Antibiotic Susceptibility Pattern of Klebsiella Pneumoniae Isolated From Cases of Urinary Tract Infection in a Tertiary Care Setup

Abstract

Urinary Tract Infection (UTI) is second on the ranking of most common infection in community practice. It leads to significant morbidity and a high economic burden for treatment. Klebsiella pneumoniae accounts for 2 nd highest organism isolated from urine samples of UTI patients after Escherichia coli. The management of UTI is complicated by the increasing prevalence of antibiotic resistant strains of Klebsiella pneumonia. Therefore, knowledge of the antibiotic resistance patterns of the pathogen is important not only to provide an appropriate therapy, but also for the prevention of resistance amongst the microbe. OBJECTIVEThe present study was therefore undertaken to determine the antibiotic susceptibility pattern of Klebsiella pneumonia causing UTI in patients admitted to a tertiary care hospital. MATERIAL AND METHODSThe details of Klebsiella pneumonia grown in urine samples received in the Department of Microbiology, MOSC Medical College, were collected from the laboratory registers. These urine samples were then processed using standard methods and antibiotic susceptibility testing was done by Kirby Bauer's disc diffusion method. RESULTDuring the period of 4 months, 35 urine samples yielding Klebsiella pneumonia were processed. These strains showed 100% resistance to Ampicillin, around 70-85% resistance to first, second and third generation Cephalosporins. They showed maximum sensitivity to Imipenem (74.3%), followed by Colistin (77%), Amikacin (65.7%), Meropenem (65.7%) and Piperacillin-Tazobactam (65.7%). CONCLUSIONIn our study, the high rate of resistance to routinely prescribed drugs like Co-trimoxazole, Norfloxacin and Nitrofurantoin could be attributed to the frequent use of these antibiotics. Carbapenems (Imipenem or Meropenem) and Amikacin should be considered as reserved drugs, especially for nosocomial infections.

Antimicrobial Resistance Patterns, Extended-Spectrum Beta-Lactamase Production, and Associated Risk Factors of Klebsiella Species among UTI-Suspected Patients at Bahir Dar City, Northwest Ethiopia

“…Besides chloramphenicol, ceftazidime, and ciprofloxacin, results of the present study indicate that meropenem is one of the most effective antimicrobials against Klebsiella species since the isolates demonstrated susceptibility ranging from 66.7% to 100%. This was in agreement with another study in India where 65.7% of K. pneumoniae were meropenem susceptible [ 36 ]. A 2018 study conducted in Germany also revealed that the carbapenem nonsusceptibility in K. pneumoniae isolates is still low even though it is slowly growing and in the light of the strong increase of K. pneumoniae isolates over the last year; this poses a significant challenge to public health [ 37 ].…”

Prevalence, antibiotic susceptibility patterns, including ESBL production and associated risk factors of Klebsiella species among UTI suspected patients at Bahir-dar town, Northwest Ethiopia.

“…The current nding pointed out that meropenem was the most effective antibiotics against ESBLproducing and non ESBL producing Klebsiella species as it showed sensitivity of 80 and 100% in ESBL producers and non ESBL producers Klebsiella isolates respectively. This was in agreement with a study conducted in India, meropenem (65.7%) sensitivity (28).…”

“…After incubating at 37 0 C for 24 hours, a ≥5mm increase in the zone diameter in comparison to ceftazidime were taken as indicative for ESBL positive/producer. Escherichia coli ATCC 25922 was used as an ESBLnegative and Klebsiella pneumoniae 700603 was used as an ESBL-positive reference strain (28).…”

Pattern of Antimicrobial Susceptibility of Klebsiella Pneumoniae Isolated from Urinary Samples in urinary Tract Infection in a Tertiary Care Hospital, Kishanganj, Bihar, 5 Years’ Experience

“…In the present study only 13.419% positive urine cultures demonstrated growth of klebsiella whereas Savda LA et al demonstrated 60.92% positive for klebsiella growth. 30 32%) was very high but in case of amikacin 67.7% (vs. 59.13%) it was nearly similar 32. Again, Manikandan C. demonstrated high sensitivity to fluoroquinolone group as compared to the present study (ofloxacin 79.2% vs. 30.28%, ciprofloxacin 76.4% vs. 33.65%, norfloxacin 75% vs. 29.32%)29 , but sensitivity of nitrofurantoin is nearly similar (50% vs. 48.07%) 31.…”