Question

1. Why did the patient with 56% burn suffering from Klebsiella oxytoca only improve after antibiotics were stopped? Why were the antibiotics initially given?

2 ,Is Klebsiella oxytoxa normally found in the gut? If so, why was it likely causing a problem?

Answer 1

Klebsiella oxytoca is a gram negative bacteria which belongs to eneterobacteriacae. They mainly occur for patients with burns because they lack the skin barrier and also faced immunosuppression due to systemic inflammatory response by the injured tissue. So such patients will be given antibiotics to prevent early infections caused by gram positive bacterias and late infections by gram negative bacterias. Thus antibiotics are given to prevent such infections. But in case of Klebsiella oxytoca it is resistant to most of the antibiotics. So incase of any infection in most cases specific test have to be done to find out which antibiotics can test the infection effectively. But in few cases Klebsiella oxytoca after antibiotic administration present an overgrowth of the toxin producing bacterium due to the changes in the normal colonic microflora. Thus withdrawal of the antibiotics is the only way to treat the infection.

2. Even though Klebsiella oxytoca is seen in gut and faeces they are considered healthy bacteria when seen in these areas like nose, mouth and intestines. But when seen in lungs they cause pneumonia and when seen in blood they cause blood stream infection. It is healthy if the gut microbial is balanced. But if the balance is changed administration of antibiotics then it colonizes and form infections activating T-helper 1 cells. Then they elicit inflammations.