A Challenging Clinically Multi-drug Resistant Klebsiellapneumoniae in Neonatal Intensive Care Unit (NICU): Two Cases

Overview

Authors present cases of Klebsiella pneumoniae long lasted in two newborns (one preterm and another term)in NICU setting. Klebsiella pneumoniae is considered one of the causative agents of neonatal sepsis though lessfrequent than Streptococcus group-B not only in developed countries, also in developing world as many recentcases in the literature confirm. In this report the fate of one preterm baby and one term baby who developed sepsiswithin 60 hours after birth is presented. Empiric antibiotic therapy and culture based indication of combinationof bactericidal antibiotics failed to achieve clinical and laboratory improvement despite reported in vitro sensitivity.In spite of the absence of the recommendation guidelines of fluoroquinolones for the neonates the administrationof Ciprofloxacin resulted in significantly better clinical effect with outcomes of survival for these neonates inKlebsiella sepsis. Nosocomial infection prevention measures are also discussed in the case presentation.

Key words:
multi-drug resistance, Klebsiella pneumoniae, neonatal sepsis, in vitro versus in vivo sensitivity