Abstract :
Background: Klebsiella pneumoniae is a notorious superbug that is rapidly becoming the most common nosocomial pathogen to be isolated from intensive care settings.
Objective: To determine the burden of Klebsiella pneumoniae and associated risk factors of late onset sepsis among neonates admitted into neonatal intensive care unit (NICU).
Materials and Methods: A prospective study was conducted among 200 neonates admitted into the NICU of Sassoon General Hospital from January 1, 2019 to December 31, 2019. Neonates 72hrs after birth were included in the study. A detailed case history format of patient information was prepared. Blood sample was subjected to identification by culture and real time polymerase chain reaction (RT-PCR). Neonates who were positive by blood culture were confirmed as having sepsis.
Results: Frequency of Klebsiella pneumoniae was 33.3% by blood culture and 38.1% by RT-PCR. Most of the septic neonates were males (n=6; 60%), formula fed (n=7; 70%), extremely low birth weight (n=6; 60%), delivered through caesarean section (n=6, 60%) and were preterm (n=7; 70%). Mortality was seen in 2 (20%) cases. All the isolates were sensitive to meropenem, piperacillin tazobactam, amikacin, polymyxin B and colistin.
Conclusion: Occurrence of Klebsiella pneumoniae was 33.3% in late onset neonatal sepsis by blood culture. Low birth weight, formula feeding, prematurity and caesarean section were associated with a higher risk of sepsis in these patients. Antimicrobial stewardship and hospital infection control measures are need of the hour in preventing late onset neonatal sepsis.
Keyword :
Klebsiella pneumoniae, late onset neonatal sepsis, neonatal intensive care unit, nosocomial, preterm, real time polymerase chain reaction