Damage to the respiratory tract by a bacterial environment

According to historical statistics, infant mortality in the Russian Empire significantly exceeded all-European indicators. The reason for this was the lack of antibacterial drugs, neglect of basic sanitary and hygienic standards for the care of infants and their congenital weakness caused by poor health and sometimes exhaustion of the parents. Most often, children were affected by intestinal infections caused by pathogenic organisms such as Staphylococcus aureus. At that time, only about 75% of babies lived to reach the age of one.

Due to poor nutrition, women in labor experienced difficulties with lactation. Obviously, without mother's milk, the situation with infant mortality worsened - the child did not receive protective substances, and therefore his immunity remained vulnerable and did not fully perform its functions. In such difficult conditions, the baby’s body was forced to fight multiple pathogens on its own.

The widespread use of antibacterial drugs and antiseptics designed to fight pathogenic microorganisms has somewhat improved the situation. However, as it turned out, the hopes of pediatricians and infectious disease doctors for a successful solution to the problem turned out to be premature.

The problem was that bacteria of the genus Staphylococcus and Enterococcus (Staphylococcus aureus and Klebsiella) had enormous resistance to medications and no less adaptability to any adverse conditions.

In the last 30-50 years, with the massive spread of antibiotics, questionable therapeutic practices have come: with or without reason, doctors recommend taking antibacterial drugs to absolutely everyone, from patients with common colds to cancer patients. In a short period of time, pathogenic microorganisms have changed so much that they have now become a huge problem for maternity hospitals and children's departments of hospitals.

Evidence of mutation of pathogenic flora, as they say, is obvious:

Staphylococcus aureus has learned to produce new enzymes that destroy antibacterial substances;

In addition, the pathogen rearranged itself and began to live in complex colonies that were insensitive to antibiotics.

Research by scientists shows that single, isolated representatives of pathogenic microflora are sensitive to almost all antibiotics, including the most common penicillin. The same effect was achieved when staphylococci lived in familiar small colonies.

No one took into account that bacteria had long ceased to exist in the form of single-layer settlements. Now they live in multi-layered colonies. The antibacterial agent destroys only the top or bottom layer, and the remaining bacteria safely continue their activity.

These two properties of Staphylococcus aureus have turned a seemingly harmless bacterium into a formidable enemy. Staphylococcus is a real scourge of hospitals. It is extremely difficult to combat it, and neither cosmetic repairs nor ultraviolet treatment will help.

It often happens that hospital workers themselves become carriers of staphylococcus.

Symptoms of staphylococcus in infants

Staphylococcus infection manifests itself quite quickly. Staphylococcus aureus is an extremely aggressive and virulent pathogenic microorganism that detects its presence almost immediately after infection. The normal level of Staphylococcus aureus in the body is zero. If the infection occurred in a maternity hospital, then by 2-5 days the baby begins to have problems with the gastrointestinal tract.

The main symptom is frequent bowel movements. However, even in a healthy baby fed with breast milk, bowel movements can be regular and quite frequent.

In this case, the disease can be identified based on additional symptoms:

Skin rashes (pustules, boils, etc.);

Long-term non-healing navel;

The appearance of green, pus, blood in the stool;

Changes in the color and structure of stool: yellow or greenish stool, foamy.

Children older than one month suffer from staphylococcal infections somewhat less frequently, and their symptoms differ. In such children, the disease occurs as gastroenterocolitis or toxic infection.

Staphylococcus often forms colonies on the surface of food. During its life, the microorganism actively produces enterotoxins. After eating contaminated foods, both the bacteria themselves and the toxins they produce enter the child’s body.

Symptoms include:

Signs of general intoxication of the body (increase in body temperature to 37.5-39.0, headache, weakness and lethargy, drowsiness, nausea);

Paleness of the skin;

Frequent vomiting and diarrhea.

Most often, a child’s body is attacked by bacteria when consuming the following products:

Fermented milk products: milk, cottage cheese, kefir, etc.;

Fruit and vegetable juices;

Baby food from jars.

Parents who constantly feed their children store-bought food are especially at risk. As you know, such products are often transported and stored incorrectly.

Any doctor from a children's infectious diseases hospital can talk about many patients under two years of age who were fed expired Agusha, Frutonyanya or Rastishka and ended up in the hospital with severe poisoning.

Children infected with staphylococcus suffer from the disease much more severely than adults:

A high degree of intoxication leads to the fact that the child practically refuses to eat;

Frequent diarrhea and vomiting lead to dehydration and removal of electrolyte salts from the body. As a result, metabolism is significantly disrupted;

If a child experiences frequent manifestations of toxic infection, and they are severe (pallor after vomiting, problems with sleep and awakening), you should immediately transport the child to the hospital on your own or by calling an ambulance.

The acidity of a child's stomach does not have the same degree as that observed in an adult. During its life, staphylococcus produces a lot of enzymes and toxins that destroy the cellular structures of the mucous membranes. As a result, damage occurs to the mucous membrane of the stomach, small and large intestines. The so-called gastroenterocolitis develops.

The disease includes two components:

Gastritis. In children, the disease is expressed in refusal to eat and frequent vomiting. It is not so easy to distinguish vomiting from natural regurgitation without special knowledge. To draw the right conclusion, you need to keep in mind that experts consider vomiting in an infant to be a volume of vomit that exceeds three tablespoons. Regurgitation more than three times a day is also considered pathological.

