Skip to main content
The Journal of Hygiene logoLink to The Journal of Hygiene
. 1979 Apr;82(2):177–193. doi: 10.1017/s0022172400025602

Nosocomial klebsiellas. I. Colonization of hospitalized patients.

M L Haverkorn, M F Michel
PMCID: PMC2130136  PMID: 429785

Abstract

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.

Full text

PDF
177

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. COWAN S. T., STEEL K. J., SHAW C., DUGUID J. P. A classification of the Klebsiella group. J Gen Microbiol. 1960 Dec;23:601–612. doi: 10.1099/00221287-23-3-601. [DOI] [PubMed] [Google Scholar]
  2. Datta N. Prevalence of extrachromosomal drug resistance. R Factors in Escherichia coli. Ann N Y Acad Sci. 1971 Jun 11;182:59–64. doi: 10.1111/j.1749-6632.1971.tb30643.x. [DOI] [PubMed] [Google Scholar]
  3. Eisenach K. D., Reber R. M., Eitzman D. V., Baer H. Nosocomial infections due to kanamycin-resistant, (R)-factor carrying enteric organisms in an intensive care nursery. Pediatrics. 1972 Sep;50(3):395–402. [PubMed] [Google Scholar]
  4. Eller C., Edwards F. F. Nitrogen-deficient medium in the differential isolation of Klebsiella and Enterobacter from feces. Appl Microbiol. 1968 Jun;16(6):896–899. doi: 10.1128/am.16.6.896-899.1968. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Finland M., McGowan J. E., Jr Nosocomial infections in surgical patients. Observations on effects of prophylactic antibiotics. Arch Surg. 1976 Feb;111(2):143–145. doi: 10.1001/archsurg.1976.01360200049008. [DOI] [PubMed] [Google Scholar]
  6. Forbes I., Gray A., Hurse A., Pavillard R. The emergence of gentamicin-resistant klebsiellae in a large general hospital. Med J Aust. 1977 Jan 1;1(1-2):14–16. doi: 10.5694/j.1326-5377.1977.tb130463.x. [DOI] [PubMed] [Google Scholar]
  7. Goto S., Enomoto S. Nalidixic acid cetrimide agar. A new selective plating medium for the selective isolation of Pseudomonas aeruginosa. Jpn J Microbiol. 1970 Jan;14(1):65–72. doi: 10.1111/j.1348-0421.1970.tb00492.x. [DOI] [PubMed] [Google Scholar]
  8. Hunt T. K., Alexander J. W., Burke J. F., MacLean L. D. Antibiotics in surgery. Arch Surg. 1975 Feb;110(2):148–155. doi: 10.1001/archsurg.1975.01360080014002. [DOI] [PubMed] [Google Scholar]
  9. Johanson W. G., Pierce A. K., Sanford J. P. Changing pharyngeal bacterial flora of hospitalized patients. Emergence of gram-negative bacilli. N Engl J Med. 1969 Nov 20;281(21):1137–1140. doi: 10.1056/NEJM196911202812101. [DOI] [PubMed] [Google Scholar]
  10. Lacey R. W. A critical appraisal of the importance of R-factors in the Enterobacteriaceae in vivo. J Antimicrob Chemother. 1975 Mar;1(1):25–37. doi: 10.1093/jac/1.1.25. [DOI] [PubMed] [Google Scholar]
  11. Martin C. M., Ikari N. S., Zimmerman J., Waitz J. A. A virulent nosocomial Klebsiella with a transferable R factor for gentamicin: emergence and suppression. J Infect Dis. 1971 Dec;124 (Suppl):S24–S29. doi: 10.1093/infdis/124.supplement_1.s24. [DOI] [PubMed] [Google Scholar]
  12. McBride M. E., Duncan W. C., Knox J. M. The environment and the microbial ecology of human skin. Appl Environ Microbiol. 1977 Mar;33(3):603–608. doi: 10.1128/aem.33.3.603-608.1977. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. McGowan J. E., Jr, Finland M. Infection and antibiotic usage at Boston City Hospital: changes in prevalence during the decade 1964-1973. J Infect Dis. 1974 Apr;129(4):421–428. doi: 10.1093/infdis/129.4.421. [DOI] [PubMed] [Google Scholar]
