Affiliations: Department of Neonatology, King Edward Memorial
Hospital, Rasta Peth, Pune, India | Department of Pediatrics, King Edward Memorial
Hospital, Rasta Peth, Pune, India
Note: [] Correspondence: Dr. Sandeep Kadam, MD, Division of Neonatology,
Department of Pediatrics, King Edward Memorial Hospital, Rasta Peth, Pune
411011, India. Tel.: +91 20 66037342; Fax: +91 20 26125603; E-mail:
drsandeepkadam@yahoo.com
Abstract: Multidrug resistant (MDR) Klebsiella pneumoniae an increasing
cause of neonatal sepsis in India. This observational study was designed to
monitor temporal change in prevalence of K. pneumoniae as a causative
organism for neonatal sepsis and its sensitivity pattern. The time period was
divided into four time frames of six months each [designated A
(1/10/2006–31/03/2007) to D (1/04/2008–30/09/2008)]. K. pneumoniae
isolation in all cultures sent from neonatal intensive care units doubled in
time frame D (6.3%) compared to time frame A (3.0). Similarly, the
percentage of total positive cultures in the neonatal intensive care unit that
were K. pneumoniae also doubled (27.8% in A to 55.6% in D). K.
pneumoniae sepsis tripled in inborn neonates (15.4% in A to 47.1% in D).
Incidence of MDR K. pneumoniae increased from 0% in time frame A to
76.5% in time frame D. Resistance against ampicillin and third generation
cephalosporins (cefotaxime and ceftazidime) remained 100% in all time
frames. Carbapenem (meropenem and imipenem) resistance increased from 0% in
time frame A and B to 41.2% in time frame D. Death due to K.
pneumoniae sepsis showed brisk resurgence in time frame D (17.6%) compared
to time frame C (10%). Lower gestational age and birth weight were
associated with higher mortality. MDR K. pneumoniae is emerging as a more
frequent cause of neonatal sepsis. There is an dincreasing threat of combined
quinolone and carbapenem resistant MDR K. pneumoniae.
