Authors : Anitha T.K, Anuradha K
DOI : 10.18231/j.ijmr.2019.024
Volume : 6
Issue : 2
Year : 2019
Page No : 113-116
Introduction: Septicemia is a major cause of morbidity and mortality among neonates in India, significantly threatening the survival in this period. Over the past decade, Klebsiella species, especially ESBL producers have emerged as an important cause of neonatal septicemia. ESBL producing Klebsiella species are of serious concern as they exhibit high resistance to commonly used antibiotics. Hence, the present study was undertaken to evaluate the prevalence of ESBL producing Klebsiella species as a causative agent in neonatal sepsis.
Objectives: 1. To determine the incidence of Klebsiella species as an etiological agent of neonatal septicemia from blood cultures in patients admitted in Neonatal Intensive Care Unit (NICU); 2: To evaluate the prevalence of Extended spectrum β-lactamase (ESBL) production in these isolates.
Materials and Methods: All the blood samples of clinically diagnosed neonatal septicemia, received at the Department of Microbiology, at a tertiary care center, South India, for a period of one year were included for the study. Klebsiella species were isolated by following conventional standard microbiological technique. Antibiotic susceptibility testing was done by Kirby Bauer disk diffusion method. For the resistant isolates, extended spectrum β-lactamase detection was done by phenotypic confirmatory disk diffusion test (PCDDT) as per CLSI guidelines 2010.
Results: A total of 300 blood samples which met the study criteria were processed. Among these, Blood culture positivity rate was 68.33%, of which 100(49.5%) were Klebsiella isolates. Of these, 96 (96%) were K.pneumoniae and 4 (4%) were K.oxytoca. And out of these 100 Klebsiella isolates, 39 (39%) were ESBL producers, where 38 (97.43%) were K. pneumoniae and 1 (2.56%) was K.oxytoca.
Conclusion: The present study showed that Klebsiella species are the leading cause of neonatal septicemia. Prevalence of antibiotic resistant strains among Klebsiella species is predominant and deserves more consideration. Routine testing for ESBL production will guide for proper and judicious use of antibiotics. Implementation of appropriate infection control measures and adherence to them are crucial to control the spread of antibiotic resistant organisms.
Keywords: Neonatal septicemia, Klebsiella species, Extended spectrum β-lactamase (ESBL).