الفهرس 
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Abstract
Neonates are vulnerable to hospital-acquired bloodstream infections (BSIs) because of immaturity of their immune systems and exposure to multiple risk factors during the perinatal period. This vulnerability is likely to augment the occurrence of neonatal sepsis (NS), which is a clinical syndrome manifested by symptoms, signs of infection and bacterial pathogen isolation from the bloodstream in an infant 28 days of life or younger. NS is considered a major cause of morbidity and mortality among neonates and Klebsiella pneumoniae is one of the most frequent causes of outbreaks in neonatal intensive care units (NICUs). NS is broadly categorized into two categories: Early-Onset Sepsis (EOS) and late-onset sepsis (LOS). EOS occurs in the first 72 hours of life while LOS occurs after 72 hours. Hand hygiene has been singled out as the most important infection prevention and control (IPC) measure in preventing hospital-acquired NS.
The aim of this work was to evaluate the incidence of NS and its causative organisms and risk factors in NICU at Menoufia University Hospitals, to estimate antimicrobial resistance profile of Klebsiella pneumoniae isolates and to detect rmpA and magA genes and their relation to virulence of the organism and CTX-M gene and its relation to antibiotic resistance. Also, the correlation between compliance to hand hygiene and other infection control measures in NICU, and the occurrence and outcome of NS.
The study was conducted at Medical Microbiology and Immunology Departement, Faculty of Medicine, Menoufia University and Neonatal Intensive Care Unit (NICU) in Menoufia University Hospitals during the period from April 2019 to June 2020. About 51.9% of all neonates who were admitted to NICU in Menoufia University Hospitals had clinically.