Klebsiella Pneumonia - Case Study Example

?Klebsiella Pneumonia Klebsiella Pneumonia Introduction Klebsiella is a form of Gram negative bacteria that is known to cause different health care problems especially those that are associated with infections including bloodstream infections, pneumonia, surgical or wound site infections, as well as meningitis (Wiskur, 2008; pg. 23). Notably, Klebsiella bacteria have increasingly developed antimicrobial resistance that has lately been referred to the acrbaoenem antibiotic. The Klebsiella bacteria are usually located in the human intestines where without any risk factor, they never cause diseases. They can also be found in the human faeces or stool (Samper, Pycock, and Mckinnon, 2007; pg. 07). In health care settings, the Klebsiella infections usually occur in the sickest patients that are in the process of receiving medication for their other medical conditions. Patients who are at the highest risk of being infected by the Klebsiella bacteria are those that require medical care devices including intravenous (vein) catheters and ventilators or the breathing machines as well as those who are taking long courses of certain antibiotics. It is worth noting that healthier people are never at risk of Klebsiella bacterial infections (Siegenthaler and Aeschlimann, 2007; pg. 219). Therefore, all those who were affected in the provided case are persons who were undertaking certain medical treatments (Wiskur, 2008; pg. 152). It should be noted that the Klebsiella bacteria often affect those who need the assistance of medical devices and that is why the disease mainly affected the ICU patients. Risk Factors The Klebsiella infections are usually common in people with weak or weakened immune systems. In most cases, the Klebsiella associated illness often affect older and the middle aged men who are already affected by the deliberating diseases (Rubin, Strayer, and Rubin, 2012; pg. 138). Patients within this category are usually associated with impaired respiratory host defences that include alcoholism, diabetes, liver diseases, malignancy, glucocorticoid therapy, renal failure, and chronic obstructive pulmonary diseases (COPD) among other occupational exposures (Rubin, Strayer, and Rubin, 2012; pg. 91). Most of these infections are common among persons who have been hospitalized with other medical conditions. Therefore, it is apparent that the 73 years old patient died from the effects of Klebsiella bacteria due to the exposure to the same while was undertaking his or her kidney transplantations. The use of the antibiotics is also a risk factor since it increases the nosocomial infection risks with Klebsiella bacteria. The septic shock and sepsis can lead to the entry of the Klebsiella bacteria into the blood stream (Sellon and Long, 2007; pg. 123) It should be noted that admission to the ICU makes patients to be colonized with KPC- KP that often associate with risk factors that include the previous stay of the patient in the ICU, diseases associated with chronic obstruction of the pulmonary veins, the duration of the previous hospitalization, history or previous of the carbapenems, as well as the previous use of ?- lactams or ?- lactamase inhibitors (Schlossberg, 2008; pg. 109). Of the risk factors, it should be noted that Klebsiella infection of the fifth patients among other patients could have unlikely been traced from the endemic areas (Tomashefski, Dail, and Dail, 2008; pg. 06). The families or members of the family of the persons suffering from Klebsiella infections are at lower risks of being infected by Klebsiella bacteria (Samper, Pycock, and Mckinnon, 2007; pg. 129). Nonetheless, it is vital that everyone follows a health care environment precautions outlined by health care providers to reduce chances of being infected from the Klebsiella bacteria and diseases associated with it (Sellon and Long, 2007; pg. 136). Transmission Klebsiella normally causes pneumonia and this is the disease that is commonly caused by Klebsiella outside hospital and it is usually in the form of bronchitis or the bronchopneumonia (Rubin, Strayer, and Rubin, 2012; pg. 27). Patients within this category have the tendency of developing a lung abscess, empyema, cavitation, and urinal adhesions. This disease often has a high death rate of up to 50 per cent even in the patients with antimicrobial therapy (Rubin and Reisner, 2009; pg. 201). Notably, the mortality rate can be up to 100 per cent for patients with bacteraemia and alcoholism. Other persons who are highly vulnerable to Klebsiella bacterial infection include persons with urinary tract, surgical wound sites, and lower biliary tract (Schlossberg, 2008; pg. 189). Moreover, persons with invasive devices in their body are also at high risk of being affected by the Klebsiella bacteria (Samper, Pycock, and Mckinnon, 2007; pg. 59). The 73 years old patient was highly vulnerable to Klebsiella bacteria due to his or her urinary or kidney infections as well as colon perforation. In addition, due to his kidney problems, he/she might have been equipment support and most probably the urinary catheter and this increased the transmission rate of Klebsiella infection to other parts of the body (Rubin, Strayer, and Rubin, 2012; pg. 276). Patients with elaborate previous hospitalization and ICU admission records like the 73 years old patients have higher horizontal transmission of Klebsiella infections. Moreover, the amount of the antimicrobials administered also increases the transmission of Klebsiella bacterial infections (Rubin and Reisner, 2009; pg. 122). Therefore, high KPC – KP prevalence enteric carriage in the ICU at the admission point is an important factor to consider in implementing infection control measures and outlining strict antibiotic policies prior to transfer patients to the ICU (Roberton and South, 2008; pg. 19). If such could have been adhered to, then the cross infection