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Klebsiella pneumoniae-induced mastitis

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Datasheet

Klebsiella pneumoniae-induced mastitis

Summary

  • Last modified
  • 12 July 2017
  • Datasheet Type(s)
  • Animal Disease
  • Preferred Scientific Name
  • Klebsiella pneumoniae-induced mastitis
  • Pathogens
  • Klebsiella pneumoniae
  • Overview
  • Klebsiella pneumoniae is one of a group of coliform bacteria (including Escherichia coli, Klebsiella oxytoca and Enterobacter aerogenes) that causes environmental mastitis.

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    Compendia
    CAB International
    Wallingford
    Oxfordshire
    OX10 8DE
    UK
    compend@cabi.org
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Identity

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Preferred Scientific Name

  • Klebsiella pneumoniae-induced mastitis

International Common Names

  • English: Klebsiella pneumonia infections; mastitis; mastitis in cattle; mastitis in pigs; peracute coliform mastitis

Pathogen/s

Top of page Klebsiella pneumoniae

Overview

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Klebsiella pneumoniae is one of a group of coliform bacteria (including Escherichia coli, Klebsiella oxytoca and Enterobacter aerogenes) that causes environmental mastitis.

Environmental mastitis is used to mean mastitis caused by bacteria that are transferred from the environment to the animal rather than from other infected quarters (Radostits et al., 1994).

As a result of control programmes for contagious mastitis pathogens in dairy cattle, mastitis caused by environmental pathogens is now the primary disease in well-managed dairy herds with low somatic cell count in bulk tank milk (Barkema et al., 1998).

Mastitis caused by K. pneumoniae can be particularly severe because of its poor response to conventionally applied antibiotic therapy and rapid progression to toxic shock and death (Sampimon et al., 2006).

K. pneumoniae is also a significant cause of mastitis in sows (Bertschinger et al., 1977; Ross et al., 1975, 1981). For a review of coliform mastitis in sows, see Gerjets and Kemper (2009).

Host Animals

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Animal nameContextLife stageSystem
Bos indicus (zebu)
Bos taurus (cattle)Domesticated hostCattle & Buffaloes: Cow
Capra hircus (goats)
Ovis aries (sheep)
Sus scrofa (pigs)Domesticated hostPigs: Sow

Systems Affected

Top of page blood and circulatory system diseases of large ruminants
blood and circulatory system diseases of small ruminants
mammary gland diseases of large ruminants
mammary gland diseases of pigs
respiratory diseases of large ruminants
respiratory diseases of small ruminants
urinary tract and renal diseases of large ruminants

Distribution

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Klebsiella spp. is a common cause of bovine mastitis (Podder et al., 2014). In many western countries, control programs for contagious mastitis have been in place for decades, resulting in a decrease in occurrence of Streptococcus agalactiae and Staphylococcus aureus mastitis and an increase in the relative impact of environmental mastitis pathogens. In some countries, Klebsiella spp. are appearing as important causes of mastitis (Munoz et al., 2007; Zadoks and Fitzpatrick, 2009).

Distribution Table

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The distribution in this summary table is based on all the information available. When several references are cited, they may give conflicting information on the status. Further details may be available for individual references in the Distribution Table Details section which can be selected by going to Generate Report.

Pathology

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Infections with coliform bacteria typically affect only one quarter, but cause clinical mastitis in up to 90% of cases and are usually associated with systemic disease (Nooyen, 2012).

Peracute coliform mastitis in the cow is a severe disease characterized by a sudden onset of agalactia and toxaemia. The cow may be normal at one milking and be acutely ill at the next. Complete anorexia, severe depression, shivering and trampling and a fever of 40 to 42°C are common. Within 6 to 8 h after the onset of signs the cow may be recumbent and unable to get up. The temperature may be normal or subnormal, and signs may superficially resemble parturient paresis (Radostits et al., 1994)

The affected quarter is usually swollen and warm but not remarkable. Coliform mastitis is not uncommonly missed on initial clinical examination. A discriminant analysis of clinical indicants revealed that only a history of previous mastitis in the affected quarter, muscle weakness, clear or white colour of milk, swelling of the udder, watery consistency of the milk, lack of previous mastitis in other quarters, lack of palpable udder abscesses and fever were significantly associated with coliform mastitis (White et al., 1986).

