Abstract
BackgroundNeonatal sepsis is a nuisance to clinicians and medical microbiologists, particularly those cases caused by Klebsiella pneumoniae. Thus, we aimed at investigating the profile and mechanisms of antibiotic resistance and the clonal relationships between K. pneumoniae isolated from neonates at the largest tertiary care hospital’s neonatal intensive care units (NICUs) in Minia, Egypt.MethodsThis study comprised 156 neonates diagnosed with culture-proven sepsis from February 2019 to September 2019, at a major NICU of Minia City. All K. pneumoniae isolates were collected and characterized by antimicrobial profile, resistance genotype, and pulsed-field gel electrophoresis typing.ResultsTwenty-four K. pneumoniae isolates (15.3%) were collected out of the 156 sepsis diagnosed neonates. These samples showed extensive drug resistance (XDR) to most of the tested antimicrobials, except fluoroquinolones. All the K. pneumoniae isolates possessed blaVIM and blaNDM carbapenemase genes, while blaKPC gene was detected in 95.8%. Considering extended-spectrum β-lactamases genes, blaCTX–M was found in all the isolates and blaOXA–1 gene in 75% of them. The plasmid-mediated quinolone resistance gene qnrS, was predominantly found among our isolates in comparison to qnrB or qnrA. A moderate degree of clonal relatedness was observed between the isolates.ConclusionTo the best of our knowledge, this the first report of an alarming occurrence of XDR among K. penumoniae isolates recovered from neonatal sepsis in Egypt. Our data necessitate proper antimicrobial stewardship as the choices will be very limited.
Highlights
MATERIALS AND METHODSKlebsiella pneumoniae is a Gram-negative bacterium, which causes infections with high mortality and morbidity in hospitalized and immunocompromised patients (Gorrie et al, 2017)
It is one of the most frequent causes of outbreaks in neonatal intensive care units (NICUs; Banerjee et al, 2016). This micro-organism has a wide array of resistance mechanisms to several antimicrobials, including beta-lactams, fluoroquinolones, and aminoglycosides (Fair and Tor, 2014; Dsouza et al, 2017)
The current study presents the epidemiology, clinical features, outcomes, antimicrobial profile, and molecular basis involved in the possession of XDR K. pneumoniae in NICUs in our hospital
Summary
Klebsiella pneumoniae is a Gram-negative bacterium, which causes infections with high mortality and morbidity in hospitalized and immunocompromised patients (Gorrie et al, 2017). It is one of the most frequent causes of outbreaks in neonatal intensive care units (NICUs; Banerjee et al, 2016). This micro-organism has a wide array of resistance mechanisms to several antimicrobials, including beta-lactams, fluoroquinolones, and aminoglycosides (Fair and Tor, 2014; Dsouza et al, 2017). We aimed at investigating the profile and mechanisms of antibiotic resistance and the clonal relationships between K. pneumoniae isolated from neonates at the largest tertiary care hospital’s neonatal intensive care units (NICUs) in Minia, Egypt
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