  14. Mouton R. P., Glerum J. H., van Loenen A. C. Relationship between antibiotic consumption and frequency of antibiotic resistance of four pathogens--a seven-year survey. J Antimicrob Chemother. 1976 Mar;2(1):9–19. doi: 10.1093/jac/2.1.9. [DOI] [PubMed] [Google Scholar]
  15. Noriega E. R., Leibowitz R. E., Richmond A. S., Rubinstein E., Schaefler S., Simberkoff M. S., Rahal J. J., Jr Nosocomial infection caused by gentamicin-resistant, streptomycin-sensitive Klebsiella. J Infect Dis. 1975 May;131 (Suppl):S45–S50. doi: 10.1093/infdis/131.supplement.s45. [DOI] [PubMed] [Google Scholar]
  16. Price D. J., Sleigh J. D. Control of infection due to Klebsiella aerogenes in a neurosurgical unit by withdrawal of all antibiotics. Lancet. 1970 Dec 12;2(7685):1213–1215. doi: 10.1016/s0140-6736(70)92179-3. [DOI] [PubMed] [Google Scholar]
  17. Rennie R. P., Duncan I. B. Combined biochemical and serological typing of clinical isolates of Klebsiella. Appl Microbiol. 1974 Oct;28(4):534–539. doi: 10.1128/am.28.4.534-539.1974. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Richmond A. S., Simberkoff M. S., Rahal J. J., Jr, Schaefler S. R factors in gentamicin-resistant organisms causing hospital infection. Lancet. 1975 Dec 13;2(7946):1176–1178. doi: 10.1016/s0140-6736(75)92660-4. [DOI] [PubMed] [Google Scholar]
  19. Riser E., Noone P., Bonnet M. L. A new serotyping method for Klebsiella species: evaluation of the technique. J Clin Pathol. 1976 Apr;29(4):305–308. doi: 10.1136/jcp.29.4.305. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Riser E., Noone P., Poulton T. A. A new serotyping method for Klebsiella species: development of the technique. J Clin Pathol. 1976 Apr;29(4):296–304. doi: 10.1136/jcp.29.4.296. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Rose H. D., Babcock J. B. Colonization of intensive care unit patients with gram-negative bacilli. Am J Epidemiol. 1975 Jun;101(6):495–501. doi: 10.1093/oxfordjournals.aje.a112120. [DOI] [PubMed] [Google Scholar]
  22. Rose H. D., Schreier J. The effect of hospitalization and antibiotic therapy on the gram-negative fecal flora. Am J Med Sci. 1968 Apr;255:228–236. doi: 10.1097/00000441-196804000-00003. [DOI] [PubMed] [Google Scholar]
  23. Rosenthal S., Tager I. B. Prevalence of gram-negative rods in the normal pharyngeal flora. Ann Intern Med. 1975 Sep;83(3):355–357. doi: 10.7326/0003-4819-83-3-355. [DOI] [PubMed] [Google Scholar]
  24. Selden R., Lee S., Wang W. L., Bennett J. V., Eickhoff T. C. Nosocomial klebsiella infections: intestinal colonization as a reservoir. Ann Intern Med. 1971 May;74(5):657–664. doi: 10.7326/0003-4819-74-5-657. [DOI] [PubMed] [Google Scholar]
  25. Sturtevant A. B., Cassell G. H., Bobo R. A., Feary T. W. Effect of antibiotic treatment on the incidence of infectious drug resistance among intestinal lactose-fermenting bacteria isolated from burn patients. Infect Immun. 1971 Mar;3(3):411–415. doi: 10.1128/iai.3.3.411-415.1971. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from The Journal of Hygiene are provided here courtesy of Cambridge University Press

RESOURCES