Gastritis in children is accompanied by symptoms of intoxication, as well as respiratory disorders (breathing is hoarse or noisier);

The child's voice becomes hoarse;

The sucking reflex weakens;

Dry lips are observed. The eyeballs visually sink deeper;

The peritoneal wall loses its tone. As a result of a functional test (pinching the skin), the fold straightens out slowly. This indicates dehydration of the body.

It is impossible to cope with the disease at home; you should immediately transport the child to a hospital and begin specific therapy.

The clinical picture is typical for severe colitis:

Frequent diarrhea mixed with mucus, pus, and blood;

Light yellow feces, upon contact with atmospheric air, take on a green tint;

Milk is not completely processed in the body. Lumps of curdled milk are found in the stool;

After several bowel movements, feces lose their structure and take on the appearance of yellowish or green water;

Wandering abdominal pain;

The child becomes restless. The picture is similar to intestinal colic (pulls legs towards stomach, screams, etc.);

Bloating and increased production of intestinal gases (rumbling in the abdomen), frequent passing of gases;

Signs of dehydration gradually develop: dry skin, loss of skin elasticity, sunken eyeballs, etc.

Pathology can be determined quite simply by the number of bowel movements per day. If a breastfed baby has bowel movements 7-10 times, this is not the norm. In bottle-fed children, the normal number of bowel movements is 1-2 times a day.

The presence of foreign impurities (blood, mucus, pus) in the structure of feces always indicates a pathological process in the area of ​​the large or small intestines.

Klebsiella is an opportunistic microorganism because it is constantly present in the human body. These bacteria hold the record for the frequency of intestinal infections they cause. Most often, Klebsiella affects the intestines, that is, it belongs to enterobacteria. However, once it penetrates the nasal mucosa, it can cause ozena (fetid runny nose).

Most often, Klebsiella enters the child’s body in a hospital setting.

There are several causes of infection:

Adults often neglect the rules of personal hygiene and sanitation of household items. Klebsiella usually enters a child’s body after contact with the hands of an adult carrier or dirty objects;

Klebsiella often infects infants during interaction with public toys in clinics and hospitals;

Contact with a dirty pacifier. If a pacifier falls on the changing table or floor, parents will often wipe (and sometimes suck on) the object and place it back in the baby's mouth. This is a direct path to infection.

Klebsiella is generally characterized by the same symptomatic complex. However, unlike Staphylococcus aureus, the bacterium is less aggressive and primarily affects children with weakened immunity, dysbacteriosis, or an existing staphylococcal infection.

The main clinical difference between Klebsiella and staphylococcus is the color of the stool. If with a staphylococcal infection the stool is light yellow, then with a Klebsiella infection it is dark green. Klebsiella is also characterized by more active gas formation.

Klebsiella, maternity hospital, prevention.

author admin rubric Medicine

And Klebsiellosis as a nosocomial infection.

Klebsiella in the maternity hospital is an emergency! The fact is that in a hospital setting it acquires polyantibiotic resistance and becomes aggressive. If we remember that this microorganism, as a representative of opportunistic flora, can cause disease only when the immune system is weakened, which is observed in mothers, and in newborns the immunity is not at all formed, then its penetration into the body is accompanied by a difficult clinic. A sharp rise in temperature, diarrhea, vomiting, bloating, dehydration, kidney problems - the child is admitted to intensive care.

The route of transmission of infection is through contact and household contact.

violations of the sanitary and epidemiological regime in the departments of the maternity hospital. A subtle point is the treatment of nipples for supplementing newborns with water, the boiled water itself, which must be changed every 2 hours, otherwise it becomes worse than sewage. Therefore, it is better to be with the child immediately after giving birth!

Other preventive measures:

- washing hands after using the toilet, before feeding, before child care procedures, etc.,

- use everything disposable, brought from home!

— sterilization of nipples and bottles!

- do not stay too long in the maternity hospital if there is no need for it!

Most importantly, before choosing a maternity hospital, find out its history, at least when it was washed (the frequency of this is 2 times a year). The less time has passed since its completion, the more reliable it is!

At the first signs of illness in a child (lethargy, fever), consult a doctor. It is also necessary to donate breast milk to the tank. analysis . Klebsiella in breast milk is a fairly common occurrence, even in the absence of signs of mastitis in the mother.

The period of close monitoring of the child’s condition after discharge from the maternity hospital is 7 days - this is the maximum incubation period for the development of all intestinal infections and some droplet diseases. During this period, you are guaranteed legal support!

B Treatment algorithm.

When isolating Klebsiella from stool in diagnostic dilution, it is necessary:

— consultation and treatment with an infectious disease specialist, gastroenterologist;

— consultation and treatment with an immunologist, since the immune system is weakened. Here, your child will undergo an immunogram and determine which link in the body’s defenses is suffering and will correct it.

Please note that treatment for Klebsiella itself consists of 4 stages.

Stage 1 - liberation of the intestines from waste products of an excess amount of this bacterium.

A sorbent and one of the enzymes are prescribed. The duration of taking these medications is no more than 3-5 days, otherwise constipation is possible.

Stage 2 - direct impact on Klebsiella and reduction (not complete elimination, otherwise it will be replaced by mushrooms) in its quantity. This is the use of bacteriophages. These are viruses that act only on Klebsiella and do not have a harmful effect on the body.

