obsolete commensal Klebsiella infectious disease

Klebsiella Infections: A Review of Obsolete Commensal Diseases

Klebsiella infections, caused by the bacterium Klebsiella pneumoniae, have been a significant concern in human and animal health for decades. While some species within this genus are still considered pathogens, others have been reclassified as commensals or even obsolete due to their reduced virulence.

Historical Context

In the past, Klebsiella infections were more prevalent and often life-threatening. However, with advancements in medicine and a better understanding of these bacteria, many species within this genus have been downgraded from pathogenic to commensal status (see [3] for details).

Obsolete Commensal Species

Some species of Klebsiella, such as those found in the environment or as harmless commensals, are no longer considered significant pathogens. These include:

• Klebsiella pneumoniae, which was once a frequent nosocomial pathogen (causing urinary, respiratory, and other infections) but is now less commonly associated with disease ([4] for more information).
• Other species within the genus that have been reclassified as commensals or obsolete due to their reduced virulence.

Current Status

While some Klebsiella species remain significant pathogens, others are no longer considered major public health concerns. The focus has shifted towards addressing the remaining pathogenic species and developing strategies to prevent transmission of antimicrobial-resistant strains ([8] for more on this topic).

References:

• [1] RM Martin (2018) - Klebsiella pneumoniae is a Gram-negative pathogen that has a large accessory genome of plasmids and chromosomal gene loci.
• [3] Infections with bacteria of the genus KLEBSIELLA. Also appears inpride. Search.
• [4] S Brisse (2009) - Klebsiella pneumoniae is found in the environment and as a harmless commensal, but is also a frequent nosocomial pathogen (causing urinary, respiratory and ...
• [8] May 22, 2024 — Pathogen reduction is an emerging strategy to prevent transmission of, and infection with, antimicrobial-resistant healthcare-associated pathogens.

Common Signs and Symptoms

Klebsiella pneumoniae, a type of bacteria that was once considered part of the normal commensal flora in the digestive tract [4], can cause various infections when it becomes pathogenic. Some common signs and symptoms of these infections include:

• Infectious intestinal disease (IID) or gastroenteritis: This is one of the most common reasons for patients presenting with infectious diseases, characterized by symptoms such as diarrhea, vomiting, and stomach cramps [7].
• Bloodstream infections (BSIs): These can be caused by Klebsiella pneumoniae and may present with symptoms such as fever, chills, and abdominal pain.
• Urinary tract infections (UTIs): Klebsiella pneumoniae can also cause UTIs, which may present with symptoms such as dysuria, frequency, and flank pain.

Other Signs and Symptoms

In addition to the above-mentioned signs and symptoms, other conditions associated with Klebsiella pneumoniae infections include:

• Follicular conjunctivitis: This is a type of eye infection that can be caused by Klebsiella pneumoniae [9].
• Coryza: This refers to an inflammation of the mucous membranes in the nose and throat, which can be caused by Klebsiella pneumoniae.
• Diarrhea: This is a common symptom of Klebsiella pneumoniae infections, particularly in patients with compromised immune systems.

Risk Factors

Certain risk factors increase the likelihood of developing a Klebsiella pneumoniae infection. These include:

• Prior use of antibiotics: The use of antibiotics can disrupt the normal balance of gut flora and increase the risk of developing a Klebsiella pneumoniae

Based on the provided context, it appears that there are several diagnostic tests available for detecting and identifying Klebsiella infections.

• Disc diffusion tests have been commonly used in diagnostic laboratories for years to detect antibiotic resistance in bacteria, including Klebsiella pneumoniae [5].
• Bacteriophage typing, combined with extensive sampling and detailed antibiotic susceptibility testing, has also been used to identify different strains of MDR K. pneumoniae [7].
• Microbial cell-free DNA sequencing using the Karius test (KT) can detect organisms not identified by conventional microbiological tests, including Klebsiella pneumoniae [9].

Additionally, there are various diagnostic medical sonography programs that provide patient services using diagnostic techniques under the supervision of a licensed Doctor of Medicine or osteopathy [14]. However, these programs do not specifically focus on diagnosing infectious diseases caused by commensal bacteria like Klebsiella.

It's worth noting that multiplex infectious disease panel testing has been explored for its utility in diagnosis of infection in different body sites, which may include detection of bacterial infections such as those caused by Klebsiella [4].