reported in the case study could have been avoided. Screening The diagnosis of the Klebsiella pneumonia often depends on the signs and symptoms shown by the patient (Parker et al., 2012; pg. 15). These signs and symptoms often call for physical examination. Depending on these examinations, further examinations can be initiated including X-ray, sputum culture, and blood tests (Parathasarathy, Agrawal, and Sukumaran, 2012; pg. 82). On the confirmation of the test results, a specific doctor’s recommended course of antibacterial therapy is initiated as the primary treatment mechanism; otherwise, other treatment measures are initiated (Mu?Ller, Franquet, Lee, and Silva, 2007; pg. 86). Treatment It should be noted the Klebsiella causing organism has developed resistance to drugs. The Klebsiella causing bacteria have developed resistance to multiple antibiotics. The current researchers have implicated plasmid as the main source of resistant genes (Lange and Walsh, 2007; pg. 172). Moreover, it has been realized that Klebsiella that is capable of producing extended spectrum of ?- lactamases, the ESBL often resist many classes and categories of antibiotics (Cunha, 2010; pg. 11). The commonly known resistance are the resistance to fluoro-quinolones, aminoglycosides, chloramphenicol, tetracycline, and sulfamethoxazole – trimethoprim. Therefore, the choice of any particular antimicrobial agent will depend on the specific local susceptibility pattern and the part of the body affected by the Klebsiella bacteria. Patients who are severely affected should take the prudent approach to use the initial short course of two to three days combination of therapy thereafter switching to mono-therapy especially for the patients whose susceptibility pattern have been determined (Cheng and Bostwick, 2011; pg. 84). However, if there are specific Klebsiella bacteria diagnosed with a particular patient and it is known that such Klebsiella organism is not resistant to the antibiotic, then the antibiotic is applied or used to treat the already isolated susceptible patient (Mainous and Pomeroy, 2010; pg. 231). Some of the antibiotics that are already available for treating Klebsiella diseases include ticarcillin/ clavulanate, sulbactam/ ampicillin, levofloxacin, ceftazidime, norfloxacin, Cefepime, moxifloxacin, gaitfloxacine, ertapenem, and meropenem. It should be noted that some medical experts have advocated the use of Meropenem for Klebsiella patients especially with ESBL (Dudek, 2007; pg. 44). According to them, meropenem is the best in clearing Klebsiella bacteria. However, the use of antibiotic on it is not sufficient; thus, additional surgical cleaning is recommended as an Interventional radiology Klebsiella drainage that is often needed immediately, the patient starts taking the antimicrobial agents (Burgener, Kormano, and Pudas, 2008; pg. 124). Infection Control Measures Other than treating Klebsiella, there are effective ways that the disease can be controlled. Patients with elaborate previous hospitalization and ICU admission records like the 73 years old patients have higher risks of Klebsiella infections; therefore, they should not be subjected to Klebsiella agents and prone areas (Banaei and Kallen, 2011; pg. 24). Moreover, it has been noted that the amount of the antimicrobials administered also increases the risk for Klebsiella bacterial infections; thus, the reduction in administration of such antibiotics will act as a control measure (Brant and Helms, 2012; pg. 78). Additionally, the ICU admission of high KPC – KP prevalence enteric carriage is also an important factor to consider in implementing infection control measures and outlining strict antibiotic policies prior to transfer patients to the ICU since this will reduce acquisition of antibiotic by the already vulnerable patient (Engelkirk and Duben-Engelkirk, 2008; pg. 79). Adhering to these control measures, would limit the cross infection reported in the case study. The Klebsiella infection has never subjected the family members of the affected patient to great danger of contracting Klebsiella bacteria (Goroll and Mulley, 2009; pg. 422). Nonetheless, it is vital for everyone to adhere to the healthy environmental precautions outlined by health care providers to reduce chances of the Klebsiella bacteria infections (Berrie, 2007; pg. 01). Some of these environmental precautions including adherence to hand hygiene, wearing gloves and gowns when entering the room were such patients are housed. Additionally, to prevent the spread of Klebsiella bacteria, the patients are advised to clean their hands before: eating; touching their eyes, nose, or mouth among other hygiene measures (Behera, 2010; pg. 61). Conclusion The bacteria that produce Klebsiella pneumonia Carbapenemases (KPCs) have emerged swiftly as the leading cause of multidrug resistant infection. The organisms that are capable of harbouring these enzymes are usually capable of hydrolysing a broad beta – lactam spectra that includes those of penicillin, cabapenems, cephalosporin, and monobactam among others. There Klebsiella bacteria are usually transmitted in many ways; however, the already known risk factors can be avoided by hiding to the already identified control measures. Additionally, sometimes it is never an achievement to determine the correct diagnosis for Klebsiella bacteria since some of them usually develop resistance to drugs thereby making difficult to provide treatment on the same bacteria. Nonetheless, once diagnose with Klebsiella bacteria, patients should follow medical procedures provided for by the health care provider on the same disease. List of References Top of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Top of Form Bottom of Form Top of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Bottom of Form Top of Form Top of Form BANAEI, N. and KALLEN, A. J. (12 October 2011). 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