Related Experiment Video
Updated: Aug 6, 2026

A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Risk factors associated with extended spectrum beta lactamase Klebsiella pneumoniae outbreak in a neonatal intensive
Areej Yousef Al Ali1, Gautam Hebbar1, Dalal Al-Ghanim2
1Infection Control Directorate, Kuwait Ministry of Health, Kuwait.
Objective:
(1) identify risk factors for extended-spectrum beta-lactamase Klebsiella pneumoniae (ESBL-KP) acquisition in the neonatal intensive care unit (NICU) and (2) evaluate the clinical impact of ESBL-KP acquisition on neonatal outcomes at NICU discharge.
Design:
This retrospective case-control study (Aug 2022-Sept 2025) compared neonates who acquired ESBL-KP in the NICU (cases) with those who did not (controls).
Patients:
600 neonates admitted to a Kuwaiti NICU located in a general hospital.
Methods:
Data included clinical, demographic, antibiotic, and laboratory records. The primary outcome was ESBL-KP acquisition. The secondary outcome was status at NICU discharge. Regression analysis was used to evaluate associations for the primary and secondary outcomes.
Results:
Of 600 neonates, 30% acquired ESBL-KP. Among these, 12% had bloodstream infections (BSIs). Length of NICU stay (OR:1.02, 95% CI:1.01-1.03), intrauterine growth restriction (IUGR) (OR:2.59, 95% CI:1.08-6.24), extreme-prematurity (OR:2.89, 95% CI:1.29-6.47), previous hospital admission (OR:4.45, 95% CI:1.75-11.32), and prior ampicillin use (OR:3.51, 95% CI:2.12-5.82) were statistically significant risk factors for acquisition of ESBL-KP in the adjusted regression model. Moreover, ESBL-KP-positive neonates faced 12.83 times greater odds of death from sepsis (95 % CI: 2.41-68.22), than ESBL-KP negative neonates.
Conclusions:
ESBL-KP acquisition was strongly linked to IUGR, extreme prematurity, previous admission, and ampicillin use. While a longer hospital stay correlated with acquisition, this relationship is prone to time-dependent bias and reverse causation. Acquisition also raised sepsis-related mortality risk, though small sample sizes require cautious interpretation. Targeted prevention is essential to improve neonatal outcomes.
Related Concept Videos
Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Pneumonia I: Introduction
Clinical Significance of Antibiotic Resistance
Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin create...
Atypical Pneumonia
Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies. Common...