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Klebsiella aerogenes, [2] previously known as Enterobacter aerogenes, is a Gram-negative, oxidase-negative, catalase-positive, citrate-positive, indole-negative, rod-shaped bacterium. [3] Capable of motility via peritrichous flagella, [ 4 ] it is approximately one to three microns in length.
Urinary tract infection in pediatric patients is a significant clinical issue, affecting approximately 7% of fevered infants and children. [43] If left untreated, the infection can ascend from the bladder to the kidneys, resulting in acute pyelonephritis, which leads to hypertension , kidney scarring , and end-stage kidney disease .
Nitrofurantoin cannot be used to treat infections other than simple cystitis. At the concentrations achieved in urine (>100 μg/mL), nitrofurantoin is a bactericide. It is bacteriostatic against most susceptible organisms at concentrations less than 32 μg/mL. [9] Nitrofurantoin and the quinolone antibiotics are mutually antagonistic in vitro ...
Among children, urinary tract infections are most common in uncircumcised males less than three months of age, followed by females less than one year. [28] Estimates of frequency among children, however, vary widely. In a group of children with a fever, ranging in age between birth and two years, 2–20% were diagnosed with a UTI. [28]
In Klebsiella pneumoniae, the lack of either OmpK35 or OmpK36 leads to carbapenem resistance, but with the lack of both proteins, a high level of resistance is present. [24] An observed 32- to 64-fold increase in minimum inhibitory concentrations occurs for the carbapenems when both proteins are not expressed. [24]
Klebsiella organisms can lead to a wide range of disease states, notably pneumonia, urinary tract infections, sepsis, meningitis, diarrhea, peritonitis and soft tissue infections. [ 6 ] [ 11 ] Klebsiella species have also been implicated in the pathogenesis of ankylosing spondylitis and other spondyloarthropathies . [ 12 ]
Sensitivity testing results can allow a clinician to change the choice of antibiotics from empiric therapy, which is when an antibiotic is selected based on clinical suspicion about the site of an infection and common causative bacteria, to directed therapy, in which the choice of antibiotic is based on knowledge of the organism and its ...
Other potential pathogens are Klebsiella spp., and group B streptococci. [8] [10] It is more common in women, in the elderly, in residents of long-term care facilities, and in people with diabetes, bladder catheters, and spinal cord injuries. [11] People with a long-term Foley catheter always show bacteriuria. Chronic asymptomatic bacteriuria ...