{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:17:55Z","timestamp":1790662675427,"version":"4.1.0"},"reference-count":0,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"unspecified","delay-in-days":278,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:p>This descriptive and exploratory observational case series examined intestinal colonisation and subsequent bacteraemia due to ESBL-producing <jats:italic>Klebsiella pneumoniae<\/jats:italic> (ESBL-<jats:italic>Kp<\/jats:italic>) in preterm neonates in Morocco. Prospective bacteriological cultures and antibiotic susceptibility testing were supported by phenotypic methods, including Brilliance ESBL Agar and the NG-Test CARBA-5 assay, for the rapid detection of ESBL and carbapenemase producers. Molecular analysis using PCR was also undertaken to identify specific resistance genes. A total of 567 rectal swabs were collected from 339 preterm neonates, yielding 293 <jats:italic>K. pneumoniae<\/jats:italic> isolates. ESBL-producing strains were identified in 53.6% of the neonates (182\/339). Detected resistance genes included <jats:italic>bla<\/jats:italic>SHV (26.3%), <jats:italic>bla<\/jats:italic>CTX-M-1 (42.8%), <jats:italic>bla<\/jats:italic>TEM (30.2%), <jats:italic>bla<\/jats:italic>OXA-48 (50.0%), <jats:italic>bla<\/jats:italic>NDM(15.3%), and <jats:italic>bla<\/jats:italic>VIM (4.9%). Principal risk factors for colonisation were low birth weight (OR 1.69), very preterm birth (OR 6.24), enteral tube feeding (OR 2.02), and prolonged use of third-generation cephalosporins (OR 1.26). Among the neonates studied, 32 (9.4%) developed healthcare-associated bacteraemia, with 56.2% of these cases preceded by intestinal colonisation with ESBL-<jats:italic>Kp.<\/jats:italic> Clinically, severe respiratory distress and alveolar haemorrhage were strongly associated with increased mortality (aRR\u00a0=\u00a029.32 and 4.45, respectively). The findings highlight the clinical importance of early screening to guide infection control and antimicrobial stewardship in neonatal intensive care settings.<\/jats:p>","DOI":"10.1017\/s0950268825100630","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T06:04:01Z","timestamp":1759730641000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["ESBL-producing <i>Klebsiella pneumoniae<\/i> gut colonisation and subsequent health-care associated bacteraemia in preterm newborns: a descriptive cohort with nested case\u2013control study"],"prefix":"10.1017","volume":"153","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7070-8261","authenticated-orcid":false,"given":"Moussa","family":"Benboubker","sequence":"first","affiliation":[{"name":"Sidi Mohammed Ben Abdellah University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bouchra","family":"Oumokhtar","sequence":"additional","affiliation":[{"name":"Sidi Mohammed Ben Abdellah University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Driss","family":"Oukachou","sequence":"additional","affiliation":[{"name":"Sidi Mohammed Ben Abdellah University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samira","family":"Elfakir","sequence":"additional","affiliation":[{"name":"Sidi Mohammed Ben Abdellah University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salim","family":"Belchkar","sequence":"additional","affiliation":[{"name":"Sidi Mohammed Ben Abdellah University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manal","family":"Rossi","sequence":"additional","affiliation":[{"name":"Sidi Mohammed Ben Abdellah University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelhamid","family":"Massik","sequence":"additional","affiliation":[{"name":"Sidi Mohamed Ben Abdellah University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghita","family":"Yahyaoui","sequence":"additional","affiliation":[{"name":"Sidi Mohamed Ben Abdellah University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaoutar","family":"Moutaouakkil","sequence":"additional","affiliation":[{"name":"Sidi Mohammed Ben Abdellah University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fouzia","family":"Hmami","sequence":"additional","affiliation":[{"name":"Sidi Mohammed Ben Abdellah University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,10,6]]},"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268825100630","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T09:42:54Z","timestamp":1760348574000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268825100630\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":0,"alternative-id":["S0950268825100630"],"URL":"https:\/\/doi.org\/10.1017\/s0950268825100630","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e121"}}