AUTHOR=Hassuna Noha A. , AbdelAziz Reem A. , Zakaria Amira , Abdelhakeem Mohammed 

TITLE=Extensively-Drug Resistant Klebsiella pneumoniae Recovered From Neonatal Sepsis Cases From a Major NICU in Egypt

JOURNAL=Frontiers in Microbiology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2020.01375

DOI=10.3389/fmicb.2020.01375

ISSN=1664-302X

ABSTRACT=<sec><title>Background</title><p>Neonatal sepsis is a nuisance to clinicians and medical microbiologists, particularly those cases caused by <italic>Klebsiella pneumoniae</italic>. Thus, we aimed at investigating the profile and mechanisms of antibiotic resistance and the clonal relationships between <italic>K. pneumoniae</italic> isolated from neonates at the largest tertiary care hospital’s neonatal intensive care units (NICUs) in Minia, Egypt.</p></sec><sec><title>Methods</title><p>This study comprised 156 neonates diagnosed with culture-proven sepsis from February 2019 to September 2019, at a major NICU of Minia City. All <italic>K. pneumoniae</italic> isolates were collected and characterized by antimicrobial profile, resistance genotype, and pulsed-field gel electrophoresis typing.</p></sec><sec><title>Results</title><p>Twenty-four <italic>K. pneumoniae</italic> 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 <italic>K. pneumoniae</italic> isolates possessed <italic>bla</italic><sub>VIM</sub> and <italic>bla</italic><sub>NDM</sub> carbapenemase genes, while <italic>bla</italic><sub>KPC</sub> gene was detected in 95.8%. Considering extended-spectrum β-lactamases genes, <italic>bla</italic><sub>CTX–M</sub> was found in all the isolates and <italic>bla</italic><sub>OXA–1</sub> gene in 75% of them. The plasmid-mediated quinolone resistance gene <italic>qnr</italic>S, was predominantly found among our isolates in comparison to <italic>qnr</italic>B or <italic>qnr</italic>A. A moderate degree of clonal relatedness was observed between the isolates.</p></sec><sec><title>Conclusion</title><p>To the best of our knowledge, this the first report of an alarming occurrence of XDR among <italic>K. penumoniae</italic> isolates recovered from neonatal sepsis in Egypt. Our data necessitate proper antimicrobial stewardship as the choices will be very limited.</p></sec>