Chronic coliform mastitis is characterized by repeated episodes of subacute mastitis that cannot be readily clinically distinguished from other common causes of mastitis.

Diagnosis

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A clinical diagnosis of coliform mastitis is usually based on clinical signs, culture of coliform organisms from milk, and a high somatic cell count (Nooyen, 2012). However, in the peracute case, the milk sample may be negative because neutrophils have cleared the organisms (Radostits et al., 1994).

Streaking blood agar and MacConkey agar plates with 0.01 ml and 0.1 ml of milk, respectively, may aid in obtaining detectable growth and a definitive diagnosis. If the animal has already succumbed to the effects of endotoxaemia, bacteriology of chilled mammary tissue and regional lymph nodes along with histologic evaluation of formalin-fixed mammary tissue are diagnostic in confirming coliform mastitis (Nooyen, 2012).

For a number of mastitis pathogens, polymerase chain reaction (PCR)-based diagnostic techniques are being developed (O’Grady and Doherty, 2009). As it is expensive to do a separate PCR test for every possible mastitis pathogen, assays that can test for many bacterial targets in milk at the same time are promising (Koskinen, 2009; Burr et al., 2010; Cressier and Bissonnette, 2011; Ajitkumar et al., 2012).

List of Symptoms/Signs

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SignLife StagesType
Cardiovascular Signs / Absent p waves Sign
Cardiovascular Signs / Arrhythmia, irregular heart rate, pulse Sign
Cardiovascular Signs / Atrial fibrillation Sign
Cardiovascular Signs / Heart murmur Sign
Cardiovascular Signs / Jugular pulse Sign
Cardiovascular Signs / Palpable precordial thrill Sign
Cardiovascular Signs / Peripheral venous distention, jugular distention Sign
Cardiovascular Signs / Sinus tachycardia Sign
Cardiovascular Signs / Tachycardia, rapid pulse, high heart rate Sign
Cardiovascular Signs / Ventricular premature beat, multifocal or unifocal Sign
Digestive Signs / Anorexia, loss or decreased appetite, not nursing, off feed Sign
Digestive Signs / Ascites, fluid abdomen Sign
Digestive Signs / Decreased amount of stools, absent faeces, constipation Sign
Digestive Signs / Diarrhoea Sign
Digestive Signs / Grinding teeth, bruxism, odontoprisis Sign
Digestive Signs / Hepatosplenomegaly, splenomegaly, hepatomegaly Sign
General Signs / Fever, pyrexia, hyperthermia Sign
General Signs / Forelimb lameness, stiffness, limping fore leg Sign
General Signs / Forelimb swelling, mass in fore leg joint and / or non-joint area Sign
General Signs / Generalized lameness or stiffness, limping Sign
General Signs / Generalized weakness, paresis, paralysis Sign
General Signs / Haemorrhage of any body part or clotting failure, bleeding Sign
General Signs / Head, face, ears, jaw, nose, nasal, swelling, mass Sign
General Signs / Hindlimb lameness, stiffness, limping hind leg Sign
General Signs / Hindlimb swelling, mass in hind leg joint and / or non-joint area Sign
General Signs / Inability to stand, downer, prostration Sign
General Signs / Kyphosis, arched back Sign
General Signs / Pale mucous membranes or skin, anemia Sign
General Signs / Reluctant to move, refusal to move Sign
General Signs / Sudden death, found dead Sign
General Signs / Underweight, poor condition, thin, emaciated, unthriftiness, ill thrift Sign
General Signs / Weight loss Sign
Nervous Signs / Dullness, depression, lethargy, depressed, lethargic, listless Sign
Ophthalmology Signs / Conjunctival, scleral, injection, abnormal vasculature Sign
Ophthalmology Signs / Conjunctival, scleral, redness Sign
Pain / Discomfort Signs / Pain on external abdominal pressure Sign
Reproductive Signs / Agalactia, decreased, absent milk production Sign
Respiratory Signs / Abnormal lung or pleural sounds, rales, crackles, wheezes, friction rubs Sign
Respiratory Signs / Coughing, coughs Sign
Respiratory Signs / Dyspnea, difficult, open mouth breathing, grunt, gasping Sign
Respiratory Signs / Epistaxis, nosebleed, nasal haemorrhage, bleeding Sign
Respiratory Signs / Increased respiratory rate, polypnea, tachypnea, hyperpnea Sign
Skin / Integumentary Signs / Cold skin, cool ears, extremities Sign
Skin / Integumentary Signs / Rough hair coat, dull, standing on end Sign
Skin / Integumentary Signs / Skin edema Sign
Urinary Signs / Haematuria, blood in urine Sign
Urinary Signs / Proteinuria, protein in urine Sign

