Multidrug Resistant Klebsiella Pneumoniae in Hemodialysis Patients with Central Line Associated Blood Stream Infection in Minia University Hospital: Antimicrobial Resistance Profiles and Phenotypic Detection of Resistance Mechanisms

Background Klebsiella pneumoniae is an important global health problem because of its ability to develop multidrug resistance (MDR) and form biofilms. Biofilm formation can reduce antibiotic effectiveness and make bacterial infections more difficult to treat. Objective This study aimed to investigate the relationship between biofilm formation and major antimicrobial resistance phenotypes, including extended-spectrum beta-lactamase (ESBL), carbapenem resistance (CRE), AmpC. Methods Forty-three clinical K. pneumoniae isolates were evaluated for Biofilm formation and antimicrobial susceptibility patterns . Results Biofilm formation was detected in 38 of 43 isolates (88.4%) using the MTP assay. Among the biofilm-producing isolates, 39.5% showed strong biofilm formation, 39.5% moderate formation, and 9.3% weak formation. Biofilmproducing isolates had significantly higher rates of ESBL production than non-biofilm-producing isolates (86.8% vs. 20.0%, p = 0.005). MDR was significantly more common among biofilm-producing isolates (100% vs. 60.0%, p = 0.0111). AmpC production (68.4%, p = 0.0556) and CRE (73.7%, p = 0.1529) were also more frequent among biofilmproducing isolates, although these associations were not statistically significant. Conclusion Biofilm formation was strongly associated with ESBL production and MDRO status among clinical K. pneumoniae isolates. The high prevalence of both biofilm formation and antimicrobial resistance highlights the difficulty of treating these infections and supports the need for effective strategies to improve antimicrobial activity against biofilmassociated bacteria.