Klebsiella pneumoniae Bacteremia Presenting on a Neonatal Intensive Care Unit during the First Week of Life

Abstract

Klebsiella pneumoniae is a major cause of neonatal infection that is associated with significant morbidity and mortality. Here, we define clinical aspects and outcomes of Klebsiella infection in our center. All infants newly admitted to our neonatal intensive care unit over a 1-year period were included. A blood culture was collected from a neonate during the first week of life who had any abnormal clinical and/or laboratory findings consistent with infection. Of 805 neonates, 51 (6%) had Klebsiella bacteremia in the first week of life, mostly before the 5th day (69%). Klebsiella bacteremia was 12 times more common in neonates weighing less than 2,500 g compared with those weighing 2,500 g or more. Overall, 41% of patients had subtle clinical findings; hyperbilirubinemia (86%), elevated C-reactive protein concentration (68%), and thrombocytopenia (60%) were the most common abnormalities found on laboratory testing, with all three being abnormal in around 50% of cases. Meningitis, necrotizing enterocolitis, and septic arthritis were the main complications occurring in 29% of cases. The overall mortality rate was 25%, and low birth weight was found to be a major risk for mortality.