Australian critical care : official journal of the Confederation of Australian Critical Care Nurses · 2025
Multidrug-resistant Klebsiella pneumoniae in critically ill neonates: evidence from a Brazilian cohort.
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Ferreira Isadora Caixeta da Silveira, Menezes Ralciane de Paula, Lopes Mallu Santos Mendonça, Araújo Lúcio Borges de, Ferreira Daniela Marques de Lima Mota, Röder Denise Von Dolinger de Brito
Аннотация
BACKGROUND: Antimicrobial resistance is a global health crisis, with multidrug-resistant (MDR) Klebsiella pneumoniae infections causing significant mortality, particularly in low- and middle-income countries.
OBJECTIVE: Evaluate the incidence, risk factors, antimicrobial resistance patterns, and clinical outcomes of K. pneumoniae infections in a neonatal intensive care unit (NICU) in Brazil.
METHODS: This retrospective cohort study evaluated 1627 neonates in a Brazilian NICU from 2015 to 2022.
RESULTS: Invasive K. pneumoniae infections in 3.2% of cases, with a peak incidence of 7% in 2016. Among 62 infection episodes, 54.8% were bloodstream infections and 45.2% urinary tract infections, diagnosed at a median age of 28 days. Most isolates (98.4%) were nonsusceptible, including 41.9% MDR, 6.5% extensively drug-resistant, and 43.5% extended-spectrum beta-lactamase producers, with one carbapenem-resistant isolate. Infection extended hospital stays from 11 to 50 days and had a case fatality rate of 19.2%, with a median time to death of 5 days.
CONCLUSIONS: The findings underscore the critical burden of MDR K. pneumoniae in NICUs, emphasising the urgent need for targeted antimicrobial stewardship and effective infection control strategies to mitigate neonatal morbidity and mortality.
OBJECTIVE: Evaluate the incidence, risk factors, antimicrobial resistance patterns, and clinical outcomes of K. pneumoniae infections in a neonatal intensive care unit (NICU) in Brazil.
METHODS: This retrospective cohort study evaluated 1627 neonates in a Brazilian NICU from 2015 to 2022.
RESULTS: Invasive K. pneumoniae infections in 3.2% of cases, with a peak incidence of 7% in 2016. Among 62 infection episodes, 54.8% were bloodstream infections and 45.2% urinary tract infections, diagnosed at a median age of 28 days. Most isolates (98.4%) were nonsusceptible, including 41.9% MDR, 6.5% extensively drug-resistant, and 43.5% extended-spectrum beta-lactamase producers, with one carbapenem-resistant isolate. Infection extended hospital stays from 11 to 50 days and had a case fatality rate of 19.2%, with a median time to death of 5 days.
CONCLUSIONS: The findings underscore the critical burden of MDR K. pneumoniae in NICUs, emphasising the urgent need for targeted antimicrobial stewardship and effective infection control strategies to mitigate neonatal morbidity and mortality.