Skip to main content Accessibility help
×
Home

Nosocomial klebsiellas: I. Colonization of hospitalized patients

  • Michael L. Haverkorn (a1) and M. F. Michel (a1)

Summary

The colonization of patients by Klebsiella and several other gram-negative bacteria was studied in a hospital urological ward over a period of six months. Before and during the survey there was no evidence of an outbreak of nosocomial infection and multi-drug resistant strains of Klebsiella were not isolated.

Klebsiella were biotyped by nine biochemical tests, which led to the detection of 66 biotypes spread uniformly throughout the survey period. This method of biotyping proved a useful epidemiological tool. The colonization rate of throats, hands, and faeces of patients increased after admission to the ward, especially when antibiotics were used. The effect of systemic antibiotics was greater than that of urinary antibiotics especially on throat and faeces carrier rates. Carrier rates for Klebsiella increased also after catheterization and operation – relationships which could well be multifactorial.

During the first two weeks after admission the proportion of antibiotic resistant strains of Klebsiella in carriers increased. The proportion of resistant strains amongst isolations from clinical infections was always greater than among strains isolated routinely from sites of carriage.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Nosocomial klebsiellas: I. Colonization of hospitalized patients
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Nosocomial klebsiellas: I. Colonization of hospitalized patients
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Nosocomial klebsiellas: I. Colonization of hospitalized patients
      Available formats
      ×

Copyright

References

Hide All
Alexander, J. W. (1973). Nosocomial infections. Current Problems in Surgery, August 1973, pp. 354.
Cowan, S. T., Steel, K. J., Shaw, C. & Duguid, J. P. (1960). A classification of the Klebsiella group. Journal of General Microbiology 23, 601–2.
Cowan, S. T. & Steel, K. J. (1966). Manual for the Identification of Medical Bacteria. Cambridge University Press.
Cruickshank, R., Duguid, J. P., Marmion, B. P. & Swain, R. H. A. (1973). Medical Microbiology. Edinburgh: Churchill Livingstone.
Datta, N. (1971). R-factor in Escherichia coli. Annals of the New York Academy of Sciences 182, 5964.
Edwards, P. R. & Ewing, W. H. (1972). Identification of Enterobacteriaceae. Minneapolis: Burgess Publishing Company.
Eisenach, K. D., Reber, R. M., Eitzman, D. V. & Bear, H. (1972). Nosocomial infection due to Kanamycin-resistant (R)-factor-carrying enteric organisms in an intensive care nursery. Pediatrics 50, 395402.
Eller, C. & Edwards, F. F. (1968). Nitrogen-deficient medium in the differential isolation of Klebsiella and Enterobacter from feces. Applied Microbiology 16, 896–9.
Finland, M. & McGowan, J. E. (1976). Nosocomial infections in surgical patients. Archives of Surgery 111, 143–5.
Forbes, I., Gray, A., Hurse, A. & Pavillard, R. (1977). The emergence of Gentamicin-resistant Klebsiellae in a large general hospital. Medical Journal of Australia 1, 1416.
Goto, S. & Enomoto, S. (1970). Nalidixic acid cetrimide agar. A new selective plating medium for the selective isolation of Pseudomonas aeruginosa. Japanese Journal of Microbiology 14, 6572.
Hunt, T. K., Alexander, J. W., Burke, J. K. & MacLean, L. D. (1975). Antibiotics in surgery. Archives of Surgery 110, 148–55.
Johanson, W. G., Pierse, A. K. & Sanford, J. P. (1969). Changing pharyngeal bacterial flora in hospitalized patients. New England Journal of Medicine 281, 1137–40.
Lacey, R. W. (1975). A critical appraisal of the importance of R-factors in the Enterobacteriaceae in vivo. Journal of Antimicrobial Chemotherapy 1, 2537.
Martin, C. M., Ikari, N. S., Zimmerman, J. & Waitz, J. A. (1971). A virulent nosocomial Klebsiella with a transferable R-factor for Gentamicin: Emergence and suppression. The Journal of Infectious Diseases 124, S24–S29.
McBride, M. E., Duncan, W. C. & Knox, J. M. (1977). The environment and the microbial ecology of human skin. Applied and Environmental Microbiology 33, 603–8.
McGowan, J. E. & Finland, M. (1974). Infection and antibiotic usage at Boston City Hospital: Changes in prevalence during the decade 1964–1973. The Journal of Infectious Diseases 129, 421–8.
Mouton, R. P., Glerum, J. H. & van Loenen, A. C. (1976). Relationship between antibiotic consumption and frequency of antibiotic resistance of four pathogens: A seven-year survey. Journal of Antimicrobial Chemotherapy 2, 919.
Noriega, E. R., Leibowitz, R. E., Richmond, A. S., Rubinstrin, E., Schaefler, S., Simberkoff, M. S. & Rahal, J. J. (1975). Nosocomial infection caused by Gentamicinresistant Streptomycin-sensitive Klebsiella. Journal of Infectious Diseases 131, 545550.
Ørskow, T. (1955). The biochemical properties of Kiebsiella (Klebsiella aerogenes) strains. Acta pathologica et microbiologica scandinavica 37, 353–68.
Price, D. J. E. & Sleigh, J. D. (1970). Control of infection due to Klebsiella aerogenes in a neurosurgical unit by withdrawal of all antibiotics. Lancet ii, 1213–5.
Rennle, R. P. & Duncan, I. B. R. (1974). Combined biochemical and serological typing of clinical isolates of Kiebsiella. Applied Microbiology 28, 534–9.
Richmond, A. S., Simberkoff, M. S., Rahal, J. J. & Schaefler, S. (1975). R-factors in Gentamicin-resistant organisms causing hospital infection. Lancet ii, 1176–8.
Riser, E., Noone, P. & Bonnet, M. L. (1976). A new serotyping method for Klebsiella species: evaluation of the technique. Journal of Clinical Pathology 29, 305–8.
Riser, E., Noone, P. & Poulton, T. A. (1976). A new serotyping method for Klebsiella species: development of the technique. Journal of Clinical Pathology 29, 296304.
Rose, H. D. & Schreier, J. (1968). The effect of hospitalization and antibiotic therapy on the gram-negative fecal flora. American Journal of the Medical Sciences 255, 228–36.
Rose, H. D. & Babcock, J. B. (1975). Colonization of intensive care unit patients with gram-negative bacilli. American Journal of Epidemiology 101, 495501.
Rosenthal, S. & Tager, I. B. (1975). Prevalence of Gram-negative rods in the normal pharyngeal flora. Annals of Internal Medicine 83, 355–7.
Selden, R., Lee, S., Wang, W. L. L., Bennett, J. V. & Eickhoff, T. C. (1971). Nosocomial Kiebsiella infections; intestinal colonization as a reservoir. Annals of Internal Medicine 74, 657–64.
Sturtevant, A. B., Cassell, G. H., Bobo, R. A. & Feary, T. W. (1971). Effect of antibiotic treatment on the incidence of infectious drug resistance among intestinal lactose-fermenting bacteria isolated from burn patients. Infection and Immunity 3, 411–5.

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed