Neonatal Sepsis due to Klebsiella: Frequency, Outcome and Antibiotic Sensitivity

Abstract

Sepsis is a significant cause of morbidity and mortality in neonates. The most common pathogens of bacterial sepsis and antibiotic sensitivity patterns vary in different parts of the world. The aim of this study was to determine the most common pathogens and outcome of neonatal sepsis and also antibiotic sensitivity patterns of Klebsiella species. A retrospective descriptive study was carried out. The study was performed at a neonatal care unit in Kashan between October 2000 to October 2003.Only those neonates with positive blood culture were included. Patients with Klebsiella septicemia were categorized into two groups of early and late-onset sepsis. Patterns of the antibiotic resistance of the bacterial isolates were studied by disc diffusion technique. Frequencies and Fisher’s Exact test was used to compare the early-onset outcome versus late –onset outcome. One hundred and thirty –six neonates had positive blood cultures out of 453 cases. The most common pathogens were Pseudomonas, Klebsiella and coagulase negative Staphylococci respectively. Overall crude mortality rate was 39% (Pseudomonas was the predominant cause). All Klebsiella species were resistant to ampicillin. Twenty-three percent of Klebsiella species were multiresistant considering our most common etiologic pathogens of bacterial sepsis and the significant number of resistant bacteria to ampicillin and gentamicin; it seems prudent to consider revising the present choice of empirical antibiotic treatment.