How Effective Are Antibiotics for Pneumonia?

Klebsiella pneumoniae is the most important type of bacteria in the genus Klebsiella of the Enterobacteriaceae (commonly known as pneumoniae), and the disease caused by it accounts for more than 95% of Klebsiella infections.

Klebsiella is

It is a short and thick bacillus, with a size of 0.5 0.8 × 1 2um, which is arranged individually, in double or short chains. No spores, no flagella, yes

Klebsiella

Thicker capsules, mostly pili. The nutritional requirements are not high. Large off-white mucus colonies are formed on ordinary agar medium, which can be picked by inoculating loops and easily drawn into filaments, which is helpful for identification. It can ferment lactose on enterobacteria selective media and present colored colonies.

With O antigen and K antigen, the latter is used for typing. Utilizing the capsule swelling test, the K antigen can be type 82. Klebsiella pneumoniae types 3 and 12; Klebsiella pneumoniae mainly belongs to type 4, and a small number is type 5 or 6; K. rhinosclerosis generally belongs to type 3, but not all types 3 are the bacteria.

The bacteria of this genus were killed at 55 ° C for 30 minutes. It can survive on the medium for weeks to months.

Klebsiella pneumoniae (Kpn) is important for clinical isolation and nosocomial infection

Pneumococcal pneumonia accounts for 1 to 2% of bacterial pneumonia, and its pathological changes are similar to those of Streptococcus pneumoniae pneumonia, resulting in consolidation of the lung lobe or segment (alveoli are filled with inflammatory exudates). The difference is that P. pneumoniae grows fast, is destructive, and the exudate is thick and heavy, containing a large amount of

Pneumoniae with capsules; often cause necrosis, liquefaction, and pleural involvement of the alveolar wall and lung tissue, so the incidence of pulmonary abscesses and empyema is higher than that of Streptococcus pneumoniae pneumonia. Clinical features are sudden onset, with chills, high fever, cough, expectoration, and severe chest pain, and even symptoms of severe poisoning such as disturbance of consciousness, restlessness, and slang. The sputum volume is yellow-green pus and sputum, often bloody. About 25 to 50% of the cases are typical brown-red or red grape sauce-like jelly, and the sputum is extremely sticky and difficult to come out. The disease progresses rapidly. If left untreated, the lesions can expand from one lobe to another, and cyanosis and dyspnea will soon appear. There may also be digestive symptoms such as jaundice and vomiting. The lungs may have only wet sounds or signs of consolidation (reduced respiratory motion on the ipsilateral side, dullness on percussion, increased speech tremor, and hearing tubular sounds). Increased white blood cells. X-ray chest radiographs often show large shadows of the upper right lung with uneven shadows, irregular translucent areas, and interlobular fissures. A few cases show bronchial pneumonia. Pulmonary fibrosis may occur after treatment recovery. Recurrence is common. Abscesses can develop quickly within half of the patients within 4 days of onset, and empyema occurs in about a quarter of cases. Therefore, if the disease is not treated in time, the prognosis is poor.

Klebsiella extrapulmonary infections are not uncommon. It is second only to E. coli in urinary tract infection, and its clinical manifestations and pathogenesis are similar to E. coli infection. There are urinary tract irritation signs such as frequent urination, urgency, and dysuria, and urine culture is positive. It is more common in patients with preexisting inclusion disorders or poor urination (prostatic hypertrophy, urethral stricture, bladder ureteral reflux, etc.), and retention of catheterization and urinary tract device tests are often incentives. Krebs

Bacterial septicemia occurs frequently in patients with other diseases, and most often occur in hospitalized patients. The condition is dangerous, with symptoms of endotoxemia such as high fever, chills, and sweating. Symptoms of septic shock can occur, such as cold limbs, fine pulse, skin flowering, and decreased blood pressure. The incidence of shock is sometimes as high as 63%. It can also be accompanied by changes in mind, bleeding from the skin and digestive tract, and bleeding from venipuncture sites. About 13% of the cases were complicated with migrating lesions of heart, lung, kidney, and brain. The mortality rate was 37-50%. Most of the deaths were uncontrolled infection or severe toxemia. Klebsiella meningitis has the symptoms and signs of general purulent meningitis: high fever, headache, unconsciousness and stiff neck, and purulent changes in cerebrospinal fluid (significant increase in white blood cell count and protein, low sugar).

Acute pneumonia with severe symptoms of poisoning and brown-red jelly sputum. A large number of gram-negative bacilli with capsular sputum or 2 or more sputum cultures to obtain pneumococcus pneumonia can be diagnosed. The diagnosis of sepsis depends on the detection of pneumococcus in the blood, and it should be taken out for culture before antibacterial treatment or during chills and high fever. The discovery or culture of pus or secretions from the affected tissues and organs can confirm the diagnosis of extrapulmonary infections.

The choice of antibiotics should be based on the severity of the clinical infection. Most pneumococci are sensitive to aminoglycoside antibiotics such as gentamicin, cephalosporins such as cefazolin and cefuroxime (celixin), and oxygen piperazine penicillin. Chloramphenicol and polymyxin are also sensitive. Certain effect. In severe cases, the second or third generation of cephalosporin + gentamicin or amikacin or cephalosporin + oxypiperazine penicillin is recommended.

Purulent meningitis

Combination therapy, the course of treatment is at least 2 weeks. If there is empyema, purulent meningitis, etc., puncture and pus should be removed in time, and appropriate antibiotics should be applied locally on the basis of systemic antibacterial treatment. In addition, basic diseases and complications must be actively treated to eliminate factors that can weaken the body's immune function. Strengthening supportive therapies, such as supplying sufficient heat, maintaining water, and electrolytic energy balance, cannot be ignored. ^[1]

Klebsiella is distributed in the aquatic environment and also in the intestines of humans and animals. It can cause respiratory, urogenital infections, trauma, sepsis, and diarrhea. Recent research in the medical community has found that because this bacteria is very susceptible to mutation, so The drug resistance is relatively strong, and its harmfulness to human health is also increasing year by year. This paper uses a conventional test method. Based on the basic biological characteristics of Klebsiella, six patients' sputum samples from the outpatient department of Guiyang Fifth People's Hospital in Guizhou Province were combined with MR and VP. Methods The 6 sputum samples were tested.

Therapeutic medication

The results showed that the six sputum samples were all negative. Serological tests showed that the six sputum samples were not infected with Klebsiella. Their infection may be caused by other bacteria. It is concluded from the test results that the test results of this method are ideal, the detection degree is good, the practicability is also strong, the test conditions are not high, and the test can be completed under general test conditions. ^[2]