Detection of multidrug-resistant Klebsiella species with overexpressed efflux pumps in neonatal intensive care units at Menoufia University Hospitals

• DOI: 10.21608/mid.2024.326364.2267
• Publication Date: 2024-11-12T11:44:17Z
• Authors: amal Makled; Sahar Ali; mona gharib; Engy elsaka; Zeinab AbouZouna; asmaa shaaban sleem
• Keywords: Efflux; Klebsiella

Background: Neonatal bloodstream infections caused by multidrug-resistant Klebsiella pneumoniae present a major public health challenge in developing countries, with efflux pumps being key resistance mechanism Gram-negative pathogens. This study aimed to detect NICUs, analyze antimicrobial susceptibility patterns, and assess the role of resistance. Methods: A total 44 isolates were collected from blood 205 clinically suspected neonates out 405 admitted cases NICU at Menoufia University Hospitals. Identification was confirmed using Vitek system, which also employed determine their susceptibility. The investigated acridine orange phenotypic method, along multiplex PCR amplification targeting multidrug genes (acrAB, tolC, ompK35). Results: found 34.1% infections. Infections correlated prematurity, low birth weight, intrauterine distress, invasive interventions. Gram-positive had discharge rate 70%, whereas 51.3% 26.9% mortality. (32%) most common pathogen. About 25% multidrug-resistant, 29.5% pan-drug resistant Penicillin Cephalosporins exhibited alarming levels (from 63% up 100%). Efflux predominant 81.8% isolates. Conclusion: Neonates faced infections, mainly associated prematurity procedures, as primary pathogen exhibiting driven pump mechanisms, underscoring critical