Regrine B.

Lagarteja MICRO 203

2013-88648

IDENTIFICATION OF BACTERIAL UNKNOWNS

SPECIMEN: THROAT SWAB
SPECIMEN NO.: 11
MORPHOLOGY
Grams Stain: Gram (-) bacilli

Diagram for Differential Diagnosis of Pathogenic Gram (-) bacilli
Adapted from Bergeys Manual of Diagnostic Microbiology









Regrine B. Lagarteja MICRO 203
2013-88648
CULTURAL CHARACTERISTICS
BAP: pinpoint gamma hemolytic colonies
MAC: Pinpoint Pink Colonies, Mucoid

BIOCHEMICAL CHARACTERISTICS
Biochemical Test Result
Methyl Red -
Vogues- Proskauer +
Citrate +
TSI K/A, H
2
S -
Urease +
SIM ---
*Gelatinase +
*Lysine Decarboxylase +
*Arginine Dihydrolase -
*Ornithine Decarboxylase -
*Malonate +
Sugar Fermentation
Glucose + w/ gas
Sucrose +
Lactose +
Mannitol +
*Inositol +
*Sorbitol +
*Dulcitol +/-
*Arabinose +
*Rhamnose +
*String Test +
*Neufeld Quellung Test +

*not performed

Suspected isolate: Klebsiella pneumoniae
Pathogen? NO, when not dislodged in the lungs

Klebsiella pneumoniae
Klebsiella pneumoniae is a Gram-negative, nonmotile, encapsulated, facultative anaerobic, rod-
shaped bacterium. It is part of the normal flora of the mouth, skin, and intestines. It can cause
destructive changes to human lungs if aspirated. (Ryan & Ray, 2007)
Klebsiella pneumoniae must enter the respiratory tract to cause pneumonia, the blood to cause a
bloodstream infection and end-organ damage (such as liver abscess or CNS infection), or must enter
devitalized tissues to cause infection of burns and wounds.
K. pneumoniae associated pneumonia is typically caused by aspiration of oropharyngeal microbes
into the lower respiratory tract. The pneumonia caused by this organism is sometimes associated with
thick, bloody, mucoid sputum called currant jelly sputum, but can also cause lung abscesses and
pneumonia that can be difficult to distinguish from those caused by other pathogens. Klebsiella
Regrine B. Lagarteja MICRO 203
2013-88648
infections are more likely in immunosuppressed patients, such as diabetics, alcoholics, patients who
are intubated, and others. (Tufts Medical Center, 2012)

Klebsiella pneumoniae is a very common pathogen that is encountered by many health care
providers. Other than being a hospital-acquired pathogen that causes several infections such as
urinary tract, nosocomial pneumonia and intraabdominal infections, pneumoniae has been identified
as a community-acquired infection with fluctuating prevalence. Strong correlation has been
established between the demographic and geographic distribution among world populations and the
incidents of community-acquired infections caused by K. penumoniae. K. pneumoniae has been
considered a respiratory pathogen that causes Pneumoniae, the sysmptoms include: toxic
presentation with sudden onset, high fever, and hemoptysis. Diagnosis through chest radiograph
looks for abnormalities such as bulging interlobar fissure and cavitary abscesses. Over the years the
contribution of K. pneumoniae to the total community-acquired cases of Pneumoniae has severely
declined, while its contribution to other disease states increased. Community Acquired K.
pneumoniae has been responsible for increased number of bacteremic liver abscess cases,
especially in central and far Asia. Patients with Klebsiella liver abscess also showed higher rates of
occurrence for the following complications: pulmonary emboli or abscess, brain abscess, pyogenic
meningitis, endophthalmitis, prostatic abscess, osteomyelitis, septic arthritis, or psoas abscess. It is
important to note that the rates of infections caused by community-acquired K. pneumoniae vary
among world populations. For example: the rate of meningitis caused by K. pneumonia increased
more than two folds in some hospitals in central Asia, while the same infection caused by K.
pneumoniae only accounted for less than 2% in a hospital in the United States. (Wen-Chien,
Paterson, Sagnimeni, & Hansen, 2002) (Kang, 2006)

References
Ryan, K., & Ray, C. (2007). Sherris Medical Microbiology (9th ed.). USA: McGrawHill.

Tufts Medical Center. (2012). Exposure Response Plan for the Laboratory Handling of Klebsiella
pneumoniae. Retrieved February 8, 2013, from Institutional Biosafety Committee: Tufts University-
Tufts Medical Center: http://www.tufts.edu/central/research/IBC/klebsiella_pneumoniae.html

Wen-Chien, D., Paterson, D., Sagnimeni, A., & Hansen, D. (2002). Community-Acquired Klebsiella
Pneumoniae Bacteremia: Global Differences in Clinical Patterns. PubMed .

Kang, C.-I. (2006). Community-Acquired versus Nosocomial Klebsiella Pneumoniae Bacteremia:
Clinical Features, Treatment Outcomes, and Clinical Implication of Antimicrobial Resistance. Korean
Medical Science .