Klebsiella pneumonia is one of the most common infection that cause neonatal sepsis globally. It
is responsible for a significant proportion of hospital-acquired infections including septicemias,
urinary tract infections, pneumonia, and soft tissue infections especially in the
immunocompromised hosts such as the neonate .
Aim of study:
to identify,clinical features and the outcomes associated with K. pneumonia, in all newborn at
NICU at Zawia teaching Hospital – Libya.
Materials and Methods :
Retrospective case series study conducted at neonatal intensive care unit in Zawia teaching
hospital /Libya. during one year period( 1
st of January -30st December 2012) . Four hundred and
eleven neonates who were admitted to Intensive Care Unit(ICU) in pediatric department were
selected. The following data was obtained from the patient’s medical records sex, birth weight,
gestational age, mode of delivery, time of admission(Season), blood cultures strain of the
isolates ,maternal history, clinical diagnosis and features association problems mechanical
ventilator, blood exchange ,umbilical vein catheterization ,respiratory distress syndrome , birth
asphyxia, CRP for risk patient, CRP on deterioration ,platelets concentrate transfusion and

The study results reported that 13 neonates had positive klebsiella pneumonia.9 (69.2%)
preterm,9(69.2%)were males 4(30.8%)were females with 2:1 male to female ratio ,10 (76.9%)
had low birth weight ,8(61.5%) were delivered by caesarean section , regarding maternal age
53.8% were between 31-40 years with mean maternal age 32.15 years and 5.5 standard deviation
,61.5% were infected at the second half of the year p value, History of PROM in 6( 46%),pre
eclampsia (30.8 %) maternal fever in 1(7.7%),maternal infection (7.7%). 9(69.5%)had respiratory
distress,53.8%,7 (53.8%) developed hyperbilirubenmia,4(30%)had necrotizing enterocolities
,1(7%)had acute myocarditis,1patient presented with fever and proved to have UTI with sepsis,
mechanical ventilation was needed in8 (61.5%).one patient developed Pnemothorax (7.7%)and
drained under water seal by insertion of chest tube.Umbilical vein catheterization inserted only
in one patient7.7% Exchange blood transfusion was done in one baby 7.7%. all had negative
CRP test on admission 13 (100%)and CRP was positive in all patients (100%) with positive
klebsiella pneumoniae(p value 0.0001) when sepsis was suspected.10 (76.9%)of the neonates
required platelets transfusion which indicate the higher rate of thrombocytopenia. Regarding
neonatal outcome, the result reported that 10(76.9%) of neonates with positive klebsiella
pneumonia were alive and only 3 (23.1%)died, Two due to respiratory failure and the 3rd one died
due acute myocarditis complicated by heart failure .The mortality rate about 23%. 66.6%were
preterm low birth weight .100% were males and due to ESBL producing strains .
Conclusion: The main risk factors for the infection was preterm babies, males gender, , low birth
weight, caesarean section delivery, prolonged pre labor rupture of membrane (PR0M). mostly
infected at the second half of the year and hospital stay , The clinical presentations are non
specific, Acute myocarditis is a rare presentation with fatal prognosis .CRP is valuable for early
detection of klebsiella pneumoniae infection. Thrombocytopenia is very common The mortality
rate was relatively high and all deaths were male , due to ESBL producing K.pnemoniae strains
which was similar to many studies in other countries.

Keywords: klebsiella pneumonia ,sepsis ,risk factors, clinical features ,outcome, mortality rate
,neonatal intensive care


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