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Clinical features, diagnosis, and treatment of Klebsiella pneumoniae infection

Wen-Liang Yu, MD
Yin-Ching Chuang, MD
Section Editor
Stephen B Calderwood, MD
Deputy Editor
Allyson Bloom, MD


Klebsiella pneumoniae is a member of the Klebsiella genus of Enterobacteriaceae and belongs to the normal flora of the human mouth and intestine. Of the pathogenic Klebsiella species, K. pneumoniae is the most prevalent and clinically important. Infections with K. pneumoniae are usually hospital-acquired and occur primarily in patients with impaired host defenses.

An important exception to these general observations is a community-acquired invasive primary liver abscess syndrome, which can occur in patients without any underlying predisposing medical conditions and has primarily been described in countries in East Asia, particularly Taiwan [1]. (See "Invasive liver abscess syndrome caused by Klebsiella pneumoniae".)

The epidemiology, clinical features, diagnosis, and treatment of infections due to K. pneumoniae will be reviewed here. The microbiology and pathogenesis of K. pneumoniae infection are discussed separately. (See "Microbiology and pathogenesis of Klebsiella pneumoniae infection".)


Humans are the primary reservoir for K. pneumoniae. Carrier rates of K. pneumoniae in the community range from 5 to 38 percent in stool samples and 1 to 6 percent in the nasopharynx; Klebsiella species are rarely carried on the skin [2]. Higher rates of nasopharyngeal carriage have been noted in ambulatory alcoholic patients [3].

Carrier rates are markedly increased in hospitalized patients, among whom reported rates are 77 percent in the stool, 19 percent in the pharynx, and 42 percent on the hands [2]. The higher rates of colonization are primarily related to the use of antibiotics [2,4,5]. This increase in prevalence is important clinically since, in one report, Klebsiella nosocomial infection was four times higher in stool carriers compared with noncarriers [6]. Similarly, in a study of 855 patients with K. pneumoniae liver abscess in Taiwan and 3420 age- and sex-matched controls, ampicillin or amoxicillin use within the prior 30 days of diagnosis (but not the prior 31 to 90 days) was associated with an increased risk of liver abscess [7].


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