causes inflammation of internal part of nose. Research is being carried out to mimic or associate the pathogenic genetic sequence responsible for the activation of both T cells as well as B cells. This process is popularly known as molecular mimicry. It is a process which is utilized to incite autoimmunity. Research related to this aspect is going to be a great help as it sets the ground towards understanding for various autoimmune disorders occurring amongst human population. Such research is being carried out at the King's College, London (Rashid, 2006). Another research challenge that is emerging is antibiotic resistance in Klebsiella species. It is becoming a serious issue for hospital borne infections or nosocomial infection. It is known that E. coli rates highest amongst the urinary tract infections but Klebsiella has emerged as the second most prevalent organism causing urinary tract infection. Klebsiella is therefore becoming a health-care challenge for most of the researchers. Research Methodology Study could be performed for community-acquired Klebsiella pneumonia in various hospitals. Blood sample could be collected, which are positive for K. pneumoniae. Therapeutic management could be postulated in consultation with the physicians of the respective patients. Severity of the condition could be assessed. This could be related with the type of infection caused by the Klebsiella pneumoniae strain. These could then be categorized under various heads viz. Pneumonia, Urinary tract infection, meningitis, or wound infection of osteomyelitis or inflammation of gall bladder, or liver abscesses, endophthalmitis. The sample collection should also be categorized as blood sample or the sample of cerebrospinal fluid or CSF. Fatality or cure then could be assessed with the therapeutic response or no response of the medicines. Data collected is going to be thoroughly examined and precise study be performed to correlate the findings and also to postulate the appropriate therapeutic means to cure the infection caused by the Klebsiella pneumoniae. Therapeutic means are going to be segregated in order to establish the therapeutic procedure to be followed under the defined set of disease condition. The parameters to be assessed with the help of the set methodology encompass- Age in years, Sex of the patient, fundamental disease conditions if any including- Diabetes, Liver diseases, Consumption of alcohol, any kind of liked malignancy, AIDS or HIV- infection, Any kind of renal disease or chronic renal failure, transplantation of organ or tissue if any, consumption or use of corticosteroids if any encompassing topical or non-topical, any kind of critical illness, any case of hospitalizations and also number of days of hospitalizations, use of catheters or ventilators or any respiratory aids, revival ratio and death ratio.Further, conditions to be assessed encompass- Pneumonia, abscess of liver, endophthalmitis, meningitis, acute cholangitis, any kind of skin infection, or any kind of intraabdominal abscess (Wen-Chien, 2002). Summary The research proposal is formulated to highlight the study of Klebsiella pneumoniae in almost every aspect of the condition it is reported to be fatal. Moreover it is going to establish the therapeutics along with the severity and kind of the disease condition. This is a method to establish the role of therapeutic process in eradicating the symptoms. The research aims to provide an aid to the physicians to prescribe the medicines which are going to display maximum recovery rate. Based on the statistics obtained under a given set of medical condition, further dosage of the medicine could be postulated. Moreover the research also aims in establishing the correlation between the serotypes of similar sample types, either blood or CSF. This will enable to find out the appropriate medicine to be prescribed for the given set of condition. References Podschun, R., Ullman, U. (1998). Klebsiella spp. as Nosocomial Pathogens: Epidemiology, Taxonomy, Typing Methods, and Pathogenicity Factors. Clinical Microbiology Reviews, 11 (4), 589–603. Postgate, J. (1998). Nitrogen fixation. 3rd ed. Publisher: Cambridge University Press. Pothula, V., Krellenstein, D. J. (1994). Early aggressive surgical management of parapneumonic empyemas. Chest, 105 (3), 832–6. Rashid, T., Ebringer, A. (2006). Ankylosing spondylitis is linked to Klebsiella-the evidence (Epub ahead of print). Clin Rheumatol 26 (6), 858–64. Ryan, K. J., Ray, C. G. (2004). Sherris Medical Microbiology, 4th ed. Publisher: McGraw Hill. Todar, K. Todar's Online Textbook of Bacteriology. Available at http://www.textbookofbacteriology.net [Accessed on 27th May 2011]. Wen-Chien, K. et al. (2002). Community-Acquired Klebsiella pneumoniae Bateremia: Global Differences in Clinical Patterns, Emerging Infectious Diseases, 8(2). Read More