Klebsiella pneumoniae in Neonatal Sepsis: A Growing Challenge of Multidrug Resistance in a Tertiary Care Setting

Document Type : New and original researches in the field of Microbiology.

Authors

1 Medical Microbiology & Immunology, Faculty of Medicine, Tanta University, Egypt

2 Pediatrics Medicine, Faculty of Medicine, Tanta University, Egypt

Abstract

Background: Neonatal sepsis, a potentially fatal medical condition marked by systemic infection in newborns, poses a substantial challenge for paediatricians and infection control professionals, particularly when attributed to Klebsiella pneumoniae (K. pneumoniae). Objectives: This research was designed to determine the predominant bacterial species causing late-onset neonatal sepsis (LONS) in the NICUs located at hospitals of Tanta University. The study specifically focused on evaluating the incidence of Klebsiella pneumoniae (K. pneumoniae) among these cases. Additionally, the research sought to conduct a comprehensive analysis of the phenotypes, antibiotic resistance profiles, antimicrobial resistance patterns, and of resistance mechanisms observed in K. pneumoniae isolates. Methodology: This study enrolled 100 neonates presenting with signs and symptoms of sepsis after 72 hours of birth. Standard microbiological techniques were employed for bacterial identification, with K. pneumoniae isolates confirmed through a series of biochemical reactions. The string test method was utilized to identify hypervirulent K. pneumoniae (hvKp) isolates. The determination of antibiotic susceptibility was carried out using the disc diffusion method and the colistin broth disk elution method. Results: Blood culture analysis revealed sepsis in 37% of the enrolled neonates. K. pneumoniae was identified as the predominant pathogen, responsible for 40.5% of these cases, with Staphylococcus aureus identified in 27%. Among the K. pneumoniae isolates, 33.3% were hvKp, and a significant proportion exhibited resistance: 53.3% were multidrug-resistant (MDR), 46.7% were extensively drug-resistant (XDR), and 86.7% were carbapenem-resistant (CRKP). Colistin and tigecycline demonstrated the highest efficacy against these resistant isolates. Conclusion: The substantial prevalence of K. pneumoniae in LONS underscores the critical need for robust infection control measures

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