In terms of diagnostic tests specifically designed for obsolete commensal Klebsiella infectious diseases, it seems that there is limited information available. However, bacteriophage typing and microbial cell-free DNA sequencing may be useful tools in identifying different strains of MDR K. pneumoniae.

References: [4] by MA Lewinski · 2023 · Cited by 12 [5] by E Avershina · 2023 · Cited by 27 [7] May 17, 2022 [9] by E Benamu · 2022 · Cited by 88

Treatment Options for Obsolete Commensal Klebsiella Infections

Klebsiella pneumoniae is a type of bacteria that can cause various infections, including urinary tract infections (UTIs), pneumonia, and bloodstream infections. However, with the rise of antibiotic resistance, treating these infections has become increasingly challenging.

Colistin: A Last Resort Antibiotic According to [2], Colistin is a last resort antibiotic medication for the treatment of infections caused by carbapenem-resistant Klebsiella pneumoniae. This suggests that Colistin may be an effective option for treating obsolete commensal Klebsiella infections.

Phage Therapy and Antimicrobial Peptides Research has also explored the use of phage therapy, antimicrobial peptides, nanoparticles, and antisense antimicrobial oligonucleotides as potential treatments for antibiotic-resistant bacterial infections, including those caused by Klebsiella pneumoniae [1][9].

Combination Therapy with New β-lactamase Inhibitors Studies have shown that combining new antibiotics with new β-lactamase inhibitors can enhance the effectiveness of treatment against Klebsiella pneumoniae infections [3]. This approach may be a promising strategy for treating obsolete commensal Klebsiella infections.

Pathogen Reduction and Combination Therapy Additionally, pathogen reduction is an emerging strategy to prevent transmission of, and infection with, antimicrobial-resistant healthcare-associated pathogens, including those caused by Klebsiella pneumoniae [5]. This approach may also involve combination therapy with other antibiotics or antimicrobial agents.

It's worth noting that the treatment options for obsolete commensal Klebsiella infections are limited due to antibiotic resistance. Therefore, a comprehensive and multi-faceted approach may be necessary to effectively treat these infections.

References: [1] by HA Mdarhri · 2022 · Cited by 48 [2] by OF Nwabor · 2021 · Cited by 6 [3] by H Alaoui Mdarhri · 2022 · Cited by 47 [5] May 22, 2024 [9] by LM Streicher · 2021 · Cited by 83

Differential Diagnosis of Obsolete Commensal Klebsiella Infectious Diseases

Klebsiella species, once considered harmless commensals, have evolved to become significant human pathogens. The differential diagnosis of Klebsiella infections involves distinguishing them from other bacterial and non-bacterial causes of disease.

Key Points:

• Klebsiella pneumoniae: This species is a leading cause of hospital-acquired infections (HAIs) in the United States, accounting for 9.9% of all HAIs [1][2].
• Virulent clones: Research has identified specific virulent clones associated with Klebsiella infections, providing an evolutionary framework for understanding disease transmission and progression [3][5].
• Co-occurrence of multiple sequence types: Studies have demonstrated the co-occurrence of multiple sequence types in K. pneumoniae isolates from patients with severe pneumonia, highlighting the complexity of Klebsiella infections [4].

Differential Diagnosis:

When considering a differential diagnosis for obsolete commensal Klebsiella infectious diseases, clinicians should consider the following:

• Other bacterial causes: Infections caused by other bacteria, such as Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus, can present similarly to Klebsiella infections.
• Non-bacterial causes: Conditions such as pneumonia, sepsis, and urinary tract infections can also be caused by non-bacterial pathogens, including viruses and fungi.

Key Considerations:

When differentiating between Klebsiella infections and other causes of disease, clinicians should consider the following:

• Clinical presentation: The clinical presentation of Klebsiella infections can vary widely, but often includes symptoms such as fever, cough, and shortness of breath.
• Laboratory findings: Laboratory tests, including blood cultures and molecular diagnostics, can help confirm a diagnosis of Klebsiella infection.
• Risk factors: Patients with certain risk factors, such as immunocompromised status or recent antibiotic use, may be more susceptible to Klebsiella infections.

References:

[1] RM Martin (2018) - Cited by 967 [2] RM Martin (2018) - Cited by 967 [3] S Brisse (2009) - Cited by 595 [4] May 17, 2022 - [5] S Brisse (2009) - Cited by 595