الفهرس 
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Abstract
Neonatal sepsis is a great challenge for clinicians and infection control practitioners, particularly when caused by Klebsiella pneumoniae (K. pneumoniae). Strain typing is a valuable tool in tracking the transmission of these infections. Objective: late onset neonatal sepsis (LONS) at neonatal intensive care units (NICUs) of Tanta University Hospitals, find out the bacterial species disseminating in NICUs’ environmental surfaces and on the hands of health care workers (HCWs), detect the genetic relatedness among K. pneumoniae isolates using Enterobacterial Repetitive Intergenic Consensus-Polymerase Chain Reaction (ERIC-PCR) and correlate the antibiogram profile to ERIC profile of K. pneumoniae isolates. Methods: The study was carried out on 100 neonatal blood culture and samples collected from hands of 60 HCWs and 150 random environmental samples. Identification of isolates was done via standard microbiological methods. For K. pneumoniae isolates; phenotyping, antibiogram typing and ERIC-PCR were done for detection of relatedness between neonatal, HCWs and environmental isolates. Simpson’s diversity index (DI) was calculated for comparing the discriminatory potential of different typing techniques. Results: Sepsis was proved in 37% of recruited neonates by positive blood culture: 40.5% of them were infected by K. pneumoniae. As regard HCWs and environmental isolates, Coagulase-negative staphylococci (CoNS) were ranked the first (26.7%) followed by K. pneumoniae (16.3%). Among K. pneumoniae isolates: 24.1% were hypervirulent (hvKp), 58.6% were multidrug-resistant (MDR) and 34.5% were extensively drug-resistant (XDR). Antibiogram typing of K. pneumoniae isolates showed ten different antibiotypes (A1-A10). Based on ERIC-PCR results, K. pneumoniae isolates were classified into six clusters and eighteen ERIC genotypes. A cluster of six homologous strains were isolated from five neonates and hands of a nurse, while another cluster was isolated from other neonate, a thermal warmer and a sink. ERIC-PCR gave the highest DI (0.9458). However, no statistically significant correlation was found between ERIC genotypes and neither phenotypes, antibiotypes nor resistance patterns of K. pneumoniae isolates. - Conclusion: To the best of our knowledge, this is the first report of the isolation of the same MDR K. pneumoniae ERIC genotype from a neonate and environmental samples in the same hospital ward in Egypt. among K. pneumoniae isolates is a warning sign that require implementation of strict infection control measures.