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Background: Klebsiella bacterial strains harboring Extended-Spectrum Beta-Lactamase (ESBL) enzymes are the primary culprits behind neonatal sepsis globally. These strains significantly impact clinical outcomes due to their multi-drug resistance patterns in local healthcare settings. In response to this spiraling threat, we studied the prevalence and clinical implications of ESBL-encoding genes in neonates hospitalized with confirmed sepsis. Methods: A correlational study was conducted on 51 neonates diagnosed with sepsis caused by ESBL-positive Klebsiella pneumoniae at Jimma Medical Center spanning from May 2022 to July 2023. Antimicrobial resistance profiles of the bacterial isolates were determined using the Kirby-Bauer diffusion test, while multiplex polymerase chain reaction (mPCR) techniques were employed to identify resistance genes. The correlation between resistance genes and treatment outcomes was analyzed using the phi coefficient (φ) with a significance level below 0.05. The data management was executed through the utilization of WHONET and STATA software platforms. Results: The sample consisted of 26 (50.9%) male and the remaining 25 (49.1%) female neonates, with diverse clinical characteristics. All 51 Klebsiella pneumoniae isolates were 100% resistant to trimethoprim/sulfamethoxazole and ceftriaxone, but showed varying resistance profiles ranging from 30.8% to meropenem to 94.2% to ceftazidime. Notably, all isolates demonstrated multidrug resistance, with 23% of cases showing resistance to seven different antimicrobial classes. The most prevalent resistance genes identified were blaCTX−M (96.1%), blaTEM (94.1%), and blaSHV (88.2%). The majority of isolates (94.1%) carried at least two resistance genes, such as blaTEM and blaCTX (94.1%), blaTEM and blaSHV (86.2%), and blaCTX and blaSHV (86.2%). Notably, 84.3% of the bacteria harbored the trio of blaTEM, blaCTX, and blaSHV resistance genes, and only the presence of blaSHV in monogenic (φ = 0.4, P = 0.01) or the trio of blaTEM, blaCTX, and blaSHV genes (φ = 0.3, P = 0.02) showed positive correlation with neonatal mortality. Conclusion: We observed a significant prevalence of multidrug-resistant Klebsiella pneumoniae strains among neonates. Moreover, ESBL-resistance genes were widespread, with the blaSHV gene showing a correlation with increased neonatal mortality. These findings emphasize the urgent need for enhanced infection prevention measures, robust antimicrobial resistance surveillance, innovative treatment strategies, antibiotic stewardship initiatives, further research into resistance transfer mechanisms as well as hierarchical predictors of neonatal mortality. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Background: Even though the disease has spread throughout the world, with millions killed, global COVID-19 vaccination coverage remains low, particularly in developing countries. However, epidemiological data is lacking in the area. Hence, this study aimed to assess COVID-19 uptake, willingness for vaccination, and associated factors. Method: A hospital-based cross-sectional study was conducted from May 1 to June 30, 2022, among patients attending chronic follow-up clinics in the two comprehensive specialized hospitals in Bahir Dar. The total sample size was 423. Participants were selected by a systematic random sampling technique. Data was gathered using a pre-tested questionnaire and analyzed using SPSS version 23. A descriptive analysis was performed. A binary logistic regression analysis was done to assess the association between variables. Variables with a p-value < 0.05 in the multi-variable logistic regression with a 95% confidence interval were considered statistically significant. Results: The analysis included 400 out of 423 participants, representing a 95% response rate. The COVID-19 vaccination uptake was 46.8%, while the acceptance was 60.5%. About 56% and 68% of the respondents had good knowledge and a favorable attitude, respectively. Elderly people were 2.7 times more likely to be vaccinated. Similarly, urban residents were 3.94 times more vaccinated. The probability of being vaccinated among respondents with good knowledge and favorable attitudes was 70% and 79%, respectively. The willingness for vaccination increased among those individuals with favorable attitudes (AOR: 1.82). Urban people were less likely to accept vaccination (AOR: 0.46). Some participants misunderstood that vaccination may aggravate their disease condition. Conclusion: The overall COVID-19 vaccine uptake and acceptance for vaccination were low compared to what was estimated by the WHO. Age, residence, knowledge, and attitude were associated with COVID-19 vaccine uptake and acceptance of vaccination. Besides, there was a high level of rumor about the status of the vaccine and risk factors. Hence, special emphasis is warranted to deliver centrally trusted information. Moreover, further nationwide studies are warranted in the future. [ABSTRACT FROM AUTHOR]