Disease Course

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Klebsiella spp. enter via the teat canal and multiply rapidly within the udder, causing an acute symptomatology and loss of milk production. Susceptibility to the bacteria is greatest during the first two weeks of the dry period, due to ease of bacterial access through the teat canal at this time, the proliferation of bacteria in the skin of the teat, and deficient hygiene; and during the peripartum period, due to an increase in cortisol levels which has a negative effect on the inflammatory response and neutrophil function, a negative energetic balance, and oestrus (Herrera, 2009).

The primary host defense against coliform mastitis during lactation is the elimination of bacteria by neutrophils migrating into the gland in response to inflammation. Damage to the host is mediated by the release of endotoxin. Systemic signs of clinical mastitis include anorexia, fever, dehydration, and diarrhoea. Decreased milk production during clinical coliform mastitis results both directly and indirectly from the local and systemic effects of endotoxin (Hogan and Smith, 2003).

Coliform mastitis can result in bacteraemia and septicaemia as the blood-milk barrier is destroyed (Wenz, 2001). Septicaemia resulting from coliform mastitis is rare, but is often fatal when it occurs (Hogan and Smith, 2003).

Some cases of coliform mastitis may become chronic, but more than 50% of infections end within ten days (Nooyen, 2012).

Epidemiology

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Numerous capsular types of Klebsiella pneumonia are responsible for coliform mastitis in cattle (Braman et al., 1973). Genetic studies have shown a high level of diversity in K. pneumoniae genotypes within and between dairy herds (Paulin-Curlee et al., 2007, 2008).

Coliform mastitis is common in dairy cattle housed during the winter. It is uncommon in dairy cattle that are continuously in pasture (Radostits et al., 1994). Wet bedding, particularly sawdust and shavings, has been shown to promote the growth of coliform bacteria, especially Klebsiella spp. There is a strong association between rainfall and bedding populations and incidence of K. pneumoniae mastitis (Thomas et al., 1983).

For many years, wood-based bedding materials have been considered to be the most important source of intramammary infections due to Klebsiella spp. (Vecht et al., 1987; Sampimon et al., 2006) and prevention strategies include using inorganic bedding materials. However, several investigations have shown the presence and growth of Klebsiella in both organic and inorganic bedding materials (Hogan et al., 1989; Zdanowicz et al., 2004). In dairy farms, Klebsiella has frequently been isolated from milking machine equipment (Munoz et al., 2007), milking machine wash water (Silva and Costa, 2001) and drinking water (Nonnecke and Newbould, 1984; Munoz et al., 2007; Zadoks et al., 2011).

