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Emergence of multi-drug-resistant Klebsiella pneumoniae in Neonatal Intensive Care Units: concern about antimicrobial policies

Author Affiliations

  • 1Department of Microbiology, Shree Ramakrishna Institute of Computer Education and Applied Sciences, M.T.B. college campus, Athwalines, Surat-395 001, Gujarat, INDIA

Res. J. Recent Sci., Volume 1, Issue (ISC-2011), Pages 275-280, (2012)


Antimicrobial abuse is a serious risk factor for the emergence of multi-drug-resistant (MDR) pathogens. Multidrug resistant (MDR) Klebsiella pneumoniae is an increasing cause of neonatal infections in India and in other developing countries. Objective of this study was designed to monitor temporal change in prevalence of K. pneumoniae as a causative organism for neonatal infections and its antimicrobial sensitivity pattern. Neonatal infections are clinical syndromes characterized by signs and symptoms of infections in the first month of life. 550 blood cultures were studied from suspected babies and the prevalence of K. pneumoniae among them was checked with its antimicrobial susceptibility and case fatality rate at Department of Microbiology, SRICEAS, Surat, Gujarat. Among 550 suspected neonates in the study period, positivity was found in 110 cases. Among them, 23 cases were found due to Klebsiella pneumoniae infections, 60.86% of them were fatal. High degree of resistance to many antibiotics can be seen(%). Most of our strains were shown their resistance to most of the third generation of cephalosporins used. The incidence of neonatal infections due to K. pneumoniae was higher. All spp. of K. pneumoniae found as M.D.R., which was in co relevance with the mortality caused by them which knocking and shocking data, indicating the emergence to check on the cruelty use of antimicrobials in NICUs.


  1. Lawn J.E. et al, Why are 4 million newborn babiesdying each year, Lancet, 364, 399–401 (2004)
  2. Saving Newborn Lives, The state of the world’snewborns: a report from saving NewbornLives, Washington DC, Save the Children, (2001)
  3. Hyder A.A., Wali S.A., McGuckin J., The burden ofdisease from neonatal mortality: a review of South Asiaand Sub-Saharan Africa, British journal of obstetricsand gynaecology, 110, 894–901 (2003)
  4. Mother–baby package: a road map for implementationin countries, Geneva, World Health Organization(1993)
  5. Stoll B.J., Neonatal infections: a global perspective, In:Remington J.S., Klein J.O., eds, Infectious diseases ofthe fetus and newborn infant, 5th ed. Philadelphia, WBSaunders, 139–68 (2001)
  6. Stoll B.J., Infections of the neonatal infant. In: NelsonTextbook of Pediatrics, Behrman E.d., Kleigman R.E.,RM, Jenson HB. Philadelphia: W.B.Saunders, 17th ed,623-39 (2004)
  7. Edwards M.S., Postnatal infections In: Fanaoff andMartins Neonatal-perinatal Medicine, 8thed.Philadelphia: Mosby Elsevier, 791-804 (2006)
  8. Vergnano S., Sharland M., Kazembe P., WansamboC.M., Heath PT Neonatal sepsis, An internationalperspective, Arch. Dis.Child. Fetal Neonatal Ed., 90:F220-F224 (2005)
  9. Bark A.F., Intravenous lines-related sepsis in newbornbabies admitted to NICU in a developing country, JTrop Pediatr, 49(5) 259-7 (2003)
  10. Joshi S.G., Ghole V.S., Niphadkar K.B., NeonatalGram-negative bacteremia. Indian J Pediatr, 67(1) 27-32 (2000)
  11. Koksal N., Hacimustafaoglu M., bagci S., Celebi S.Meropenem in neonatal severe infections due tomultiresistant gram-negative bacteria, Indian J Pediatr,68(1) 15-9 (2001)
  12. Roilides E., Kyriakides G., Kadiltsoglou I., Farmaki E.,Venzon D., Katsaveli A., Kremeno poulos G., Septicemia due to multiresistant Klebsiella pneumoniaein a neonatal unit: a case-control study, Am J Perinatol,17(1) 35-9 (2000)
  13. Luck s., Torny M., d’Agapeyeff K., Pitt A., Heath P.,Breathnach A., Russel Ab., Estimated early –onsetgroup B streptococcal neonattal disease, Lancet,361(9373)1953-54 (2003)
  14. Waheed M., laeeq A., Maqbool S., The etiology ofneonatal sepsis and patterns of antibiotic resistance, JColl Physicians Surg pak, 13(8) 449-52 (2003)
  15. Maksic H., Karic A., Cengic s., Incidence of early-onsetneonatal sepsis caused by group B streptococcus at thepediatric clinic of the university clinical center inSarajevo, Med Arh, 56 (3)51-3 (2002)
  16. Torres J.A., Villegas M.V., Quinn J.P., Currentconcepts in antibiotic-resistant gram-negative bacteria, Expert Rev Anti Infect Ther.,(5),833-43 (2007)
  17. Fanos V., Cuzzolin L., Atzei A., et al, Antibiotics andantifungals in neonatal intensive care units: a review, JChemother,(19) 5-20 (2007)
  18. Shakil S., Khan R., Zarrilli R., et al, Aminoglycosidesversus bacteria—a description of the action, resistancemechanism, and nosocomial battleground, J BiomedSci.,(15) 5-14 (2008)
  19. Rahman S., Hameed A., Roghani M.T., Ullah Z., Multidrug resistant neonatal sepsis in Peshhawar,Pakistan, Arch. Dis. Child. Fetal Neonatal Ed., 87(1)F52-F54 (2002)
  20. Bhttacharjee A., Sen M.R., Prakash P., Gaur A.,Anuprba S., Increased prevalence of extended spectrum_ Iactamase producers in neonatal septicaemic cases ata tertiary referral hospital, Indian J. Med. Microbiol.,264(4) 356-360 (2008)
  21. Bansal S., Jain A., Agarwal J., Malik G.K., Significanceof coagulase negative staphylococci in neonates with late onset septicemia, Indian J. Pathol. Microbiol.,47(4) 586-568 (2004)
  22. Agnihotri N,, Kaistha N,, Gupta V., Antimicrobialsusceptibility of isolates from neonatal septicemia JPN, J. Infect, Dis., 57(6) 273- 275 (2004)
  23. Lund A.M., Christensen E., Skovby F., Diagnosis andacute treatment of inborn metabolic diseases in infants, Ugeskrift for Laeger, 164(48) 5613-5619 (2002)
  24. Radhy H., Neonatal sepsis causative agents andoutcome, Thesis submitted to the Iraqi commission formedical specialization 1-36 (2001)
  25. Jaber E., AL. Zwaini k., Neonatal septicemia in theneonatal care unit in AL- Anbar governorate in Iraq, East Med. Health J, 8 (4): 30-36 (2002)
  26. Rodriguez M., Canadiani C., Garcia J., et al, Morbidityand Mortality from neonatal sepsis in a tertiary carelevel hospital, Salud publica de Mexico 45 (2):,90-95(2003)
  27. Kurnuvilla K. A., Bacterial Profile of Sepsis in aNeonatal Unit in South India, Indian Pediatr,35851-858(1998)