The clinical significance of klebsiella infections in the tropics

Finnie, Evelyn (1971) The clinical significance of klebsiella infections in the tropics. MD thesis, University of Glasgow.

Abstract

This thesis is a bacteriological and clinical analysis of cases of klebsiella infection occurring in patients in the University Hospital of the West Indies from April, 1966, to March, 1967. Matched control specimens are taken from infected and normal sites. The literature on the various clinical infective syndromes associated with this organism is reviewed, but few of these papers coordinated clinical findings with full bacteriological investigations. Two hundred and ninety isolates of Klebsiella aerogenes from 248 patients are considered. The incidence of isolation from normal and infected throats is similar; in sputum, klebsiella isolation is related to a variety of clinical infective syndromes. Urinary tract infection is related to urethral stricture. In the female genital tract klebsiella is probably not a primary invader. Cases of klebsiella abscess formation and wound infection occur in this hospital. Diabetes mellitus does not predispose to klebsiella infection. Approximately one third of all klebsiella isolates are hospital acquired, but cross infection does not play an important role since a great variety of serotype and biotype combinations are encountered. Multiple infection with different serotypes and biotypes of klebsiella is a feature of several cases, and the importance of determining the serotype and biotype in any studies of this type is emphasised. Eighty-nine out of 248 patients were on antibiotics at the time of first isolation of klebsiella, and this com-pares closely to the incidence of antibiotic prescription in a carefully matched control group of hospital patients showing no evidence of klebsiella infection. When the anti-biotic history is further analysed, there is seen to be a predisposition to develop klebsiella infection after seven or more days multiple chemotherapy. Strains of K. aerogenes isolated from specimens of urine are more biochemically heterogeneous than isolates from other sources. Part Two of this study demonstrates that the various klebsiella serotypes produce quite different cross reactions in two species of laboratory animals, rabbit and mouse. It is thought that these differences are probably genetically related. Further work is indicated on the immunological specificity of the capsular polysaccharides of klebsiella, and on the modifying effect of adjuvants, if any, on the antigenic determinant site. Similarities are apparent between infection due to type III pneumococcus and Klebsiella aerogenes.

• Item Type: Thesis (MD)
• Qualification Level: Doctoral
• Additional Information: Adviser: E M McGirr
• Keywords: Epidemiology
• Date of Award: 1971
• Depositing User: Enlighten Team
• Unique ID: glathesis:1971-73846
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 14 Jun 2019 08:56
• Last Modified: 14 Jun 2019 08:56
• URI: https://theses.gla.ac.uk/id/eprint/73846