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Am J Perinatol 2000; Volume 17(Number 01): 035-040
DOI: 10.1055/s-2000-7290
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

SEPTICEMIA DUE TO MULTIRESISTANT KLEBSIELLA PNEUMONIAE IN A NEONATAL UNIT: A CASE-CONTROL STUDY

Emmanuel Roilides1 , George Kyriakides2 , Isaac Kadiltsoglou1 , Evangelia Farmaki1 , David Venzon4 , Argyro Katsaveli3 , George Kremenopoulos2
  • 13rd Department of Pediatrics
  • 2Neonatology Department, Aristotle University of Thessaloniki
  • 3Microbiology Department, Hippokration Hospital, Thessaloniki, Greece
  • 4Biostatistics and Data Management Section, National Cancer Institute, Bethesda, Maryland.
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Publication History

Publication Date:
31 December 2000 (online)

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ABSTRACT

An unusually high incidence of septicemia due to multiresistant Klebsiella pneumoniae occurred in the Aristotle University Neonatology Department. Forty neonates suffered from 42 episodes of septicemia. Mortality was 43% ranging from 32% in neonates with birth weight (BW) ≥ 1500 g to 55% with < 1500 g. No differences were found between 17 neonates who died and 23 survivors. All isolates were resistant to aminoglycosides, third-generation cephalosporins, and aztreonam, but susceptible to imipenem and ciprofloxacin. The neonates with septicemia due to K. pneumoniae were matched 1:1 with neonates without septicemia (31 pairs) or with neonates with septicemia due to other organisms (8 pairs) according to BW and time of admission. Factors associated with septicemia were mechanical ventilation (p = 0.004) and ongoing parenteral nutrition (p = 0.027). In a multivariate model, nutrition exhibited no independent association after adjusting for ventilation. No differences were detected between the patients with Klebsiella septicemia and those with septicemia due to other organisms. Enhanced Infection Control measures and a temporary change of antibiotic policy reduced this serious complication. Three small outbreaks of multiresistant K. pneumoniae previously reported in neonates are reviewed.

KEYWORD

Septicemia - Klebsiella pneumoniae - neonates - risk factors

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