Prevalence of multidrug-resistant Klebsiella pneumoniae in urinary tract infections: A retrospective observational study in eastern India

Background: Urinary tract infection (UTI) commonly affects people of different ages. It is important to explore the antibiotic susceptibility of the bacterial agents to improve the empirical antibacterial prescription to tackle the fast emerging of multi-drug resistant (MDR) bacteria. Klebsiella pneumoniae, a Gram-negative bacterium, is widely known for its hypervirulence, drug resistance and opportunistic nature, with significant implications for critically ill or immunocompromised patients. The study aim is to determine the prevalence of antibiotic resistance pattern among isolates from urinary tract infections (UTIs) and provide valuable insights for healthcare management. Methods: This is a retrospective observational study including 250 patients among 500 sample screened to have UTI at the largest hospital in eastern India from July 2020 to November 2022. All UTI patients underwent agar-based bacterium identification and antibiotic sensitivity testing using the disc diffusion method. Results: Klebsiella pneumoniae (122 cases) and Escherichia coli (74) were the first and second most frequent Gram-negative isolates, followed by Pseudomonas aeruginosa (45) and Acinetobacter baumannii (9). Notably, ten Klebsiella pneumoniae strains were resistant to five major antibiotic classes: β-lactam, aminoglycosides, fluoroquinolones, tetracyclines, and Polymyxin. Piperacillin/Tazobactam, Ceftazidime, Aztreonam, and Imipenem exhibited high resistance rates when tested against Klebsiella pneumoniae isolates. In contrast, Gentamicin, Levofloxacin, Minocycline, Fosfomycin, and Colistin demonstrated relatively lower effectiveness against Klebsiella pneumonia isolates. Conclusion: Monitoring of multidrug-resistant bacteria becomes critical for prudent antibiotic use, ultimately dropping the prevalence of hospital-acquired infections and contributing to the larger fight against antimicrobial resistance.