IDENTIFICATION AND CLINICAL SIGNIFICANCE OF KLEBSIELLA SPECIES IN CHEST INFECTIONS.

Using a short series of biochemical tests already in use in many routine laboratories, it is possible to identify strains of the genus Klebsiella and to differentiate K. aerogenes from other types. Marked production of slime is not peculiar to the group and colonial appearance alone is not a satisfactory basis for identification. K. aerogenes is the type most commonly isolated from all clinical specimens. It is suggested that the name may be retained in clinical bacteriology and used when applicable, particularly when reporting urinary strains. K. aerogenes is of doubtful pathogenicity when isolated from sputum; frequently its appearance follows antibiotic treatment for other organisms. It should be clearly distinguished from other Klebsiella types occurring as primary pathogens in sputum. Friedlander's bacillus is considered a suitable collective term for the latter, namely K. edwardsii-edwardsii, K. pneumoniae, and K. edwardsii-atlantae. The clinical significance of K. rhinoscleromatis and K. ozaenae could not be assessed as so few isolations were made. On the rare occasions when they occur they would, with the tests recommended, be included as Friedlander's bacillus, the distinction not being readily made in the clinical laboratory.