TITLE:
Nosocomial Klebsiella variicola Infection in Neonatal Intensive Care: A New Emerging Pathogen
AUTHORS:
Soraya Hani, Abdessamad Lalaoui, Fatiha Bennaoui, Nabila Soraa, Nadia El Idrissi Slitine, Fadl Mrabih Rabou Maoulainine
KEYWORDS:
Newborn, Nosocomial Infection, Klebsiella variicola, Neonatal Resuscitation, Antibiotic Therapy
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.13 No.3,
May
30,
2023
ABSTRACT: Klebsiella variicola is a human pathogen that has been misidentified as K. pneumoniae. This misidentification has led to a lack of understanding
of important clinical and biological aspects of this bacterial species. It is
responsible for serious and potentially fatal infections, with a prevalence of
multi-resistance to routine antibiotics. We present through three clinical
observations, the case of three newborns having been hospitalized in the
neonatal intensive care unit and whose evolution was complicated by the
occurrence of a nosocomial infection in front of which a blood culture was done on blood agar, with a manual antibiogram on antibiotic disks, isolated the germ Klebsiella variicola. The management of the newborns was initially centered
on non-invasive ventilation with a bi-antibiotic therapy based on carbapenem
and amikacin for two newborns and switched to colymicin for the third case.
Newborn follow-up was based on assessment of general condition, clinical signs
of infection, as well as a biological control made of a blood count, a
c-reactive protein, a complete ionogram, and a blood culture, every four days
or if signs of clinical call. The evolution was favorable for two cases with
good clinical and biological improvement, and complicated by death due to
alveolar hemorrhage in the third case. Given the high pathogenicity of this
germ, and the frequency of misidentification, it is crucial to know the
clinical spectrum of Klebsiella variicola infections in neonatal intensive care units, in order to adapt the antibiotic
therapy and to mitigate the fulminant evolution of this germ.