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Klebsiella pneumonia and oxytocin in infants

 

Klebsiella in infants is the presence of a bacterium in the urine, the feces of a child, which can cause various diseases. But this is not always a cause for concern, because this microorganism is opportunistic and can be in a certain concentration and normal. However, there are diseases that can develop because of this bacterium, so you need to know about all such cases.

Epidemiology

Statistics of the Klebsiella distribution suggest that more than 57% of the first year of life have Klebsiella as a representative of normal microflora. And only in 13% of children this pathogen causes disturbances on the part of the intestine. As for Klebsiella pneumonia, this microorganism causes pneumonia in 12% of cases. This is a very large figure, which indicates the need for treatment taking into account this particular pathogen.

Causes of the klebsiella in infants

What is so dangerous klebsiella in babies? Before talking about such dangers, you need to understand what Klebsiella is and what role it plays in the child's body.

Klebsiella is a microorganism that belongs to enterobacteria. It has the shape of a medium-sized rod, does not form any spores and does not have flagella. Klebsiella can live in conditions with air access (aerobic), but it can also exist without access to air (anaerobic). Due to such properties, it can survive in different environments of the human body. In addition, the bacterium is covered with a capsule, which is very resistant to environmental factors. Because of such a tight capsule, she can live for a long time on household items, as well as skin and mucous membranes, not succumbing to the action of cilia of the epithelium. This bacterium can release endotoxin, which affects the clinic for diseases caused by Klebsiella.

Klebsiella enters the human body by airborne droplets and by contact. When it comes to babies, the first hit of this bacterium can be immediately after birth. This bacterium is located on the mucous membranes and skin of the mother, and during childbirth gets on the skin and mucous baby. Further, the Klebsiella descends into the gastrointestinal tract, where it is located along with other bacteria, providing antagonism to pathogenic factors. But in the case when the Klebsiella multiplies in large numbers, it causes pathology.

There are several species of these microorganisms: Klebsiella pneumonia, Klebsiella ozene, Klebsiella oxytoca.

Klebsiella pneumonia can cause pneumonia, can affect joints, meninges, and cause urinary tract infection. This causative agent is a representative of the normal flora of the child, both a newborn and a child of the first year of life. The bacterium is located on the mucous membranes of the respiratory tract or intestines and can cause pathology only under certain conditions. Most often these are children born with broncho-pulmonary dysplasia who have leukemia or other diseases. The development of the disease occurs due to the fact that the pathogenic strains of the bacteria get on the mucous membrane of the upper respiratory tract, and thanks to a dense capsule and adhesion factors, it is tightly attached. After that, the bacterium multiplies at the site of localization and causes the disease. If we talk about the infection of the urinary tract, then the mechanism of infection is likely upward. That is, in contact with the skin and mucous mums during childbirth, the bacterium enters the genital organs of the child and there it can persist. In girls, it easily penetrates the urinary tract and can cause pyelonephritis, cystitis and other inflammatory infections. Often, the clinic of pneumonia can be preceded by diarrhea or other symptoms from the gastrointestinal tract, and only after that there are symptoms of pneumonia.

Klebsiella ozen often affects the mucous membrane of the nose and paranasal sinuses. It is dangerous in terms of development of mucosal atrophy.

Klebsiella oxytoca can cause the same pathologies as other species, but more it is prone to damage to the oral mucosa with the development of stomatitis, gingivitis, and can also cause sepsis.

Since this organism can normally live only in the intestine in a certain concentration, the appearance of a Klebsiella in a baby can be associated with an external infection of the child in contact with sick people. The pathogenesis of diseases caused by Klebsiella is characteristic of any infectious pathology. It penetrates the skin or mucous membranes, secretes toxins and thus stimulates the immune response. So there is inflammation and symptoms appear.

