Prevalence and Antibiogram of Multidrug Resistant Klebsiella Species

Aim: To find out the prevalence and susceptibility of MDR klebsiella isolates in Karachi.

Study Design: Pre-clinical in-vitro study.

Place and Duration of Study: Study was conducted at the microbiology lab of the tertiary care hospital of Karachi, Pakistan during May to October 2021.

Methodology: About 550 samples of blood, urine and wound swab were inoculated on blood agar and MacConkey agar and incubated at 37° Celsius for 24 hours. The antibiotic susceptibility was identified by Kirby Bauer’s disc diffusion method. Antibiotic disc of amoxicillin-clavulanate 20 µg, Fosfomycin 200 µg, Ciprofloxacin 5 μg, Moxifloxacin µg, Gentamicin 10 μg and Ceftolozane/tazobactam (30/10 μg) were placed on agar plate and then incubated at 35°C for 16-24 hours. Data was analyzed by using Statistical Package for Social Sciences (SPSS) version 20.

Results: Out of total 550 strains of Klebsiella 35% were multidrug resistant while 64% were not. Sensitivity and resistance pattern of multiple antibiotics against Klebsiella showed that majority of antibiotics were resistant to Klebsiella. The highest resistance was noted with amoxicillin that was 90%, followed by amoxiclave, nitrofurantoin, doxycycline, ceftazidime and ciprofloxacin with frequency of 86%, 75%, 64% 56% and 54% respectively. On the other hand, combination of Ceftolozane and tazobactam were highly sensitive against klebsiella followed by fosfomycin, Imipenem and combination of piperacillin and tazobactam with frequency of 95%, 89%, 88% and 68% respectively.

Conclusion: It can be concluded that klebsiella species have developed high resistance against a number of antibiotics resulting in high morbidity and mortality. Currently combination of Ceftolozane and tazobactam is highly sensitive so it should be preserved as a future lifesaving drug. Beside this, fosfomycin, Imipenem and combination of piperacillin and tazobactam also reported high sensitivity.