phenylephrine-hydrochloride and Klebsiella-Infections

The alteration of the microbial community in the upper respiratory tract (URT) can contribute to the colonization and invasion of respiratory pathogens. However, there are no studies regarding whether the characteristics of the URT microbiota can be affected by infections in lower respiratory tract (LRT). To elucidate the microbial profiles of the URT during pneumonia, the oral, nasal, and lung microbiota was evaluated at the early phase in a murine pneumonia model by direct intratracheal inoculation of Klebsiella pneumoniae. The meta 16S rRNA sequencing of bronchoalveolar lavage fluid after K. pneumoniae inoculation presented alterations in the beta diversity of the microbes, but not in the alpha diversity. At this point, a significant increase in microbial alpha diversity was observed in the oral cavity, but not in the nasal cavity. The significant increase was observed in the family Carnobacteriaceae and family Enterococcaceae. These results suggest that characterizing the microbial community of the respiratory tract may not just involve a simple downstream relationship from the URT to the LRT. The health status of the LRT may influence the oral microbiota. Thus, evaluation of the oral microbiota may contribute towards monitoring lung health; the oral microbiota may act as a diagnostic marker of pneumonia.

Topics: Animals; Bronchoalveolar Lavage Fluid; Disease Models, Animal; Female; Klebsiella Infections; Klebsiella pneumoniae; Lung; Mice; Mice, Inbred C57BL; Microbiota; Mouth; Nose; Pneumonia, Bacterial; RNA, Ribosomal, 16S

Topics: Anti-Bacterial Agents; Bacterial Proteins; beta-Lactamases; Carbapenems; Drug Resistance, Multiple, Bacterial; Genes, Bacterial; Humans; Hydrolysis; Infant, Newborn; Klebsiella Infections; Klebsiella pneumoniae; Microbial Sensitivity Tests; Nose; Respiratory Distress Syndrome, Newborn

Ozena, or atrophic rhinitis, is a chronic nasal process seen in Africa, India, and the Middle East. It is marked by the triad of fetid nasal discharge, crusting, and atrophy, and is often associated with Klebsiella infection. We present cases of ozena with nasal Klebsiella in three unrelated patients, including two east African children and one Saudi adult. All three patients grew Klebsiella species in culture and required prolonged treatment with multiple methodologies, including antibiotics, saline rinses, and surgical debridement. They differed greatly in time from presentation to diagnosis, and demonstrated various stages of the disease process. Ozena is rarely seen in the United States, and when it is seen, it is often misdiagnosed. Lack of prompt, adequate treatment can lead to long-term sequelae such as obliteration of nasal architecture, anosmia, sinus and skull base destruction, and social disenfranchisement due to the extreme foul smell of the nasal discharge. Clinicians should maintain a high index of suspicion for primary atrophic rhinitis when presented with its classic symptoms. Culture-directed and prolonged therapy with appropriate follow-up is a necessary component of a successful treatment plan.

Topics: Aged; Amoxicillin; Azithromycin; Child; Clavulanic Acid; Drug Resistance, Multiple, Bacterial; Emigrants and Immigrants; Ethiopia; Female; Gentamicins; Humans; Infant; Klebsiella; Klebsiella Infections; Male; Nose; Refugees; Rhinitis, Atrophic; Saudi Arabia; Somalia; Treatment Outcome

Rhinoscleroma is a chronic granulomatous respiratory tract disease. The initial lesion site is often intra-nasal. Giant tumor presentations are rare. The authors report a case of extensive nasal rhinoscleroma.. A 35-year-old African male patient consulted for a large tumor of the nose. The tumor had appeared 25 years before; the initial lesion site was intra-nasal. It presented as a small non-obstructive growth. The tumor was removed 20 years before, and recurred in an exophytic presentation. The main tumor was associated to peripheral, peri-nasal, and upper lip nodules. There was a central granuloma, bleeding on contact. Nasal obstruction was complete. The histological and bacteriological examination of a biopsy specimen confirmed the diagnosis of rhinoscleroma. Trimethoprim-sulfamethoxazole was effective on the infection.. Rhinoscleroma is frequently located on the nasal mucosa, but extra-nasal giant tumor presentations are rare. It can involve the whole respiratory tract. It is endemic in developing countries. Sporadic cases have been described in non-endemic areas, among migrants. The diagnosis is proved by histology. Specific and early antibiotic therapy is effective. It avoids surgical mutilation, sequels, and recurrence.

Topics: Adult; Anti-Infective Agents; Disease Progression; Humans; Klebsiella Infections; Klebsiella pneumoniae; Male; Nasal Obstruction; Nose; Pefloxacin; Plastic Surgery Procedures; Rhinoscleroma; Trimethoprim, Sulfamethoxazole Drug Combination

We report a case of intranasal porous polyethylene implant extrusion 7 years after insertion in a patient with Hashimoto disease. We also discuss the possible causes of the extrusion and convey the histopathologic examination and microbiological investigation results of the samples taken from the removed implant.

