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Journal of Clinical Microbiology, August 1998, p. 2331-2332, Vol. 36, No. 8
Department of Medical Microbiology and
Virology,
Received 14 January 1998/Returned for modification 17 February
1998/Accepted 24 April 1998
This is the first report on the isolation of Klebsiella
planticola from neonates. Over a period of 1 year, oropharyngeal
and rectal swab specimens from 131 newborns on a neonatal ward were monitored for Klebsiella spp. Thirteen strains of K. planticola could be isolated, and these represented 9% of all
Klebsiella spp. found. Capsule type K27 predominated,
followed by capsule type K68. Our findings suggest a significant rate
of colonization by K. planticola among neonates.
Klebsiellae belong to the eight most
common bacterial pathogens causing nosocomial infections
(4). Immunocompromised patients, especially elderly people
and infants, comprise the population most at risk. In pediatrics, too,
nosocomial Klebsiella infections are remarkably troublesome,
particularly in premature infants and intensive care units
(3). Pediatric patients are easily colonized by
Klebsiella spp. (5). Intestinal and oropharyngeal colonization acts as the main reservoir for nosocomial outbreaks (3, 13).
In 1981, a new Klebsiella species, Klebsiella
planticola, was described (2). Originally thought to
occur solely in aquatic, botanic, and soil environments, this species
was also recently isolated from human clinical specimens. These
investigations found a surprisingly high frequency of K. planticola among clinical Klebsiella isolates. However,
to date only three studies have examined the occurrence of K. planticola in human clinical material (6, 8, 9). So far
nothing is known about the expression of virulence factors by K. planticola, and no data on its ability to colonize the human host
exist.
To our knowledge, the present study is the first to investigate whether
and to what extent neonates are colonized by K. planticola. To evaluate the carriage rate, the intestinal and oropharyngeal flora
of 131 infants from a neonatal after-care ward were examined.
Patient specimens.
The occupants of a ward for premature
infants (after-care ward; 18 incubators) at the Pediatric Clinic,
University of Heidelberg, Heidelberg, Germany, were monitored for a
period of 12 months (August 1993 to August 1994). At 14-day intervals,
rectal and oropharyngeal swab specimens were taken from a total of 131 infants and were investigated with respect to the isolation of
Klebsiella species.
Identification of bacteria.
The swabs were streaked onto blood
agar and onto MacConkey agar plates. Colonies suspected of being
klebsiellae (mucoid and/or lactose-positive colonies) were isolated and
were subjected to identification in the API 20E system.
Klebsiella isolates were further differentiated by the tests
recommended by Bagley et al. (2). Especially important for
the identification of K. planticola are the fecal coliform
test, growth at 10°C, pectate degradation, L-sorbose
fermentation, melezitose fermentation, and utilization of
m-hydroxybenzoate and hydroxy-L-proline.
Antimicrobial susceptibility tests.
The MICs of ampicillin,
piperacillin, amoxicillin-clavulanic acid, cefuroxime, cefotaxime,
imipenem, tobramycin, co-trimoxazole, and ciprofloxacin were determined
by the agar dilution method.
Capsule typing.
The isolates were serotyped by the capsular
swelling reaction. Polyvalent immune sera were used for screening, and
monospecific sera were used for typing. Immune sera were produced in
rabbits as described by Ullmann (14). Isolates were grown on
Worfel-Ferguson agar (1) for 24 h at 37°C and at room
temperature for a further 24 h. Polyvalent sera were used for
screening, and monovalent sera were used for typing.
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Isolation of Klebsiella planticola from
Newborns in a Neonatal Ward

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FIG. 1.
Incidence and serotype distribution of K. planticola strains isolated from 131 premature children on a
neonatal ward. A total of 149 Klebsiella isolates were
recovered from neonatal rectal and oropharyngeal swab specimens.
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ACKNOWLEDGMENTS |
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We thank Andrea Hölzgen for expert technical assistance.
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FOOTNOTES |
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* Corresponding author. Mailing address: Department of Medical Microbiology and Virology, University of Kiel, Brunswiker Str. 4, 24105 Kiel, Germany. Phone: 49-431-597-3305. Fax: 49-431-597-3296. E-mail: Mikrobio.Kiel{at}t-online.de.
Present address: Institute of Hygiene, University of
Halle-Wittenberg, Halle-Wittenberg, Germany.
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REFERENCES |
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