Is Klebsiella pneumonia contagious?

Klebsiella pneumoniae Transmission and Infection Control

Klebsiella pneumoniae is highly contagious in healthcare settings and requires strict infection control measures, including contact precautions for all colonized or infected patients, to prevent transmission. 1

Transmission Dynamics

• K. pneumoniae spreads primarily through patient-to-patient transmission via the hands of healthcare workers, making hand hygiene compliance critical for prevention 2
• The organism can contaminate healthcare workers' gloves and gowns during patient care, with studies showing 14% of healthcare worker-patient interactions resulting in contamination 3
• Patients with unrecognized K. pneumoniae colonization serve as reservoirs for transmission during healthcare-associated outbreaks 1
• The basic reproduction number (R₀) can reach 2 in hospital settings with poor hand hygiene compliance (21%), meaning each infected patient can infect two others on average 2

Risk Factors for Transmission

• Healthcare settings, particularly intensive care units, are high-risk environments for K. pneumoniae transmission 1, 4
• Patients with prolonged hospitalization, critical illness, and exposure to invasive devices (ventilators, central venous catheters) are at increased risk 1
• The gastrointestinal tract of hospitalized patients serves as a reservoir for transmission 4
• Carbapenem-resistant K. pneumoniae (CRKP) poses significant treatment challenges and has been associated with increased mortality, length of stay, and costs 1

Infection Control Measures

Hand Hygiene

• Implement hand hygiene education programs with alcohol-based hand rubs before and after all patient contacts 1
• A minimum hand hygiene compliance level of 50% is necessary to control transmission 2
• Regular monitoring of hand hygiene compliance with feedback to healthcare workers is essential 1

Contact Precautions

• All patients colonized or infected with K. pneumoniae, especially carbapenem-resistant strains, should be placed on contact precautions 1
• Healthcare workers should wear gloves and gowns before entering the room of colonized patients and remove them promptly after care 1
• Regular auditing of adherence to contact precautions is necessary to ensure effectiveness 1

Surveillance and Screening

• Implement active surveillance cultures to identify colonized patients, particularly in high-risk units 1
• Screen patients with epidemiologic links to confirmed cases 1
• Use alert codes to promptly identify patients known to be colonized at hospital/ward admission 1
• Surveillance cultures should include stool samples or swabs from the rectum/perirectal area 1

Patient Isolation and Cohorting

• Isolate colonized and infected patients in single rooms to reduce transmission risk 1
• Cohort patients with the same resistant strain in designated areas when single rooms are unavailable 1
• Cohort staff caring for colonized patients to minimize cross-transmission 1

Environmental Cleaning

• Implement regular environmental cleaning procedures with appropriate disinfectants 1
• Monitor cleaning performance to ensure consistency 1
• Dedicate non-critical medical equipment to individual colonized patients when possible 1
• Shared equipment should be properly disinfected between patient use 1

Antimicrobial Stewardship

• Implement antimicrobial stewardship programs to limit the use of specific antimicrobials based on patient comorbidities 1
• Restrict antibiotic usage, particularly third-generation cephalosporins, to reduce the spread of resistant K. pneumoniae 4
• Judicious use of carbapenems is essential due to increasing carbapenem resistance 5

Special Considerations

• The prevalence of multidrug-resistant K. pneumoniae has increased significantly in recent years, with studies showing rises in extensively drug-resistant strains from 62.5% to 71% in ICU patients 6
• In endemic settings, a combination of surveillance cultures, contact precautions, isolation/cohorting, and improved hand hygiene compliance can lead to rapid control within 8-12 weeks 2
• The emergence of hypervirulent K. pneumoniae strains has broadened susceptibility to include previously healthy individuals 7