The reasons why the bacterium begins to multiply in large numbers are more often caused by bowel pathology. Very often in infants against the background of a change in diet, normal flora can be inhibited and then the upper side takes the opportunistic pathogen. If the child has impaired absorption in the intestine (malabsorption syndrome, lactase deficiency), then it causes food stagnation and fermentation. In such conditions klebsiella can reproduce. Feeding a child with a mixture in the first half of life can also cause an imbalance between the Klebsiella and other bacteria.

If a child is treated with an antibiotic, this can affect the growth of the Klebsiella in the intestine. Violation of the ratio of pathogenic, opportunistic and normal microorganisms often has a secondary character in the defeat of digestive organs due to other pathologies.

Risk factors

In infants, a disturbance in the composition of normal microflora is due to the insufficiently coordinated work of different organs and their response to harmful environmental factors. Therefore, under the influence of adverse factors, children are particularly sensitive to such influences and it is necessary to identify risk factors in order to pay attention to this in advance:

  1. children who are born with pathological births and who can not immediately be attached to the breast. After all, the first contact with the skin of the mother plays a major role in the development of the microbiocenosis in the child.
  2. antibacterial therapy without protection of microflora;
  3. technical manipulation or resuscitation of a child with a disruption of the protective function of mucous membranes and skin;
  4. artificial feeding of a child;
  5. inadequate complementary feeding or diet, which have a bad effect on the flora of the child.

Such risk factors must be taken into account and corrected.

Symptoms of the klebsiella in infants

Symptoms of Klebsiella in the baby depend on where the pathogen is located. If we are talking about Klebsiella pneumonia, it causes pneumonia and is localized in the alveoli. If the inflammatory process is localized near the root of the lung, then focal pneumonia develops. When the inflammation covers a separate lobe of the lung, then it is a question of croupous or lobar pneumonia.

Inflammation of the lungs caused by Klebsiella pneumonia is more often observed in newborns with the development of early pneumonia. This causative agent refers to the flora, which is a hospital, which is the factor of infection of the child after childbirth. With regard to pneumonia in infants, the Klebsiella can cause inflammation at any age, then the transmission factor may be sick people.

The first signs of pneumonia appear on the first day of the disease. The leading symptom is intoxication. At the same time, the child begins to eat poorly, is capricious, and the body temperature rises. At the beginning of the disease, body temperature can be subfebrile, but on the second day it usually rises to 39. The smaller the age of the child, the less it is necessary to focus on the temperature indicator, because it may not rise in very young children.

Along with these symptoms, there are signs of shortness of breath. For pneumonia, the first-second degree of dyspnea is characteristic. In infants this is manifested by pallor of the skin and cyanosis around the mouth, which appears when the child is restless. In addition, additional muscles participate in the act of breathing - you can notice the child's swelling of the wings of the nose, retraction of the supraclavicular areas. The child is inactive, often lies and does not want to play. It is important at this stage to drink a child well, because with increased temperature, it loses a lot of fluid. In addition to these symptoms, a cough is characteristic of pneumonia. At first it has a dry character, if pneumonia develops without the previous rhinitis. Further, the cough becomes deeper and moist. Intoxication increases with an increase in body temperature. There is also an increase in the respiratory rate of the baby and an increase in heart rate.

All these symptoms of respiratory failure indicate a high probability of pneumonia, which immediately need to pay attention. The fact that exactly can be said about the Klebsiella, the causative agent of pneumonia, can not be distinguished at the initial stage. More accurate diagnosis can only be after conducting laboratory tests. Klebsiella and Staphylococcus aureus in infants, as causative agents of the inflammatory process in the lungs, are characterized by the development of severe pneumonia. The combination of these two pathogens leads to a rapid development of necrotic changes in the alveoli, which are difficult to later correct. Such pneumonia, as a rule, develop in children with severe concomitant pathologies or immunodeficiencies.