Topics: Adult; Biocompatible Materials; Female; Follow-Up Studies; Hashimoto Disease; Humans; Hyperemia; Klebsiella Infections; Klebsiella oxytoca; Nose; Nose Diseases; Polyethylene; Polyethylenes; Porosity; Prostheses and Implants; Serratia Infections; Serratia marcescens

Klebsiella rhinoscleromatis and Klebsiella ozaenae are associated with chronic diseases of the upper airways: rhinoscleroma and ozena, respectively. These have become uncommon in developed countries. We report herein one case of each disease in patients living in Marseilles, France, and include a review of the literature.. Diagnosis was made by direct evidence of bacteria (specific cultures and autoimmunohistochemistry on nasal biopsy) and using an indirect method (serology). In addition, the literature review showed that the majority of publications were old, confirming the fact that these diseases have been long forgotten.. The specific and original methods used have allowed us to confirm the pathogenic role of K. ozaenae in ozena and confirmed rhinoscleroma in a granulomatous lesion. In the literature, K. rhinoscleromatis is only associated with rhinoscleroma whereas K. ozaenae is also associated with clinical diseases other than chronic rhinitis.. In cases of chronic rhinitis, ozena and rhinoscleroma should be kept in mind, even in developed countries, and systematically screened for, especially as there are specific diagnostic tools and effective treatments available.

Topics: Adult; Aged; Female; Humans; Klebsiella Infections; Klebsiella pneumoniae; Nose; Rhinitis, Atrophic; Rhinoscleroma

During 11 months 58 extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (ESBL-Kp) isolates were grown from 10 patients on a neurological early rehabilitation unit. The patients had no signs of infection but were colonized in the nose and trachea, and unusually only one had colonization in the gut. A single clone of ESBL-Kp was identified by pulse field gel electrophoresis. Strong hygienic precautions similar to those for Methicillin-resistant Staphylococcus aureus patients prevented spread of the bacteria to other wards. However, rehabilitation for patients with severe neurological failures made it very difficult to follow hygienic requirements. Disinfection of mucous membranes was difficult. Eventually the application of a nasal spray containing povidone-iodine proved to be successful.

Topics: Anti-Infective Agents, Local; beta-Lactamases; Carrier State; Cross Infection; Drug Resistance, Microbial; Environmental Microbiology; Humans; Infection Control; Klebsiella Infections; Klebsiella pneumoniae; Microbial Sensitivity Tests; Nose; Physical Therapy Department, Hospital; Povidone-Iodine; Trachea

The effectiveness of two aerosol delivery systems, nose-only and whole-body, were compared using Swiss-Webster mice and two pathogens, Klebsiella pneumoniae and Venezuelan equine encephalitis (VEE) virus. With K. pneumoniae the median lethal dose (LD50) and the mean time to death correlated with the inhaled dose. An LD50 value of 335 colony forming units (cfu) for nose-only exposure was significantly less than the LD50 value of 3741 cfu obtained for whole-body exposure. The LD50 values obtained with VEE virus for nose-only exposure [8 plaque forming units (pfu)] and whole-body exposure (11 pfu) were similar to each other. Following a 10-min nose-only exposure, concentrations of K. pneumoniae approximating 10(4)/g were present after 24 hr in the upper respiratory tract (URT) and lungs. The numbers of bacteria reached a peak at 72 hr, when resolution of the infection began. Detectable levels of bacteria in the blood and tissues were delayed in mice given whole-body exposure, plus there was a decreased concentration of bacteria per gram of tissue. Major pathological lesions induced by K. pneumoniae were mild suppurative rhinitis and minimal suppurative bronchopneumonia. Viremia was greatest at 96 hr following aerosol exposure to VEE. Virus concentrations in the URT, lungs, cerebrum, spleen and mesenteric lymph nodes reached maximum titers earlier for mice exposed by nose-only than for mice exposed to whole-body aerosols.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Aerosols; Animals; Disease Models, Animal; Encephalomyelitis, Venezuelan Equine; Female; Klebsiella Infections; Klebsiella pneumoniae; Lethal Dose 50; Mice; Nose; Respiratory Tract Infections

Topics: Female; Humans; Klebsiella Infections; Klebsiella pneumoniae; Lip; Middle Aged; Nose; Rhinoscleroma; Skin Diseases

Topics: Female; Humans; Klebsiella Infections; Klebsiella pneumoniae; Laryngostenosis; Larynx; Middle Aged; Nose; Rhinoscleroma

Nosocomial infections in an intensive care nursery (ICN) due to kanamycin-resistant Klebsiella pneumoniae during a four-month period with an infection rate of 12% and mortality of 47% are reported. Emergence of this organism was thought to be due to the widespread use of kanamycin. Transmission probably occurred via hands of personnel contaminated during care of colonized or infected infants. Control measures advocated are better handwashing technic and discriminate use of antibiotics. This report emphasizes the need for awareness of this continuous threat and for infection surveillance in an ICN.

Topics: Asepsis; Cross Infection; Drug Resistance, Microbial; Hexachlorophene; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intensive Care Units; Kanamycin; Klebsiella Infections; Klebsiella pneumoniae; Nose; Nurseries, Hospital; Retrospective Studies

Topics: Aged; Arm; Bacterial Infections; Ear Diseases; Ear, External; Escherichia coli Infections; Female; Foot; Foot Diseases; Gangrene; Hand; Humans; Hypotension; Ischemia; Klebsiella Infections; Leg; Male; Middle Aged; Nose; Nose Diseases; Pneumococcal Infections; Pseudomonas Infections; Sepsis; Thrombosis

Topics: Adult; Anti-Bacterial Agents; Carrier State; Cross Infection; Female; Humans; Klebsiella; Klebsiella Infections; Male; Medical Staff, Hospital; Microbial Sensitivity Tests; Nose; Pharynx