CLINICAL OUTCOMES OF MULTIDRUGRESISTANT KLEBSIELLA SEPSIS IN NEONATES: A PROSPECTIVE OBSERVATIONAL STUDY IN A TERTIARY CARE CENTRE

Background: Klebsiella pneumoniae is a major cause of neonatal sepsis in NICUs, often associated with multidrug resistance (MDR) and poor outcomes.Local epidemiological data are essential to guide empirical therapy and infection control.To evaluate the incidence, antimicrobial resistance patterns, and clinical outcomes of Objective: culture-positive Klebsiella sepsis among neonates admitted to a tertiary care NICU.Retrospective analysis of Methods: 85 neonates (52 inborn, 33 outborn) with culture-positive Klebsiella sepsis.Demographic, clinical, and microbiological data were collected.Statistical comparisons were performed using Chi-square, Fisher's exact, and Mann-Whitney U tests.The majority were preterm (65.9%) and male (55.3%), with no significant differences between inborn Results: and outborn groups (χ² = 0.013-0.019,p > 0.05).Meningitis occurred in 26 cases (30.6%), with similar prevalence across groups (Fisher's exact = 0.65, p = 0.65).Overall, 63 neonates (74.1%) were discharged, 17 (20%) died, and 5 (5.9%) left against medical advice.Mortality was higher in outborn neonates (27.3% vs 15.4%), though not statistically significant (Fisher's exact = 0.18, p = 0.18).Treatment duration was significantly longer in meningitis cases (median 21 vs 14 days; Mann-Whitney U = 42, p < 0.001).Resistance rates were high for ampicillin (70-92%) and cephalosporins (58-86%).Outborn isolates showed higher resistance to cephalosporins (χ² = 3.81, p = 0.051), carbapenems (χ² = 2.19, p = 0.139), and colistin (χ² = 0.88, p = 0.348), though differences were not statistically significant.MDR Klebsiella sepsis Conclusion: remains a significant challenge in NICUs.Meningitis cases require prolonged therapy, and outborn isolates demonstrate higher resistance trends, particularly to cephalosporins.These findings underscore the need for strengthened antimicrobial stewardship and infection control measures in tertiary care settings.