Klebsiella, Serratia, Enterobacter (KES) group

Question 1

General Features and habitat of all three

Answer 1

Gram –

Rod shape

Reservoir- normal intestinal flora (Enterobacteriaceae) and upper respiratory tract

Question 2

Biochemical Properties of all three

Answer 2

Lactose fermenters (+)
Klebsiella and Enterobacter are fast fermenters; Serratia is slow fermenter

Facultative anaerobe

Question 3

Pathogenesis of all three

Answer 3

Nosocomial infection

Endotoxin (Gram negative)- LPS

Question 4

Clinical Feature of all three

Answer 4

Lobar Pneumonia (Klebsiella pneumonia often called ‘Friedländer pneumonia’)

Urinary Tract Infection (UTI)

Question 5

Diagnosis of all three

Answer 5

MacConkey agar- producing pink colonies (lactose fermentation)

Culture of sputum or clean catch urine sample

Question 6

Treatment of all three

Answer 6

Multi-Drug Resistant (ESBL- resistant to Penicillin and Cephalosporin) Carbapanem, Monobactams, Fluoroquinolones, Aminoglycosides

Question 7

Individual biochemical properties of Klebsiella pneumoniae

Answer 7

Immotile
Large polysaccharide capsule
Urease positive (+)
Glucose + Indole and H2S -

Question 8

Individual feature of Serratia marcesnes

Answer 8

Motile

Question 9

Individual feature of Enterobacter cloacae

Answer 9

Motile with peritrichous flagella

Question 10

Individual clinical features of Klebsiella pneumoniae

Answer 10

Sputum is generally thick and bloody (without foul smell)

Sinusitis, Otitis media

Cholecystitis, Cholangitis

Wound infection

Sepsis

Question 11

Other diagnostic features of Klebsiella pneumoniae

Answer 11

Culture:

EMB medium- dark blue / purple colonies

Simple agar- mucoid, large colonies with urine smell

Serology- capsule swelling test

Commonly affect Alcoholics Invade body by Aspiration Create Abscesses

Question 12

Other diagnostic features of Serratia marcesnes

Answer 12

Produces red pigment when cultured and create pink rings in showers