Klebsiella pneumoniae

After our “1 year away from the ward anniversary” we take S. off Augumentin.

We knew its a risk. But we need it to do it. 2.5 years on antibiotics – even if its a prophylactic dose- has to leave some effects …..its obvious it can effect other organs.

Day after we stopped, urine sample was cloudy and full of sediment but since there was no other – typical or UTI’s- symptoms we decide not to panic and wait for couple days. Very naive- or maybe wishful -thinking : I thought its S’s body is clearing from the drug after such a long time of taking it. A week later when nothing changed we dropped a sample to GP who confirmed UTI.

SO we are back on prophylactic antibiotics.

Two months later we met with our one and only Professor Mortell who suggest a change of treatment. A Week later our nephrologis Dr Atif Awan agreed – its time to change the antibiotic as Augumentin works well against other strains of bacterias. Fair enough. We might need it more when there is something going on.

In last sensitivity test S. had done a year ago she was sensitive to Nitrofurantoinas well so we switched her to it.

Three days later same story- cloudy and dark urine with lots of sediment.

Sample to laboratory – a bacteria. KLEBSIELLA PNEUMONIA (!!!).

Super fast action- faxed a prescription to pharmacy, and we started treatment. It was much better 3 days later. When we finished a 10 day course we dropped a sample to be checked.

I popped into nephrology to double check if we should carry on on Nitrofurantoinor go back to Agumentin – since S.got UTI straight after we changed the treatment. Renal team decided – stay on Nitrofurnatoin. Ok then.

And here is what I found out:

“In addition to pneumonia, Klebsiella can also cause infections in the urinary tract, lower biliary tract, and surgical wound sites. The range of clinical diseases includes pneumonia,thrombophlebitisurinary tract infectioncholecystitisdiarrhea, upper respiratory tract infection, wound infection, osteomyelitismeningitis, and bacteremia and septicemia. For patients with an invasive device in their bodies, contamination of the device becomes a risk; for example, neonatal ward devices, respiratory support equipment, and urinary catheters put patients at increased risk. Also, the use of antibiotics can be a factor that increases the risk of nosocomial infection with Klebsiella bacteria. Sepsis and septic shock can follow entry of the bacteria into the blood. “
( source: wikipedia – link in links section)

SO…. bit of surprise. Prophylactic antibiotics in order to protect kidneys, but same time risk of some crap that can actually damage them. God…

We have been told not to panic and not rush with a sample to laboratory every time its cloudy or dark and full of sediment, as its doesn’t have to be an infection each time.

But to be on the safe side I think we will. If we wouldn’t the last time ( for example) we wouldn’t find out its Klebsiella.

Note to myself: trust your instincts 🙂

Links :

Klebsiella Pneumoniae

http://emedicine.medscape.com/article/219907-overview

http://emedicine.medscape.com/article/219907-treatment

https://en.wikipedia.org/wiki/Klebsiella_pneumoniae

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