Epidemiology

Klebsiellas are part of the normal flora of the intestine in a small percentage of individuals. Colonization of the mouth and throat is common in debilitated individuals, especially in an institutional setting. In hospitals and nursing homes, the organisms are often resistant to antimicrobial medications, and they readily colonize patients taking the medications. Klebsiella resistance to antimicrobial medications can be chromosomal or plasmid-mediated. The organisms easily acquire and are a source of R factors, all of which contain transposons. This allows resistance genes to spread readily to other species and genera when antibacterial medications are used. ■ R plasmids and transposons, pp. 210, 212

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