Order of the Ministry of Health of the Russian Federation No. 231 dated 06/09/03 approved the following bacteriophages that are acceptable for use:

— polyvalent liquid pyobacteriophage (it contains phages from 6 bacteria of different genera (Klebsiella, Pseudomonas aeruginosa, etc.);

- polyvalent Klebsiella phage (here phages from Klebsiella pneumoniae, oxytoca and ozanae),

— Klebsiella pneumoniae bacteriophage purified.

— if the isolated Klebsiella is sensitive to a multicomponent phage, then after a course of it a short course of a monophage is necessary;

— out of every 10 examined, only one Klebsiella pneumoniae is isolated from 2 people; y – 5 – Klebsiella pneumoniae and oxytoca,

3 had Klebsiella pneumoniae and Staphylococcus aureus, 6 had Klebsiella spp, staphylococcus and candida fungi (this is taken from the results of my work over the past 10 years!)

This means that after the klebsial phage, there should be a staphylococcal phage,

If if there are mushrooms. then we need to treat them here too. Otherwise there will be no result from the treatment!

This stage of treatment lasts on average 3 weeks. The use of antibiotics (3rd generation cephalosporins and aminoglycosides) at this stage is only for special indications.

Stage 3 – colonization of the intestine with the main normal flora: bifidobacteria and lactobacilli. Course duration is 3 weeks.

Stage 4 - consolidation of the effect and use of means to prevent dysbacteriosis. Yes, yes - I was not mistaken. Duration 10 - 12 days.

If the child is breastfed, the mother must be treated along with him, at least for the first 2 stages. Otherwise, the effect of treatment will be significantly delayed.

In a word, the treatment is complex and specific in each case!

In Prevention.

— mother’s health during pregnancy;

- absence of intrauterine infection of the fetus;

— compliance with the sanitary and epidemiological regime in the maternity hospital;

- proper care and breastfeeding of the child at least until 6 months of birth;

— compliance with the terms and conditions for the introduction of complementary foods and corrective additives;

— timely and correct treatment of emerging diseases;

How dangerous is staphylococcus in infants?

In the absence of adequate antibacterial therapy, staphylococcal infection leads to many severe and deadly complications:

Development of dehydration. Prolonged and painful diarrhea, as well as frequent vomiting, lead to the fact that water along with electrolyte salts is removed from the body at tremendous speed. The body is not able to bring all systems into a state of dynamic equilibrium (homeostasis). As a result, shock may develop and death may occur. In children, dehydration begins much earlier due to less fluid in the body;

Infectious-toxic shock. Staphylococcus aureus is one of the leaders in reproduction speed. As mentioned, the bacterium produces many toxic substances. With excessive proliferation of toxins and enzymes there are so many that the body loses the ability to maintain all necessary vital functions: the kidneys, heart, liver and brain fail;

Intestinal bleeding. Long-term enterocolitis leads to destruction of the intestinal epithelium, perforation of its walls and massive bleeding;

Peritonitis. With perforation of the walls, food and feces leave the intestine, infecting the abdominal cavity;

Sepsis. By destroying the intestinal walls, staphylococcus can penetrate the bloodstream. This will lead to blood poisoning, and the risk of death will increase many times;

Development of carriage of Staphylococcus aureus. Even if treatment is carried out timely and effectively, there is a risk of developing carriage of the bacterium. The microorganism begins to exist in a latent form. Clinically, carriage resembles a sluggish dysbacteriosis: decreased appetite, stool instability, diarrhea alternating with constipation and periods of normal bowel function, heaviness in the abdomen, bloating, flatulence (colic), frequent regurgitation.

Why is the disease dangerous?

It may seem that if the Klebsiella bacterium is an opportunistic microorganism and often inhabits the body of children, then there is no need to treat the disease. It's a delusion. Failure to provide assistance can have dire consequences.

Important! The first time after birth, the baby continues to develop the internal organs, and infection with such an infection can lead to irreversible consequences.

Klebsiella oxytoca in infants (as well as Klebsiella pneumonia) can cause the following diseases:

• gastritis;
• dysbacteriosis;
• enteritis;
• sinusitis;
• rhinitis;
• pneumonia;
• cystitis;
• pyelonephritis;
• conjunctivitis;
• vaginitis;
• meningitis.

Some of the pathologies are difficult to treat and take away the strength the baby needs for development, so you need to cope with the disease as best you can.

Often, Klebsiella pneumonia in infants can cause damage to bone tissue and joints. In childhood, this disrupts the process of growth and development.

The most dangerous complication that this bacterial disease can cause is sepsis. It occurs when the infection enters the blood. In other words, this is blood poisoning.

Treatment of staphylococcus in infants

Therapy for staphylococcus infections comes down to three main aspects:

Establishing control over the intensity of microorganism reproduction, destroying pathogens using the method of sanitation and taking bacteriophages;

Maintenance treatment (restoration of water balance in the body, prescription of therapeutic nutrition);

Treating infants with antibiotics is absolutely unacceptable. Antibacterial therapy using macrolides or cephalosporins is advisable only in children with confirmed sepsis.

In all other cases, antibiotics destroy the intestinal microflora, and staphylococcus safely continues to exist and enterocolitis flares up even more strongly, since the pathogenic flora no longer experiences competition from bifidum and lactobacilli.

