Klebsiella Pneumoniae (friedlander's Bacillus) Infections

Klebsiella pneumoniae infections are uncommon in premature and maternity units as well as in paediatric wards. Hospital epidemics are exceptional, only some five published reports being known to us. Kliewe (1930) reports an epidemic in which pneumonia developed in 11 or 12 infants in a single ward, Kiebsiella having been cultured from the pharynx of all 11. Two infants died. Of the remaining 130 children in the institution, only one had a positive throat culture. Jampolis, Howell, Calvin and Leventhal (1932) witnessed an outbreak of diarrhoea in 34 newborn infants caused by Bacillus mucosus. There were 14 deaths. Walcher (1946) found Bacillus mucosus in 12 cases of infantile diarrhoea. Obrinsky, Dormont, Fowler and Ruhstaller (1950) recorded 10 infantile infections caused by the Friedlander aerogenes group of organisms, with five deaths. Ocko-Cetkovic and Vesenjak-Zmijanac (1953) report on fulminant pneumonia and grave diarrhoeal disorders caused by Aerobacter aerogenes in premature babies and infants. In our hospital, during the period between December 7, 1953, and July 1, 1954, positive Kiebsiella cultures were obtained from the pharyngeal swabs of 52 premature babies, newborn babies and infants, of two children and two adults, as well as from the mucopurukent discharge in two children with otitis, and from the cerebrospinal fluid of a newborn infant, altogether on 94 occasions. The organism was often isolated in pure culture or was found to be predominant. The infections were severe, moderate or even mild. Notwithstanding its presence in throat cultures, it proved very often entirely harmless. It may be, however, that a Kiebsiella population of a purely saprophytic nature assumes pathogenic properties. Such a high incidence of Kiebsiella pneumwniae infections seems to be unrecorded as yet in the paediatric literature, and the publication of our material, therefore, may be of some use. Diffrertiatk of the Escberichiae