Klebsiella pneumoniae: Properties, Diseases and Laboratory Diagnosis

Klebsiella pneumoniae is a Gram-negative rod shaped bacteria of genus Klebsiella and family Enterobacteriaceae. They are members of normal intestinal flora of humans and animals and may be isolated from a variety of environmental sources.

K. pneumoniae was first isolated in the late 19th century and was initially known as Friedlander’s bacterium

Klebsiella pneumoniae causes infections in people of all age groups especially in infants, elderly, immunocompromised and alcoholics.  It is one of the leading cause of hospital-acquired (nosocomial) infections. The range of infections includes pneumonia (it is a frequent case of ventilator associated pneumonia), urinary tract infection, blood stream infection (BSI), and liver abscesses. Though Klebsiella pneumoniae accounts for a small percentage of pneumonia cases, the case fatality rates are high (up to 90% in untreated cases).

Klebsiella pneumoniae is a major threat to public health with the emergence of multidrug-resistant strains, rendering infection by these strains very challenging to treat. Strains of K. pneumoniae producing extended-spectrum beta-lactamases (ESBLs) or carbapenemases are considered global priority pathogens.

General Properties:

  1. Gram negative
  2. Non-spore-forming rods
  3. Facultative anaerobes
  4. Catalase Test: Positive
  5. Oxidase Test: Negative
  6. Lactose fermenter (forms pink colored colonies in MacConkey Agar).
  7. Presence of polysaccharide capsule (in the culture plate mucoid colonies are seen).
  8. Non-motile (Klebsiella species are nonmotile and nonflagellated and thus have no H antigens).

Virulence Factors of K. pneumoniae

  • Capsule
  • Cell wall receptors
  • Lipopolysaccharide (endotoxin)
  • Fimbriae
  • Siderophores

Virulence factors of Klebsiella pneumoniae will be discussed in-depth in another post.

Virulence factors of K. pneumoniae (Source)

Laboratory diagnosis of K. pneumoniae infection

Sample: Sputum (Red currant-jelly sputum may be seen in patient infected with K.pneumoniae), mid-stream urine or blood (depending on the suspected illness/clinical presentation).

Colony characteristics of Klebsiella pneumoniae  

Various biochemical tests using conventional methods or miniature commercial system (API-20E or Enterotube test) is done to identify the suspected colony as Klebsiella pneumoniae.  Some of the commonly used tests for the identification of Klebsiella pneumoniae is given below.

Test Name Results
Indole Production Test Negative (K.oxytoca is Indole positive)
Methyl-Red Test Negative
Voges-Proskauer Test Positive
Citrate Utilization Test Positive
Hydrogen Sulfide Production
(TSI)
Negative
Urea Hydrolysis Test Positive
Lysine Decarboxylase Test Positive
Arginine Dihydrolase Test Negative
Ornithine decarboxylase test Negative
Motility at 36 °C Non-motile
D-Glucose (acid/gas) Positive/Positive
D-mannitol fermentation Positive
Sucrose fermentation Positive
Lactose fermentation Positive
D-sorbitol fermentation Positive
Cellobiose Positive
Esculin hydrolysis Positive
Acetate Utilization Test Positive
ONPG Test Positive

Note: To minimize the cost and effort, some diagnostic/hospital laboratories perform only certain tests such as Triple Sugar Iron Agar (TSI), Sulphite Indole Motility (SIM) / Urease Indole Motility (UIM) and Citrate utilization test to identify isolates of Enterobacteriaceae family, full panel/commercially available miniature test system (API-20E and Enterotube test) is used only when the tests results are inconclusive.

About tankeshwar 385 Articles
Hello, thank you for visiting my blog. I am Tankeshwar Acharya. Blogging is my passion, I am working as an Asst. Professor and Microbiologist at Department of Microbiology and Immunology, Patan Academy of Health Sciences, Nepal. If you want me to write about any posts that you found confusing/difficult, please mention in the comments below.

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