KLEBSIELLA IN RESPIRATORY DISEASE

Abstract

Klebsiella pneumoniae and Aerobacter aeorgenes cannot be distinguished on any basis. Since 1952, organisms fitting the criteria of Kauffmann have been differentiated by capsular type. Serotypes 1 to 10 were distinguished. It is concluded that Klebsiella may occasionally be present in the respiratory tract without causing clinical disease at the time the organism is isolated. Those strains which can be typed with sera for capsular types 1-10 compose a minority of the strains isolated, and the classic respiratory types 1,2 and 4 are uncommon. The latter are associated in 1/3 of the cases with destructive lung disease, whereas higher types are seldom found in such patients. Usually only the higher types were found in persons without respiratory disease. However, in patients with respiratory disease any type of Klebsiella may be isolated from patients with any of the pulmonary disease. The majority of Klehsiella strains of types higher than 1, 2 and 4, and a majority of the higher types are isolated from patients treated with penicillin or another drug to which the organism is resistant. In most such instances the Klebsiella does not seem to be pathogenic, but occasionally it may give rise to superinfection. In vitro studies of Klebsiella susceptibility suggest that streptomycin and chloramphenicol are the drugs of choice. Ninety-three per cent are susceptible to one or both of these antibiotics.