A Clinico-Microbiological Study of Β-Lactamase Producing Klebsiella Pneumoniae Among Neonates From Neonatal Intensive Care Unit At Tertiary Care Hospital, Ujjain

Abstract

Abstract: Infection caused by drug resistance Klebsiella pneumoniae is very common now days in community as well as nosocomial environment. K.pneumoniae is second most common pathogen in neonatal septicemia. Our aim to detect drug resistance K.pneumoniae by production of β-lactamase enzymes such as extended spectrum β-lactamase (ESBL), AmpC β-lactamase, metalo β-lactamase (MBL) and carbapenemase in neonatal septicemia. A total 13 isolates of K.pneumoniae detected from neonates admitted in tertiary care centre during study period from February 2015 to July 2016. We analyzed risk factors in K. pneumoniae infection among neonates on the basis of prolong rupture of membrane, preterm birth, onset of septicemia etc. Antimicrobial susceptibility testing was performed by Kirby-Bauer disk diffusion methods. β-lactamase enzymes includes, Extended spectrum β-lactamase(ESBL), AmpC β-lactamase, metalo β-lactamase (MBL)and carbapenemase were detected by phenotypic methods using standard guidelines. Distribution of MDR, XDR and PDR detected according to antimicrobial resistance pattern as per guideline. Among 13 K.pneumoniae isolate, antimicrobial resistance profile was studied. Isolates were 100% resistant to third generation cephalosporin and least resistant to imipenem 54%. MDR K.pneumoniae were 23 %, XDR were 77% and no PDR isolated. ESBL production seen in 23.1%, AmpC in 7.7 %, MBL in 00 % and Carbapenemase in 46.1 %. The study indicates that drug resistance higher in NICU of our institute. It requires strict implementation of infection control guidelines in NICU by safe hygiene practices, restricted use of broad spectrum antibiotics as empirical therapy and also formulation of uniform antibiotic policy for such patients based on the current trend of antibiotic resistance.