Faeces have been shown to be a source of environmental Klebsiella contamination (Munoz et al., 2006; Verbist et al., 2011). Zadoks et al. (2011) found the faecal shedding of Klebsiella spp. contributes to pathogen loads in the environment, including bedding, alleyways, and holding pens. Hygiene of alleyways and holding pens is an important component of Klebsiella control on dairy farms.

Impact: Economic

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Mastitis caused by K. pneumoniae can be particularly severe due to its poor response to antibiotic therapy, rapid evolution to toxic shock, and death (Silva and Costa, 2001). Infection with Klebsiella spp. affects the profitability of dairy farmers due to discarded milk, costs of antibiotic treatment, and extra labour, death, or culling of infected animals and decreased fertility. Klebsiella spp. mastitis causes a considerable and often sustained decrease in milk production, with average losses of 7.6 kg/day shortly after infection and 5 kg/day in subsequent months (Gröhn et al., 2004).

Zoonoses and Food Safety

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As opportunistic pathogens, Klebsiella spp. can cause a variety of illnesses in humans, including pneumonia, urinary tract infections and septicaemia, in the immunocompromised or those with underlying conditions (Broberg et al., 2014).

Raw milk is commonly contaminated with K. pneumoniae (Hattier et al., 1988; Gran et al., 2003; Ebtesam et al., 2008; Nam et al., 2010; Gundogan and Avci?, 2013).

Some K. pneumoniae strains produce enzymes called extended-spectrum beta-lactamases (ESBLs) and are resistant to many penicillin and cephalosporin antibiotics and often to other types of antibiotic. ESBL-producing K. pneumoniae have been detected on dairy farms, which could be a concern for both public and animal health (Ohnishi et al., 2012; Nóbrega et al., 2013; Timofte et al., 2014).

Disease Treatment

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Most studies suggest that traditional antibiotics have only limited effects in treating K. pneumoniae mastitis (Erskine et al., 2002; Roberson et al., 2004; Ribeiro et al., 2008). However, Schukken et al. (2011) found that intramammary treatment of non-severe clinical mastitis with ceftiofur hydrochloride resulted in a significant increase in bacteriological cure compared with nontreated controls in animals infected with E. coli or Klebsiella spp.

Broad spectrum intravenous antimicrobials are given to severely affected cows to reduce the bacteraemia which may be present in up to 48% of coliform mastitis cases. Stripping of the affected quarter several times a day, in conjunction with oxytocin injections, has also been utilized to reduce the number of bacteria and endotoxin in the gland. Anti-inflammatory and fluid therapy may also be necessary to prevent shock and maintain overall hydration status (Nooyen, 2012).

Prevention and Control

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The control and prevention of coliform mastitis is a challenge for dairy producers. Control measures that are applied for contagious mastitis pathogens are often ineffective in controlling mastitis caused by coliform bacteria. Because of the poor response to treatment, hygienic measures are the most appropriate control strategy for Klebsiella mastitis (Munoz et al., 2006). Vaccination has been reported to provide some protection against the risk of culling but does not affect the incidence or severity of clinical mastitis due to Klebsiella spp. (Wilson et al., 2007).

Since faecal shedding of Klebsiella spp. contributes to pathogen loads in the environment; hygiene of alleyways and holding pens is an important component of Klebsiella control on dairy farms (Zadoks et al., 2011). Important control measures include frequent changing of bedding, alley scraping, and strict cleaning of teats before milking.

References

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Bertschinger HU; Pohlenz J; Hemlep I, 1977. The mastitis-metritis-agalactia syndrome ('milk fever') in the sow. II. Bacteriological findings in spontaneous cases. In: Bertschinger, H. U.; Williams, D.; Pohlenz, J. Experimental Klebsiella mastitis of swine.: Experimentelle Klebsiellenmastitis beim Schwein. Schweizer-Archiv-fur-Tierheilkunde, 119(6):223-233.

Bradley AJ; Green MJ, 2000. A study of the incidence and significance of intramammary enterobacterial infections acquired during the dry period. Journal of Dairy Science, 83(9):1957-1965.