Probiotics do not help in this case, since while taking antibiotics, the beneficial flora does not take root, and staphylococci or Klebsiella quickly destroy the incoming insignificant number of beneficial bacteria.

It is most reasonable to carry out treatment with specialized bacteriophages - viruses that devour a specific type of bacteria:

Staphylococcus bacteriophage is used in pure form or as a complex (a mixture of phages of Staphylococcus, Salmonella, Shigella, etc.);

The duration of taking the bacteriophage is 1-2 weeks;

If there is no therapeutic effect, a second course of treatment is carried out;

The drug requires special storage conditions. Temperature - no higher than 6 °C. This means that it can only be stored in the refrigerator. For direct use, the drug should be brought to room temperature. It cannot be heated. This is the main difficulty of use.

The following medications are used to fight bacteria:

Nitrofurans. Stopdiar, Ersefuril, Enterofuril. Their use is allowed starting from one month from birth. The drugs are effective against both staphylococci and Klebsiella. Duration of treatment: 7 days. Children over one year old are recommended to take furazolidone;

Enterosorbents. Should be used with great caution, as there is a high risk of developing intussusception. It is recommended to take Smecta;

Immunostimulants. Kipferon is recommended for use in infants. The course of treatment is 5 days;

Probiotic preparations. Used to restore normal intestinal microflora. Specific names should be selected based on the general health of the child;

To restore the water-salt balance, complex therapy is used. It is almost impossible to restore balance on your own. Between feedings, the baby should be given clean water at the rate of 100 ml of water per kilogram of weight. After the general condition improves, they move on to maintenance supplementation. The volume of water is 100 ml per kilogram of weight per day. This means that a child weighing 4 kg should receive 400 ml of water per day.

To stop vomiting, cerucal is injected intramuscularly. In combination with it, they continue to take fluids. Every 4-10 minutes - a teaspoon of water. Solutions of hydralazine and rehydron are administered, as well as 5% glucose in a ratio of 1:4. If this method of restoring the water-salt balance is ineffective and symptoms of dehydration are observed, the only way is hospitalization and intravenous infusions.

How to treat Klebsiella in a child

Klebsiella in a child. If the pediatrician has diagnosed mild or moderate Klebsillosis, treatment will be limited to the use of polyvalent Klebsylosis bacteriophage. This drug contains special microorganisms - bacteriophages.

Their peculiarity and benefit is that they act only on Klebsiella cells, without affecting the intestinal mucosa and other microflora. Phages envelop Klebsiella cells and, destroying bacteria, use them for their own reproduction. The bacteriophage has no side effects.

It is advisable for children of any age to include fermented milk products (or fermented milk formulas for infants) containing bifidobacteria and lactobacilli in their diet.

Treatment of the disease occurs in three stages. Each of them takes five days. During the first and third periods, the infant is given 5 ml of bacteriophage heated to room temperature twice a day, 20 minutes before feeding.

At night, the baby is given an enema with the same drug. 10 ml of undiluted bacteriophage is injected into the child’s intestines and left for 10-15 minutes. During this time, the medicine is absorbed into the intestinal mucosa, while simultaneously affecting Klebsiella. Between the two treatment periods there is a short break (usually 5 days).

While treatment is ongoing, the doctor may prescribe a course of probiotics. The child will need to be given them for two weeks. The effect of treatment with bacteriophage is noticeable already on the second day. Colic becomes less intense and painful, the child sleeps better and more calmly, and eats more actively.

In severe cases of the disease, the bacteriophage is useless, so the child is prescribed antibiotics. At the same time, the baby will need to be supported in the form of vitamins, probiotics and immunostimulating drugs.

These are the so-called natural probiotics, most often used for Klibsiella and are a good alternative to drugs:

• Bifidok: is kefir with the addition of Bifidumbacterin: restores normal flora in the intestines, helps suppress putrefactive and opportunistic bacteria, slow down the growth of staphylococcus;
• Bifilin: can be used from the very birth of the baby, contains bifidobacteria, can also be used during antibiotic treatment; restores intestinal microflora;
• Immunele: contains a large amount of lactobacilli and vitamins; normalizes microflora, improves immunity;
• Activia: contains bifidobacteria, but can only be used from a child over 3 years of age;
• Actimel: contains lactobacilli, also helps restore intestinal microflora.

Prevention of staphylococcus in infants

Staphylococcus aureus is everywhere. It is impossible to protect a child from this bacterium. However, if the immune system is sufficiently functioning and the staphylococcal infection is treated in a timely manner, this is not a problem. According to statistics, almost 100% of the world's population are carriers of Staphylococcus aureus in a suppressed state.

However, the risk of infection should be minimized in the first months of a child’s life.

For this it is recommended:

Properly disinfect household and feeding items: bottles, nipples should be processed in sterilizers, and if they are not available, boiled;

Avoid contact with public toys. In a clinic or hospital, toys must be your own;

Nipples that fall onto any surface should be sent for sterilization;

The room in which the child is located must be ventilated regularly;

You should wet clean the room as often as possible. Staphylococcus thrives on dust particles.

Thus, staphylococcal infection is one of the most dangerous and formidable. Staphylococcus is the causative agent of many dangerous inflammatory diseases. The infection is most severely suffered by children under one year of age, especially infants, whose immunity is not yet sufficiently effective.

