Klebsiella pneumoniae

Klebsiella pneumoniae is a Gram-negative, facultative anaerobic rod-shaped bacterium belonging to the genus Klebsiella.

Among others, Klebsiella pneumoniae causes the following nosocomial infections:

  • Pneumonia (including the chronic Friedländer pneumonia affecting the upper lobes of the lungs)

  • Urinary tract infections

  • Wound infections

  • Meningitis (inflammation of the meninges)

  • Sepsis

The pathogen is more commonly encountered in immunocompromised individuals. Klebsiella pneumoniae is ubiquitous, meaning that the bacterium can be present in any environmental setting.

Relevance of pathogen in transmission in endoscopy

  • Gastroenterology: Very high

  • Pulmonology: Very high

  • Ear, nose, and throat: Very high

  • Urology: Very high

Relevance for endoscope surveillance

  • High concern organism

Transmission route

In healthcare facilities, Klebsiella can be transmitted through human-to-human contact, such as patient to patient via the contaminated hands of the healthcare professionals. Less commonly, transmission occurs via contaminated surfaces.

There is also a risk of Klebsiella pneumoniae being transmitted if endoscopes are improperly reprocessed.

Resistance to antibiotics

Klebsiella pneumoniae belongs to the multi-resistant Gram-negative bacteria (MRGN). Some strains of the bacterium are resistant to 3 antibiotics groups (3MRGN), while others are resistant to 4 (4MRGN). Resistances include penicillins, 3rd generation cephalosporins, and monobactams.

Find more information here: Mobile colistin resistance (MCR-1) transmitted via a duodenoscope.

Sources and further readings

  1. Duodenoscope Surveillance Sampling & Culturing, Reducing the Risks of Infection, Department of Health and Human Services Collaboration, 2018, https://www.fda.gov/media/111081/download. Accessed on 05.05.2021.

  2. Gries O, Ly T: Infektologie – Kompendium humanpathogener Infektionskrankheiten und Erreger, Springer-Verlag Berlin Heidelberg 2019.

  3. Hygienemaßnahmen bei Infektionen oder Besiedlung mit multiresistenten gramnegativen Stäbchen, Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut (RKI), Bundesgesundheitsbl 2012 · 55:1311–1354.

  4. Klebsiella pneumoniae in Healthcare Settings, Centers for Disease Control and Prevention, https://www.cdc.gov/hai/organisms/klebsiella/klebsiella.html. Accessed on 05.05.2021.

  5. Snyder G. M. Introduction to Transmission of Infection: Potential Agents Transmitted by Endoscopy, Gastrointest Endosc Clin N Am. 2020 Oct;30(4):611-618.