Braman SK; Eberhart RJ; Asbury MA; Hermann GJ, 1973. Capsular types of Klebsiella pneumoniae associated with bovine mastitis. Journal of the American Veterinary Medical Association, 162: 109-111.

Broberg CA; Palacios M; Miller VL, 2014. Klebsiella: a long way to go towards understanding this enigmatic jet-setter. F1000 Prime Reports, 6(64):(1 August 2014). http://f1000.com/prime/reports/b/6/64

Burr P; Haig KT; MacCallum S; Edmondson P, 2010. Comparative trial of BactoproofTM QPCR and conventional culture for mastitis testing. In: British Mastitis Conference 2010, Sixways, Worcester, UK, 6th October 2010 [ed. by Pocknee, B.]. Taunton, UK: The Dairy Group, 87-88.

Cressier B; Bissonnette N, 2011. Assessment of an extraction protocol to detect the major mastitis-causing pathogens in bovine milk. Journal of Dairy Science, 94(5):2171-2184. http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B9887-52P7J64-V&_user=3325428&_coverDate=05%2F31%2F2011&_rdoc=5&_fmt=high&_orig=browse&_origin=browse&_zone=rslt_list_item&_srch=doc-info(%23toc%2359175%232011%23999059994%233128777%23FLA%23display%23Volume)&_cdi=59175&_sort=d&_docanchor=&_ct=59&_acct=C000050221&_version=1&_urlVersion=0&_userid=3325428&md5=ffccea9b7d4c36aa0611c12cacb386b0&searchtype=a

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Hogan JS; Smith KL; Hoblet KH; Todhunter DA; Schoenberger PS; Hueston WD; Pritchard DE; Bowman GL; Heider LE; Brockett BL; Conrad HR, 1989. Bacterial counts in bedding materials used on nine commercial dairies. Journal of Dairy Science, 72(1):250-258.

Ibtisam EME; Kutzer P; El-Owni OAO, 2010. Frequencies and antibiotic susceptibility patterns of bacteria causing mastitis among cows and their environment in Khartoum State. Research Journal of Microbiology, 5(8):731-739. http://www.academicjournals.net

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Ribeiro MG; Motta RG; Paes AC; Allendorf SD; Salerno T; Siqueira AK; Fernandes MC; Lara GHB, 2008. Peracute bovine mastitis caused by Klebsiella pneumoniae. Arquivo Brasileiro de Medicina Veterinária e Zootecnia, 60(2):485-488. http://www.journal.vet.ufmg.br

Roberson JR; Warnick LD; Moore G, 2004. Mild to moderate clinical mastitis: efficacy of intramammary amoxicillin, frequent milk-out, a combined intramammary amoxicillin, and frequent milk-out treatment versus no treatment. Journal of Dairy Science, 87(3):583-592. http://jds.fass.org/cgi/content/abstract/87/3/583

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Sampimon OC; Sol J; Kock PA, 2006. An outbreak of Klebsiella pneumoniae mastitis. (Een uitbraak van Klebsiella pneumoniae mastitis.) Tijdschrift voor Diergeneeskunde, 131(1):2-4. http://www.knmvd.nl

Schukken YH; Bennett GJ; Zurakowski MJ; Sharkey HL; Rauch BJ; Thomas MJ; Ceglowski B; Saltman RL; Belomestnykh N; Zadoks RN, 2011. Randomized clinical trial to evaluate the efficacy of a 5-day ceftiofur hydrochloride intramammary treatment on nonsevere gram-negative clinical mastitis. Journal of Dairy Science, 94(12):6203-6215. http://www.sciencedirect.com/science/article/pii/S0022030211006540

Silva N; Costa GM, 2001. An outbreak of acute bovine mastitis caused by Klebsiella pneumoniae in a dairy herd. Arquivo Brasileiro de Medicina Veterinária e Zootecnia, 53(4):401-405.

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