Most often, Staphylococcus aureus affects the mucous membranes of the intestines and stomach, which causes the development of severe gastroenterocolitis.

Diagnosis of diseases caused by Staphylococcus aureus is not particularly difficult. It is much more difficult to choose the optimal and safe treatment for the child. Antibacterial therapy is indicated in a strictly limited number of cases; the use of bacteriophages is more effective and safer. In general, therapy should be comprehensive.

Klebsiella is less aggressive and causes infectious lesions only in weakened children. Often the bacterium coexists peacefully with Staphylococcus aureus. Both the manifestations and methods of treating Klebsiella infections are similar to the fight against staphylococcus.

It is desirable that the child does not encounter such dangerous pathogens in the first months of life, so special attention should be paid to preventive measures.

They are not afraid of cold, ultraviolet radiation, or disinfectants. They do not manifest themselves in any way when they are in low concentrations. But when their number rapidly increases, this phenomenon provokes the development of the disease.

Let's consider the causes of development, symptoms and advice on treating the infection from Dr. Komarovsky.

Treatment methods

Based on the test results and the patient’s medical history, the doctor selects treatment. Depending on the nature of the intestinal damage and clinical manifestations, the issue of using antibiotics is decided. Therapy should be aimed not only at suppressing Klebsiella, but also at restoring the balance of intestinal microflora.

Use of antibiotics

They try to treat children for bacillus without using antibacterial therapy. However, there are indications for taking antibiotics:

• complicated forms of klebsiellosis (for example, when it is combined with Staphylococcus aureus and other bacteria) (see also: main signs of Staphylococcus aureus in children);
• long-term course that is not amenable to alternative treatment;
• poor clinical picture, high risk of complications, when there is no time to use more gentle means.

In such cases, 3-4 generation cephalosporins are used for treatment: Ceftriaxone, Cefotaxime, Suprax. It should be noted that the bacterium is resistant to penicillin and oxacillin groups.

Causes of the disease

Komarovsky, who wants to treat a child whose child is wealthy or not, urgently demands that the situation be monitored from the moment typical symptoms of the disease appear. In this case, you do not need to take into account only the usual change in the child’s stool, liquid feces.

Symptoms should be varied:

The causes of the disease can be very different.

Firstly, the cause of infection may be insufficient disinfection and lack of hygienic conditions in maternity hospitals, hospitals, and clinics. Secondly, Friedlander's bacillus is transmitted through untreated water. Thirdly, the cause of infection may be contact with a human carrier of the infection (fecal-oral route).

Basically, strains of microorganisms enter the baby’s body tissues through the mother. The process occurs during or after childbirth.

There are also nosocomial strains. And the last option is through dust, water, animal hair and food.

The disease affects those children whose immunity has not yet strengthened. The body of a newborn child is still quite weak. The baby has not yet formed normal protective flora.

The situation is aggravated if the child was born premature, suffered a serious illness, was treated with antibiotics, etc. All this leads to the development of a dangerous disease, the transition of infection to severe forms.

Necessary tests and their significance

When asked whether it is necessary to treat Klebsiella in an infant, Komarovsky, the famous doctor, answers unequivocally.

Infection is suppressed when the impact of microbes on the baby’s health is obvious. He begins to lose weight and becomes restless. This does not always happen, but under certain circumstances.

The detection of microorganisms in the analysis of urine and feces is not a reason for prescribing treatment.

This is understandable, since microbes have existed and always exist on human skin. This applies to both staphylococci and klebsiella.

For example, if symptoms of dehydration are not addressed promptly, parents risk losing their young child forever. Therefore, early diagnosis of the disease is important for adequate treatment. This is also important, since the disease can be easily confused with pneumococcal pneumonia or dysbacteriosis.

During a laboratory examination, analysis is taken from both the mother and the child. To determine the strain of the bacterium, you need to obtain a culture from the stool and do a urine test.

If there are problems with how to recognize the disease or identify staphylococcus or Klebsiella in an infant, Komarovsky advises getting tested for dysbacteriosis. It is this that allows you to determine the exact number and type of bacteria in feces.

According to the instructions of the Ministry of Health, there are maximum limits for the amount of bacteria in stool analysis.

When it comes to Friedlander's wand, for every gram of baby's stool there should be no more than 10 to the fifth power of Klebsiella bacteria.

If a bacillus, Klebsiella pneumonia, is observed in the baby’s stool, Komarovsky recommends starting treatment, but only with mild agents. These include:

• Probiotics. They help restore normal intestinal microflora.
• Enzymes. They are needed for normal digestion.
• Bacteriophages. They are designed to destroy harmful bacteria.
• Intestinal antiseptics. They are necessary to prevent the proliferation of pathogenic microorganisms.

Solutions to restore water balance in the body.

Methods of infection, causes of the disease

When conducting tests, this microorganism can be detected in the child’s stool, but it is completely safe for him if the infection is inactive, its amount is within normal limits, and the baby is healthy.

How can an infection enter a baby’s body?

• When drinking water;
• With milk. Including with breast milk during breastfeeding (as a rule, this happens if the woman’s nipples are not washed thoroughly enough);
• Due to non-compliance or insufficient compliance with hygiene rules;
• By airborne droplets (from sneezing or coughing);
• Quite often, Klebsiella enters a child’s body with poorly washed vegetables and fruits, since it can live in the soil for some time.

Usually the reason that microorganisms become active and multiply rapidly lies in the weakness of the baby’s defenses.

