Klebsiella aerogenes
(Previously Enterobacter aerogenes)
Gram Stain
- Gram negative bacilli - fermenter
Clinical Significance
This organism is an opportunistic pathogen which rarely causes primary infections in healthy individuals.
It is a frequent colonizer in hospitalized patients, especially those who have received broad-spectrum antibiotics.
K. aerogenes has been associated with a variety of nosocomial infections in debilitated/ immunocompromised individuals.
Infections include respiratory and urinary tract infections, wound/ulcer infections (especially burns), osteomyelitis, meningitis, bacteremia, and endocarditis.
Bacteremia with this organism is often polymicrobial.
Usual Susceptibility Pattern
This organism produces a chromosomally mediated inducible cephalosporinase (AmpC) and is resistant to penicillins and 1st/2nd generation cephalosporins.
Although they often exhibit in vitro susceptibility to 3rd generation cephalosporins, use of these agents may result in selection of resistant strains.
The beta-lactamase produced by these organisms is not inhibited by beta-lactamase inhibitors and as such, beta-lactamase inhibitor combinations are not recommended.
K. aerogenes is usually susceptible to aminoglycosides, quinolones, and TMP/SMX.
These organisms are resistant to fosfomycin and nitrofurantoin.
Empiric Therapy |
---|
Ciprofloxacin |
or |
TMP/SMX |
CNS/severe infection: |
Meropenem |