ABSTRACT
Nosocomial Klebsiella pneumoniae infection is associated with a high mortality in neonates and antimicrobial therapy
of these infections has been complicated by the emergence of multiresistant strains.
These organisms remain susceptible to only a few antimicrobial agents, and some of
these are not recommended for use in children. In this study the antimicrobial agents
used in the treatment of 33 neonates with Klebsiella pneumoniae (K. pneumonia) infection in our tertiary neonatal unit, during an outbreak were: piperacillin/tazobactam
(13), imipenem/cilastatin (17), cefotaxime (2), and ciprofloxacin (1). Extended-spectrum
β-lactamase production was detected in K. pneumoniae isolates from 18 of 33 (54.5%) neonates. All - cause mortality was 13 of 33 (39.4%)
and there was no significant difference in mortality between neonates treated with
imipenem/cilastatin (6 of 17 or 35.3%) and neonates treated with piperacillin/tazobactam
(6 of 13 or 46.2%). The duration of antimicrobial therapy and total hospital stay
was similar between neonates who received imipenem/ cilastatin and those that received
piperacillin/tazobactam. This report suggests that piperacillin/tazobactam may be
a useful antimicrobial agent in neonatal infections caused by β-lactamase-producing
organisms.
Keywords
Klebsiella pneumoniae
- extended-spectrum beta-lactamases - drug resistance, multiple - piperacillin/tazobactam
