Abstract
Background Neonatal sepsis remains a significant cause of morbidity and mortality among infants ≤ 28 days of age, especially in developing and underdeveloped countries, ranking as the third major cause of death among neonates. Klebsiella pneumoniae is a Gram-negative bacterium of the family Enterobacteriaceae, a frequent pathogen in sepsis, and often exhibits multi-drug resistance (MDR), thereby complicating therapeutic options and prolonging hospital stay. This study aimed to evaluate the current trends in the bacteriological profile of neonatal sepsis and assess antimicrobial susceptibility patterns, with special emphasis on K. pneumoniae and its MDR status in a tertiary care NICU setting. Methods This prospective cross-sectional study was conducted over six months in the Neonatal Intensive Care Unit (NICU), Medical College, Kolkata. Blood cultures were obtained from 100 neonates with clinically suspected sepsis and processed using the automated system for microbial identification and antibiotic susceptibility testing. Data analysis was performed using Microsoft Excel (Microsoft® Corp., Redmond, WA) and SPSS Statistical Product and Service Solutions (SPSS, version 20.0; IBM SPSS Statistics for Windows, Armonk, NY). Results Culture positivity was observed in 66% of the cases. K. pneumoniae was the most predominant organism with 16% of all cases; 93.75% of these isolates were identified as multidrug-resistant. High resistance rates were observed against a wide array of commonly used antibiotics such as cephalosporins, aminoglycosides, carbapenems, and aztreonam. Other notable pathogens isolated were Acinetobacter baumannii (15%) and Burkholderia cepacia (8%), both showing considerable resistance patterns. Conclusion This study reveals the growing burden of multidrug-resistant K. pneumoniae in neonatal sepsis and highlights the immediate need for antibiotic stewardship and infection control practices. Early and accurate identification of causative organisms and their resistance profiles is essential in guiding treatment modalities and curbing the spread of infections in neonatal care settings.