Molecular Identification of Multi Drug-resistant Klebsiella pneumoniae Isolated from Neonates with Sepsis in Egypt

Abstract

Neonatal sepsis is one of the most prevalent infections today, claiming the lives of almost one million newborns in developing countries. Our objective is to determine the bacteria that cause sepsis in newborns in Egyptian hospitals, as well as to discover their resistance profiles, allowing for the selection of appropriate drug combinations against multidrug resistant (MDR) bacteria.  Nine hundred and eighty-nine blood samples were collected from neonates in Al Demerdash and Ain Shams University Specialized Hospital from March 2019 to March 20121 according to the standard protocols. Bacterial identification and antimicrobial susceptibility test AST were performed using VITEK® 2 system.  The results revealed that 51.4 % of patients had positive blood cultures, with 60.3 % females and 39.7 %. Males. Sepsis with late onset was detected in 95% of positive cases, while sepsis with early onset was observed in only 5% of the total positive cases. According to the study, 98.3 % of Klebsiella Pneumoniae isolates were resistant to Ampicillin, 91% to Ampicillin/sulbactam, and 90% to Ceftazidime and Cefotaxime. Quantitative Real-time RT-PCR analysis of the blaCTX-M-15 gene expression found that (69%) of MDR K. pneumoniae isolates expressed the gene at a significantly higher level than susceptible isolates, with a mean fold change of 10.0349 versus 1.8646.  In conclusion, Klebsiella pneumoniae is the leading cause of neonatal sepsis in the majority of Egyptian hospitals' NICUs. Application of infection prevention and control strategies, in conjunction with appropriate antimicrobial stewardship programs, may be beneficial in overcoming this challenge.