Prevalence of Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae in Neonatal Units in Kano State

ESBL-producing Klebsiella pneumoniae has emerged as one of the most dangerous nosocomial pathogens in neonatal intensive care units globally, threatening the survival of preterm and low-birth-weight infants. This study determined the prevalence of ESBL-producing K. pneumoniae in neonatal units at Aminu Kano Teaching Hospital and Sir Mohammed Sunusi Specialist Hospital, Kano State, in the North West geopolitical zone of Nigeria. Clinical samples including blood, cerebrospinal fluid, tracheal aspirates, and nasopharyngeal swabs were collected from 200 neonates over six months. K. pneumoniae isolates were identified by biochemical methods and confirmed by API 20E strips. ESBL production was screened and confirmed by combined disc diffusion per CLSI guidelines. The overall prevalence of K. pneumoniae was 34 percent among culture-positive neonates, with 64.7 percent of these being confirmed ESBL producers. All ESBL-producing strains demonstrated resistance to third-generation cephalosporins and piperacillin-tazobactam, with retained susceptibility only to carbapenems. Mortality among neonates with ESBL-K. pneumoniae bacteremia was 43 percent. Urgent implementation of strict contact precautions, carbapenem-sparing strategies, and enhanced environmental cleaning protocols in neonatal units is advocated. Keywords: ESBL, Klebsiella pneumoniae, neonatal infection, Kano, antibiotic resistance.