Klebsiella

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Background

The majority of Klebsiella infections are caused by K. pneumoniae, followed by K. oxytoca.

Characteristics

  • Gram-negative
  • Lactose-fermenting
    • Grows pink on MacConkey agar
  • Urease positive

Differential Diagnosis

Causes of Pneumonia

Bacteria

Viral

Fungal

Parasitic

Antibiotic Sensitivities[1]

Category Antibiotic Sensitivity
Penicillins Penicillin G R
Penicillin V R
Anti-Staphylocccal Penicillins Methicillin R
Nafcillin/Oxacillin R
Cloxacillin/Diclox. R
Amino-Penicillins AMP/Amox R
Amox-Clav S
AMP-Sulb S
Anti-Pseudomonal Penicillins Ticarcillin R
Ticar-Clav S
Pip-Tazo S
Piperacillin S
Carbapenems Doripenem S
Ertapenem S
Imipenem S
Meropenem S
Aztreonam S
Fluroquinolones Ciprofloxacin S
Ofloxacin S
Pefloxacin S
Levofloxacin S
Moxifloxacin S
Gemifloxacin S
Gatifloxacin S
1st G Cephalo Cefazolin S
2nd G. Cephalo Cefotetan S
Cefoxitin S
Cefuroxime S
3rd/4th G. Cephalo Cefotaxime S
Cefizoxime S
CefTRIAXone S
Ceftaroline S
CefTAZidime S
Cefepime S
Oral 1st G. Cephalo Cefadroxil S
Cephalexin S
Oral 2nd G. Cephalo Cefaclor/Loracarbef S
Cefproxil S
Cefuroxime axetil S
Oral 3rd G. Cephalo Cefixime S
Ceftibuten S
Cefpodox/Cefdinir/Cefditoren S
Aminoglycosides Gentamicin S
Tobramycin S
Amikacin S
Chloramphenicol I
Clindamycin R
Macrolides Erythromycin R
Azithromycin R
Clarithromycin R
Ketolide Telithromycin R
Tetracyclines Doxycycline I
Minocycline I
Glycylcycline Tigecycline S
Daptomycin R
Glyco/Lipoclycopeptides Vancomycin R
Teicoplanin R
Telavancin R
Fusidic Acid R
Trimethoprim I
TMP-SMX I
Urinary Agents Nitrofurantoin I
Fosfomycin S
Other Rifampin R
Metronidazole R
Quinupristin dalfoppristin R
Linezolid R
Colistimethate S

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

Table Overview

See Also

References

  1. Sanford Guide to Antimicrobial Therapy 2014