Most often, the Klebsiella infection is activated due to an insufficient number of beneficial bacteria in the intestines, respiratory organs, on the baby’s skin, or due to insufficient immunity.

The background, which is favorable for various kinds of pathologies, can also be:

• Allergy;
• Lack of vitamins and nutrition;
• Intestinal diseases;
• Treatment with antibiotics to help suppress beneficial bacteria in the body.

With frequent use of antibiotics, not only suppression of beneficial microorganisms in the intestine can be observed, but also infection, including Klebsiella, adapts to them.

Treatment for infants according to Komarovsky

When Klebsiella is suspected in a baby, Komarovsky advises not to panic. The main thing for parents is to replenish the amount of lost fluid.

The baby should be fed breast milk on the same schedule. And only a baby over one year old is prescribed vegetarian food: no milk, oatmeal infusions, porridge with milk.

To understand the percentage of fluid loss in the body, you need to have an electronic scale at home. If the weight of 10 diapers with loose stools for half a day is 1 kg, then dehydration will be noticeable.

A child who should grow and gain weight every day has lost 1000 grams! This is a reason to call an ambulance!

When Klebsiella is diagnosed in the stool of an infant, Komarovsky identifies characteristic signs of dehydration:

• Dry tongue, dry mucous membranes;
• No urine for 6 hours;
• Crying without tears;
• Sunken eyes.

An increase in temperature signals that Friedlander's bacilli and their decomposition products release toxins into the baby's blood. The high temperature must be brought down.

But, regarding Klebsiella disease in a child, Komarovsky recommends not using any antibiotics or bacteriophages. The body is able to independently produce antibodies to infection. This process lasts about 4-5 days. Then the development of infection stops.

If you plan to treat Klebsiella in an infant, Komarovsky requires care to preserve normal intestinal microflora. Destroying the balance is simple with the help of antibiotics. How to maintain a normal state? Obviously, you should take bacteriophages, synbiotics, and prebiotics.

99% of cases of a dangerous disease are cured without any special consequences. All manipulations to restore the child’s health are organized at home. 1% of all severe cases of infectious disease are observed in hospitals, as improper treatment leads to pneumonia, sinusitis and meningitis.

It is in the hospital that resuscitation measures and emergency therapy for newborn babies are carried out. The mother undergoes treatment and diagnostics together with the child.

Diagnosis and treatment

Successful treatment of Klebsiella in newborns and the prevention of severe forms and consequences depends on timely diagnosis.

Important! Infection with the form of Klebsiella pneumonia may be accompanied by a severe cough and sputum streaked with blood.

Detection

If you suspect the presence of these microorganisms in an infant, you should contact a gastroenterologist and infectious disease specialist. Most often, Klebsiella is found in the feces of infants.

But for a complete picture, a diagnostic examination is prescribed, which includes:

• stool culture to detect Klebsiella;
• coprogram (combined description of physical, chemical and microscopic examination of feces);
• general urine analysis;
• detailed blood test;
• serodiagnosis (detection of antibodies to Klebsiella in the body);
• bacterioscopy.

It should be noted that Klebsiella pneumonia is also detected in the urine, but it is extremely rare to diagnose it in children, so choosing the right treatment is a complex process.

Treatment

Treatment for Klebsiella depends on the severity of the disease and is prescribed strictly by a doctor. In severe forms, hospitalization is possible.

If Klebsiella is detected in a child's stool in a timely manner, standard therapy involves the complex use of drugs containing the following components:

• bacteriophages;
• pro- and prebiotics;
• synbiotics.

Bacteriophages (for example, polyvalent pyobacteriophage) are prescribed in an amount of 5 ml for children under 6 months and 10 ml from 6 months to one year. The course of treatment usually lasts from 5 to 10 days.

Pro- and prebiotics are taken 2-3 times a day with food. The course of treatment usually lasts from 2 to 3 weeks.

Important! In severe cases of the disease, antibiotic therapy and, in some cases, hospitalization are indicated.

Prevention

It is better to take preventive measures so that the disease does not attack at the most unpleasant moment. These include:

• Maintaining hygiene during pregnancy;
• Hardening of a newborn;
• Adjusting the nutrition of a nursing mother;
• A special diet for babies with vitamins and easily digestible carbohydrates.

According to Komarovsky, the norms of Klebsiella in urine can reach extreme values. But this is no reason to worry.

Believe in the best and monitor your child's symptoms!

Klebsiella is a conditionally pathogenic bacteria that lives and reproduces without the presence of oxygen. In the human body they are found in the form of sticks, outside of it - in capsules. In capsules their survival rate is greater.

Due to their high resistance to antibacterial drugs, the World Health Organization classified Klebsiella bacteria as very dangerous in 2020. Klebsiella poses a particular threat to infants.

What to do in such a situation? To get started, we recommend reading this article. This article describes in detail methods of controlling parasites. We also recommend that you consult a specialist. Read the article >>>

Where does Klebsiella come from in babies and why is it dangerous?

In infants, Klebsiella most often appears in the body from the external environment, but intrapartum (during childbirth) infection also occurs.

Characteristics of the microorganism

Klebsiella is a bacterium belonging to the Enterobacteriaceae family, genus Klebsiella. This genus includes 4 types of microorganisms, of which Klebsiella pneumoniae (75-86% of all cases of the disease) and Klebsiella oxytoca (13-25% of cases) are of medical importance.