Klebsiella oxytoc in infants causes the development of stomatitis and gingivitis. She under normal conditions can be on the skin in a small concentration, but under certain conditions gets on the mucosa and begins to multiply. Therefore, the peak incidence of Klebsiella oxytoc is the age of children starting from six months. It is at this time that teething begins and the child can become infected through dirty objects and toys. The first symptoms of stomatitis caused by klebsiella are characterized by the presence of inflammatory foci on the mucosa. Elements of rashes have the color of white dots that cover the entire mucosa from the inside of the oral cavity, or there can be single foci on the mucosa of the cheek. Rashes in the mouth cause itching and burning, so the child can not eat anything and refuses to breast. Body temperature may increase. Such stomatitis has the danger of spreading further to the gastrointestinal tract with the development of inflammation. Therefore, it is important to immediately pay attention to the first signs of stomatitis.

If klebsiella gets upwards on the urinary tract and kidneys, then this can lead to the development of inflammation of the urogenital system. And klebsiella, as one of the possible pathogens, occupies one of the highest priority places. It causes acute pyelonephritis in girls of the first year of life in more than 45% of cases.

The first symptoms of pyelonephritis or infection of the urinary tract are often manifested by an increase in body temperature. The child also becomes restless and refuses to eat. At the same time, there are no other symptoms, since the baby can not tell about back pain. The only symptom that mom can notice is a violation of the process of urination. A child may be less or more likely to urinate, and the color of urine may be cloudy. But it's difficult to diagnose if the baby wears a diaper. Therefore it is necessary that the mother pay special attention to this, especially if there are no other reasons for raising the temperature.

Klebsiella, as the causative agent of intestinal infection, is the most frequent manifestation of infection in infants. This is due to the fact that the baby has a small amount in the intestine, and under certain conditions, when the local beneficial flora decreases, symptoms of intestinal infection may appear. This is manifested by the fact that the child becomes restless, screams and already against this background can develop colic. A frequent symptom that can be alarmed in terms of infection with klebsiella may be a violation of the character of the stool. Most often the liquid stool develops, which should alert the mother. The stool can be normal, but an increase in the number of stools greater than five per day can also be considered diarrhea. This is due to the fact that the pathogenic microorganism multiplies and causes the movement of water from the cells of the intestine into space - this leads to the onset of diarrhea. If diarrhea develops against the background of Klebsiella, then the body temperature can rise, as a reaction to any infection. Vomiting is a characteristic symptom of a severe course of intestinal infection in the infant caused by klebsiella. A child can tear with food, which he ate the day before. With a severe degree of infection, there may be dehydration against diarrhea and vomiting. The stages of dehydration, which are characteristic of the defeat of the klebsiella, are limited only to the first, since the klebsiella by its mechanism can not cause serious diarrhea. But the main signs of dehydration can be dryness of the mucous baby, the lack of sweat in the underarms.

Different types of Klebsiella can cause different symptoms, depending on the organ in which the inflammatory process is localized.

Complications and consequences

The consequences of persistence of Klebsiella in the body of an infant may be only if the microorganism is in excess of the normal range. If klebsiella causes pneumonia, then with untimely diagnosis, the consequences can be very serious. Complications of pneumonia can be caused by the same pathogen, or other organisms that persist in the background of pneumonia. Frequent complications are purulent inflammatory processes of the ear with development of otitis, as well as abscesses of the lung or other organs. If the inflammatory process in the lungs remains untreated for a long time, there may be complications in the form of the spread of inflammation to the pleura with the development of pleural empyema or purulent pleurisy. These processes are very dangerous if caused by a klebsiella, as the risk of serious purulent processes rises in this case.

Complications of diarrhea caused by klebsiella can also be in the form of disturbances in absorption processes and development of malnutrition, insufficiency of microelements and the development of anemia. Allergic reactions against the background of intestinal infection also develop much more often in such children.

Diagnostics of the klebsiella in infants

Diagnosis klebsiella is very important, because the use of the treatment of drugs that act specifically on this microorganism, accelerates recovery.

