The Prevalence of Multidrug-Resistant Isolates of Escherichia coli and Klebsiella pneumoniae at a Tertiary Care Hospital in Chitwan District, Nepal

Abstract Background: The increasing antimicrobial resistance (AMR) among Escherichia coli and Klebsiella pneumoniae is a growing global health concern. This study aims to evaluate the antimicrobialsusceptibility patterns of these bacteria isolated at a tertiary care hospital in Nepal. Methods: This study included 629 nonduplicate Enterobacteriaceaeisolates, collected from various clinical specimens at Chitwan Medical College Teaching Hospital, Nepal, between February and November 2020. The Kirby–Bauer disk diffusion method was used to assess their AMR. Results: Among the 629 Enterobacteriacaeisolates, E. coli was the most common (69.8%), followed by Klebsiella pneumoniae (19.9%). E. colishowed the highest resistance to penicillins (95.0%), followed by macrolides (70.0%), folate pathway inhibitors (63.6%), cephalosporins (62.6%), fluoroquinolone (61.6%), β-lactamase inhibitors (53.8%), carbapenems (30.8%), and aminoglycosides (21.4%). K. pneumoniae also had the highest resistance to penicillins (88.9%), followed by nitrofurans (67.7%), cephalosporins (67.2%), β-lactamase inhibitors (53.3%), folate pathway inhibitors (45.8%), carbapenems (20.8%) and aminoglycosides (19.7%). Polymyxins were the most effective antibiotics against both pathogens. Multidrug resistance was observed in 73.6% of E. coli and 69.6% of K. pneumoniae. Conclusion: This study underscores the high level of drug resistance in Nepal, highlighting the urgent need for better infection control.