Photo: https://protrakt.ru/analizy/klebsiella-v-kale.html

Features of Klebsiella:

• Klebsiella visually appears as straight rods, in relation to staining during bacterioscopy - gram-negative. In the structure of the bacterium, the presence of a capsule and fimbriae is important. The capsule has a protective function: it prevents destruction by phagocytes and the penetration of antibiotics. Fimbriae provide attachment to the epithelium;

Thanks to the capsule, Klebsiella can form L-forms in the body under the influence of antibiotics and immune factors. Then the disease becomes chronic.

• are opportunistic microorganisms, i.e. they are part of the microflora inhabiting the intestines, mucous membranes of the upper respiratory tract and skin;
• very stable in the external environment: they persist for up to several months in wastewater, soil and water. They tolerate high and low temperatures well. Resistant to ultraviolet light and antiseptic solutions;
• resistance to antibiotics develops very quickly;

For the first time, enzymes that inactivate antibiotics were identified in Klebsiella.

• There are two types of toxin (endotoxin and exotoxin);
• secrete enzymes that inactivate lysozyme, splitting the walls of the body's cells. They secrete substances that kill other bacteria;
• successfully resist the bactericidal effect of blood.

Klebsiella, which has such a unique set of adaptive abilities, is a frequent causative agent of severe nosocomial infections.

Sources of infection

The source of infection is a sick person or a bacteria carrier (for example, Klebsiella pneumoniae is isolated from the oropharynx and intestines in healthy individuals in 5% of cases). It can also be an animal (cattle, horses, pigs). Klebsiella is excreted in feces, sputum and mucous discharge from the nasopharynx, urine, etc., depending on the affected organ.

Transmission routes

The main routes of transmission of clebsiellosis:

• Food.

A person eats contaminated foods - meat, dairy products, salads. In infants, improper preparation and storage of infant formula is important.

• Contact and household.

Transmission factors in this route may include medical instruments in hospital settings.

• Airborne.

Photo: https://pixabay.com/photos/baby-bottle-suck-feed-mother-105063/

What is the danger for the child?

Klebsiellosis poses a danger to weakened young children: premature babies and newborns born in a state of asphyxia, those who have suffered a traumatic birth, with developmental defects, low birth weight, etc. Klebsiellosis often joins other viral and bacterial infections, aggravating their course.

Normally, up to 3 weeks of age, even in healthy newborns and premature infants, physiological hippogammaglobulinemia is present. Only from the 3rd week do they begin to produce immunoglobulins of class M, and from the 3rd month - immunoglobulins of class G. In premature infants, this period may be extended.

Doctor Komarovsky's opinion

Under normal conditions, Klebsiella is present in the child’s body, but does not manifest itself in any way. It is absolutely safe and lives in the body of any healthy child and adult.

Once there is a disruption in the immune system, for example after the use of antibacterial drugs, the normal intestinal flora changes.

Bifidobacteria and other beneficial bacteria became suppressed, there was no one to slow down the intensive growth of Klebsiella, and so their intensive growth began. But this is already a threat to the life of a small child. The danger lies in their strong toxic effect on the body of infants.

What can trigger growth and launch development

1. Transition from breastfeeding to artificial.
2. Violation of sanitary regime and hygiene.

Question: Is Klebsiella in breast milk?

The site provides reference information for informational purposes only.
Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required! We are only 2 months into breastfeeding. We suffer from stomach pain: it’s constantly bloated, loose stools. In the milk of my left breast they found grade 3 Klebsiella pneumatosis, in my right breast it was negative. I myself have problems with the nasopharynx, constantly stuffy nose, foul-smelling mucus. During pregnancy, they found staphylococcus in the nose and throat, but they said it was normal. How to recover?

Most likely, the cause of the child's stool disorder was Klebsiella, which entered the child's body along with breast milk. The baby needs a stool test for dysbacteriosis, based on the results of which a pediatric gastroenterologist will be able to prescribe adequate treatment. Most likely, medications containing normal intestinal microflora, as well as bacteriophages, will be prescribed. It should be remembered that bacteriophages are almost completely destroyed in the stomach without reaching the intestines, therefore, the evening dosage of the bacteriophage should be used in the form of a therapeutic microenema. You can read more about bacteriophages in our section of the same name: Bacteriophages. You can read more about the diagnosis and treatment of intestinal dysbiosis in infants in the article: All about dysbiosis in infants. You need to undergo an examination by an ENT doctor, do a bacterial culture from the nasopharyngeal mucosa, preferably immediately with an antibiogram - determining the sensitivity of identified infectious agents to antibiotics of various groups. Based on the results of this examination, the ENT doctor will be able to prescribe antibacterial treatment with those drugs to which sensitivity is maximum. During your treatment, with the use of antibiotics, breastfeeding will need to be stopped (the baby will need to be temporarily transferred to artificial feeding), the milk will need to be expressed (to maintain lactation) and poured out. After a course of antibiotic therapy, you will need to re-see breast milk for sterility; if the results are good, feeding can be continued.

Thank you for your answer, but I don’t understand how to cure myself from Klebsiella in the chest, what medications are needed and which doctor should I see

Usually, treatment in such situations is prescribed by a general practitioner, after consulting an ENT doctor, taking into account your complaints of constant congestion in the nasopharynx.