If pneumonia is caused by klebsiella, then for accurate diagnosis, laboratory tests are needed, because the clinic has no specific symptoms. This inflammation of the lungs has a difficult course, so it is necessary to start specific therapy as soon as possible. Characteristic diagnostic signs of pneumonia for objective examination are crepitation and asymmetric wet wheezing in the lungs during auscultation. When percussion, blunting sounds. In severe pneumonia, oxygen saturation can be reduced, so it is necessary to measure this index. Normally it is at least 95%.

Changes in laboratory data that may indicate pneumonias caused by Klebsiella are not specific. There is a characteristic pattern for any bacterial infection - an increase in the number of leukocytes in the dynamics and the increase in rods, the growth of ESR.

Instrumental diagnosis in confirming pneumonia is the main method. To do this, X-rays of the chest cavity are performed and inflammatory foci in the lungs can be seen in the form of infiltrative shadows.

Specifically to confirm klebsiella, as the causative agent of pneumonia, it is possible by means of laboratory diagnostics of sputum of the sick child. To do this, you need to examine the smear under a microscope, which can point to the Klebsiella indirectly. But the best method of diagnosis is microbiological. This method allows to grow Klebsiella on a nutrient medium and to study its sensitivity to antibiotics.

Diagnosis of Klebsiella as causative agent of intestinal infection is the simplest task, since it is quite easy to identify the pathogen. When there are symptoms of diarrhea or any symptoms from the intestine, a stool test is performed. Klebsiella at the baby in the feces may be normal, but if it exceeds the figure, then we can say that this is the cause of the violations. For this diagnosis it is necessary to pass an analysis of feces for dysbiosis. Analyzes for dysbiosis in infants are informative only with the correct technique of delivery. The container for feces must be sterile, because the content of other microbes there can affect the result. Under normal conditions, a healthy child is determined by the total amount of intestinal flora, as well as the number of E. Coli, streptococci, hemolytic and non-hemolytic strains of staphylococci, fungi. The rate of Klebsiella in the infants in the stool should not exceed 10 in the fifth degree, and if the result of the analysis indicates more content, then most likely the Klebsiella caused disturbances.

Klebsiella in the urine of a baby in normal conditions should not be determined. If the general urine analysis has changes in the form of mucus, bacteria, leukocytes, and also klebsiella, then together with clinical symptoms one can speak of an acute urinary tract infection.

Differential diagnosis

Differential diagnosis should be performed with other pathologies that have a similar clinical picture. If the child develops pneumonia, then it is necessary to differentiate this pathology with heart diseases, which may be in a child of congenital etiology.

Disturbances of the stool should be differentiated with dysbiosis and intestinal infections of the viral etiology.

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Treatment of the klebsiella in infants

Treatment of this pathogen, even regardless of the localization of the inflammatory process, has several mandatory conditions. One of them is the use of antibacterial agents that are effective against klebsiella. Without antibiotics, treatment of any pathology is not possible. Klebsiella now has resistance to some antibiotics, so the best way to choose an effective remedy is to use a test for sensitivity to antibiotics. But if you can not get the growth of microorganisms, then the only possible option is the empirical use of antibacterial agents.

  1. Ampicillin, protected by clavulanic acid (Amoxiclav or Augmentin) is an antibiotic from the group of aminopenicillins, which acts on the Klebsiella by destroying its wall. This drug neutralizes the cell membrane of the bacterium and disrupts its reproduction. The dosage of the drug for infants is at least 45 milligrams per kilogram of the child's body weight. The course of treatment is not less than one week. Method of application - in the form of a suspension, dividing the daily dose into three doses. Side effects can be in the form of allergic reactions, and also due to the action of clavulanic acid there may be diarrhea. Precautions - do not use with an allergy in the history of this group of drugs.
  2. Neomycin is an antibiotic from the aminoglycoside group, which is effective against klebsiella when other antibiotics are ineffective. It acts on the bacterial wall of the bacterium and increases its permeability to water, which leads to the destruction of the microorganism. The dosage of the drug is 10 milligrams per kilogram. The route of administration is intramuscular or intravenous. Side effects can be in the form of systemic or skin allergic reactions.
  3. The use of probiotics in the treatment of antibiotics in infants is mandatory. Also, if the klebsiella causes disruption of the bowel, the use of the probiotic is the main element of the treatment. In this case, it is better to use probiotics with antagonistic properties.

