Extensively-Drug ResistantKlebsiella pneumoniaeRecovered From Neonatal Sepsis Cases From a Major NICU in Egypt

Background Neonatal sepsis is a nuisance to clinicians and medical microbiologists, particularly those cases caused byKlebsiella pneumoniae. Thus, we aimed at investigating the profile and mechanisms of antibiotic resistance and the clonal relationships betweenK. pneumoniaeisolated from neonates at the largest tertiary care hospital's neonatal intensive care units (NICUs) in Minia, Egypt. Methods This study comprised 156 neonates diagnosed with culture-proven sepsis from February 2019 to September 2019, at a major NICU of Minia City. AllK. pneumoniaeisolates were collected and characterized by antimicrobial profile, resistance genotype, and pulsed-field gel electrophoresis typing. Results Twenty-fourK. pneumoniaeisolates (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 theK. pneumoniaeisolates possessedbla(VIM)andbla(NDM)carbapenemase genes, whilebla(KPC)gene was detected in 95.8%. Considering extended-spectrum beta-lactamases genes,bla(CTX-M)was found in all the isolates andbla(OXA-1)gene in 75% of them. The plasmid-mediated quinolone resistance geneqnrS, was predominantly found among our isolates in comparison toqnrB orqnrA. A moderate degree of clonal relatedness was observed between the isolates. Conclusion To the best of our knowledge, this the first report of an alarming occurrence of XDR amongK. penumoniaeisolates recovered from neonatal sepsis in Egypt. Our data necessitate proper antimicrobial stewardship as the choices will be very limited.