Clonal relatedness in the acquisition of intestinal carriage and transmission of multidrug resistant (MDR) Klebsiella pneumoniae and Escherichia coli and its risk factors among preterm infants admitted to the neonatal intensive care unit (NICU)

BackgroundGastrointestinal carriage of multidrug resistant (MDR) Gram-negative bacilli, especially Klebsiella pneumoniae and Escherichia coli, was highly associated with severe nosocomial infections. The main objectives this study were to determine the clonal relatedness intestinal transmission risk factors MDR E. coli K. amongst preterm infants admitted neonatal intensive care unit (NICU).MethodsA prospective cohort gestational age < 37 weeks conducted in NICU University Malaya Medical Centre (UMMC). Infants' stool specimens collected on day 1 (meconium), week 1, 2, 8 10 during their admission (from 1st June 31st August 2017) until discharge. presence antibiotic resistance pattern determined. Strain clonality explored via pulsed-field gel electrophoresis (PFGE) fingerprints. for strains acquisition evaluated using Cox proportional-hazards model Firth logistic regression.ResultsA total 139 obtained from 50 subjects. Twenty-six (52%) colonized and/or coli. High dissemination between two clusters ESBL-producing seen PFGE profile. We detected a persistent, dominant, aminoglycosides-resistant cluster (cluster B), which harbored blaTEM, blaSHV, blaOXA-1, blaCTX-M-1, ompK35 ompK36 genes. Infants born women who anemic pregnancy [OR = 0.01 (CI 0.00–0.39), P-value 0.042] exposed penicillin/β-lactams group antibiotics first life 0.02 0.02–0.32), 0.013] found have lower colonization.ConclusionsThe prevalence dominant is alarming. Awareness vigilance will enable reduction cross-transmission high-risk infants. Gastrointestinal (NICU). A regression. colonization.