Symptoms and manifestation

Based on location, bacteria can be roughly divided into main types:

• Klebsiella pneumonia;
• Klebsiella intestinal infection.

Klebsiella pneumonia is a very dangerous disease for infants and newborns. If treated incorrectly or untimely, the disease is fraught with numerous complications.

Main symptoms

• high temperature (up to 40 degrees);
• lethargy, weakness;
• severe cough (first dry, then with stringy mucus, possibly mixed with blood).

In advanced forms of the disease, death is possible.

But such pronounced symptoms are not always present in an infant. Parents should be wary if the baby has loose stools or lethargy. There may be no fever, but a cough and symptoms of bronchitis appear.

In infants, the progression of the disease occurs like an avalanche: from mild illness to serious complications, it can take just a few hours.

At the first symptoms of the disease, you must immediately consult a doctor!

Dangerous consequences

With normal immunity of the child, the wand can live peacefully in the intestines and not pose a danger or threat. With any colds or infectious diseases, Klebsiella begins to manifest itself.

It is also dangerous for infants, due to the fact that their immune system is not fully formed.

How dangerous is Klebsiella and how to protect your baby from danger? If Klebsiella is advanced and proper treatment is not carried out on time, then serious complications are quite possible, which will be quite difficult to eliminate without proper and long-term therapy.

Of the main possible complications of Klebsiella in an infant, the following are worth noting:

• pneumonia;
• conjunctivitis;
• severe forms of rhinitis;
• severe intestinal infections;
• meningitis;
• sepsis;
• lesions and abnormalities in the respiratory system.

The speed and complexity of the development of the disease, as well as complications and consequences in a newborn, depend on his immunity and age.

If Klebsiella is detected in time and prompt and adequate treatment is carried out, then there are no special threats or dangers. The difficulty is that even experienced doctors cannot always determine the presence of a rod in the body.

At the first suspicion, the baby must undergo all the necessary tests. First of all, this is feces and blood for certain titers of antibodies to strains of the disease.

If Klebsiella is found in the feces of an infant, it is difficult to say why such a diagnosis is dangerous; additional research must be carried out. A culture of urine, vomit (if any), and cerebrospinal fluid (if diagnosis is difficult) is done.

Klebsiella in the intestines of a baby

The correct diagnosis cannot always be made immediately, since the symptoms are similar to enteritis, enterocolitis and other acute gastrointestinal diseases.

The onset of the disease is rapid:

• high body temperature of the child (reaches 39 C);
• vomiting up to 8 times a day;
• severe diarrhea (up to 15-20 times);
• foam and blood in stool;
• the color of stool changes to green;
• putrid smell of feces;
• stomach is painful;
• refusal to eat;
• the child’s condition deteriorates very quickly;
• Dehydration sets in quickly.

With these terrible symptoms, the child needs urgent hospitalization! This is very dangerous for an infant!

If you do not experience all of the listed symptoms, but only some, you need to consult a doctor.

Klebsiella in a baby's urine

Urine in infants is practically sterile. The presence of Klebsiella in the urine does not always indicate a disease. It is very difficult to collect clean urine from infants, so it is necessary to take tests three times.

The possibility of incorrect collection will thus be eliminated. If, during subsequent tests, Klebsiella is again sown in large numbers, the presence of the disease can be assumed.

To clarify the diagnosis in newborns or infants, a urological examination is performed.

Norms

To diagnose Klebsiella infection, any child’s secretions are used: feces, urine, mucus from the nasopharynx, etc. The main method for determining bacteria is a stool culture tank.

If more than 106 microbial representatives are detected in 1 g of feces, klebsiellosis is diagnosed. As a rule, the average value of klebsiella in feces is 10 4 and is normal.

If Klebsiella is detected in the urine and clinical manifestations of the disease are present, then the child has an acute urinary tract infection.

What diseases can Klebsiella cause in an infant?

Klebsiella in newborns and premature babies, as well as in children under one year in general, causes the following diseases (they can be divided into primary and secondary):

a) primary (the disease develops without a visible primary focus):

• gastroenterocolitis,
• pneumonia (can be both primary and secondary),
• pyelonephritis, urinary tract infections (can also be primary or secondary in origin),
• wound infection (postoperative patients are vulnerable in this regard, and in newborns the entrance gate may be the umbilical wound),
• otitis,
• conjunctivitis;

b) secondary (there is a primary focus, the infection spreads due to bacteremia):

• meningitis, meningoencephalitis,
• osteomyelitis,
• abscesses of various organs (liver, lungs, kidneys, brain, etc.),
• sepsis.

How to treat

Newborns and children with severe intoxication are treated in a hospital.

The general treatment regimen is aimed at:

1. Prescription of intestinal antiseptics (Uroxolin, Furazolidone).
2. Prescription of probiotics (Bifiform, Lactovit).
3. The use of enzymes (Festal, Pancreatin).
4. Use of bacteriophages (Bacteriophage Klebsiella).

Approximate treatment regimen for systemic infection.

A drug	Dosage
Ampicillin From 6 to 1 year – 10ml; 14 days.
Bifiform The treatment regimen, dosage and necessary medications are prescribed only by a doctor! With timely treatment, recovery occurs relatively quickly. To prevent the disease, it is necessary to strengthen the immune system. It is this that is the limiting factor in the development of Klebsiella.

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