Subalin is one of the probiotics, which is most often used today. The composition of the drug includes a strain of living bacteria Bacillus subtilis. This strain contributes to the death of Klebsiella and other pathogenic bacteria, and also contributes to the normalization of the qualitative composition of bacteria in the intestinal tract of the baby. The method of application of the drug for children of the first year of life can be in the form of a sachet or in vials. Dosage of the drug for treatment is a single dose (in the form of a sachet or in a vial) twice a day. The drug should be dissolved in a teaspoon of milk or mixture and give the child. Duration of therapy is about 10-15 days. Side effects when using the drug may be in the form of a short-term constipation.

  1. Enterol infants with Klebsiella is recommended for treatment, and also after two weeks for the prevention of complications. The preparation includes yeast-like fungi Sacromycettes bullardi, which show their antagonistic effect against many pathogenic microbes involved in the development of intestinal infection in the baby, including Klebsiella. Also fungi neutralize toxins that are released in the intestines and disrupt its normal functioning. The drug reduces the severity of diarrhea due to direct action. The way to use the drug for babies - it's best to use the sachet. Dosage - one sachet once a day for seven days. Side effects are very rare.
  2. Prema is a preparation from the group of synbiotics, which contains prebiotics in the form of fructo-oligosaccharides and probiotic Lactobacillus rhamnosus GG. This medicine is today considered to be one of the most effective means for treating diarrhea in children, including those caused by Klebsiella. This drug, getting into the intestines of the baby, immediately begins to work at the expense of the prebiotic. It inhibits the multiplication of pathogenic bacteria and prevents their further growth. The method of application in the form of drops - ten drops per day, dissolving them in milk. Treatment can be carried out for two to four weeks. There were no side effects.
  3. Enterofuril with Klebsiella in the baby is also widely used, when antibiotics can not be used in treatment. The active substance of this drug is nifuroxazide. This drug is an intestinal antiseptic and exhibits antagonistic properties against Klebsiella. Dosage of the drug - 5 milliliters three times a day. Method of application - in the form of a suspension for children older than two years. Precautions - use in infants only on the recommendation of a doctor.

Vitamins can be used after the child's recovery to improve the state of digestion and better recovery after illness. For this purpose, you can use Pikovit - a complex vitamin preparation with minerals. Dosage - 2 milliliters three times a day.

Physiotherapeutic treatment in acute period is not used.

Alternative treatment for Klebsiella in infants

Alternative therapies can be used for pneumonia caused by Klebsiella, in the form of broths for drinking by the baby. With a urinary tract infection, decoctions with an anesthetic septicemia can also be used. To treat klebsiella, as a causative agent of diarrhea, alternative therapies can also be used.

  1. The use of home-made yogurt balances the composition of microflora well and reduces the amount of pathogenic. For the preparation of such kefir you need to take fresh milk, boil it and sue. In warm milk, you need to add a special bacterial starter, bought in the store, and hold kefir in a warm place for 12 hours. You can give your child 100 grams of this kefir two or three times a day.
  2. Juice made from berries of mountain ash can be used to treat the organs of the genitourinary system, since it has pronounced antiseptic properties. For the medicine you need to take a hundred grams of berries, grind them to kashitsi, add as much boiled water. You need to give your baby a drink on the spoon, if there is no allergy.
  3. A very good effect in the treatment of the inflammatory process of the genitourinary system is revealed by the herb and the bear's ears. To do this, you need to take 30 grams of grass bear's ears and the same number of seeds of the middling, pour boiled water and insist. It is necessary to give the child two drops three times a day.

Herbal treatment can also be used to correct a child's condition.

  1. The herb of oregano has antiseptic and antitoxic properties, therefore it can be used for infection of the lungs and urogenital organs. To make a tincture on a glass of hot water, take 50 grams of dry leaves. After insisting, you need to dilute this glass of water twice and give the child to drink a teaspoon at night.
  2. Purity, string and chamomile are known for their antiseptic and antibacterial properties. To prepare medicinal tinctures, you need to take thirty grams of each herb and pour hot water. After the infusion of half an hour - can be used to wash away with cystitis in girls, which is caused by klebsiella.
  3. You need to take a hundred grams of flowers and linden leaves, pour them with water and this solution should be infused for two hours. After that, the tea should be heated and given to drink the child in a warm form instead of liquid.
  4. Infusion of flax seeds also has antiseptic properties and promotes the normalization of the stool after intestinal infection. To prepare the infusion, you need to take 50 grams of flax seeds and pour 250 water. After the solution is infused for two hours, the mother can take a teaspoon in the morning and evening if she is breastfeeding. For a baby, this medicine is very allergenic.

Homeopathy can be used to normalize stool and bowel movements after a Klebsiella infection. In the acute period of pneumonia or urinary tract infections, the use of homeopathy can be only on the recommendation of a doctor.

  1. Nuks vomica is a homeopathic preparation of plant origin, which is used in the treatment of acute and chronic intestinal pathology in children. It is especially effective against dysbiosis, which is caused by a transferred bacterial infection. The dosage of the drug for children can be three granules, which must first be dissolved in boiled water and the first week applied three times a day, and then again for three weeks - once. Side effects are in the form of redness of the skin of the face, which indicates the need to reduce the dose.
  2. Sodium iodate is a homeopathic remedy of organic origin, the main element of which is sodium iodide. The drug is used to treat infectious lesions of the intestine, which is accompanied by a disturbance of the stool with severe systemic manifestations - fever, spasmodic pain in the abdomen. Therefore, the systemic use of the drug is recommended, and if the mother is breast-feeding, it is recommended that the mother is recommended. The drug is applied to the mother in a dose of one granule four times a day. Adverse events can only be with mum's intolerance, while in the first few days a baby may have constipation. 
  3. Sanguinaria is a known homeopathic remedy that is used in the treatment of inflammations of bacterial etiology, as well as with problems with the intestines. Dosage is one pellet per day, which can be used for grudnichka raster, and give under the tongue. It dissolves quickly, and has a sweet taste. Side effects can be in the form of deterioration of the condition for a while.
  4. Ignacy is a remedy of homeopathic origin, which is used to improve the condition after intestinal infection and improve digestion. Produced in the form of a mono drug in granules. Dosage of the drug for a child at the beginning of therapy - two pellets three times, and in more severe cases, the dose is doubled. There may be side effects in the form of pale skin and mucous baby. Precautions - do not use in atopic dermatitis in a child.

Surgical treatment for Klebsiella infection is not used.

Prevention

Prevention of klebsiella in infants is the simple rules of proper feeding of the baby. It is necessary to use breast milk, which has all the vitamins and immune factors that protect the baby's body from any pathogenic bacteria, including Klebsiella.

Forecast

The prognosis in the presence of Klebsiella in the infants in the feces is positive, because the condition can be corrected in the presence of correct therapy. If klebsiella causes pneumonia in a child, then the prognosis is more serious, because the microorganism is aggressive in inflammation in the lungs. But the use of antibiotics, to which this strain is sensitive, has a good prognosis for recovery without complications.

Klebsiella in infants is the infection of the child's body with a bacterium that can cause pneumonia, urogenital system, stomatitis, enteritis. Symptoms of the disease do not have specific signs, so it is important to conduct laboratory tests. Timely treatment is the main task in identifying the child Klebsiella, as the causative agent of the disease.

Last update: 25.06.2018
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Medical expert editor

Portnov Alexey Alexandrovich

Education: Kiev National Medical University. A.A. Bogomolets, Specialty - "General Medicine"

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