Resistance Trends in Klebsiella pneumoniae Strains Isolated from Bloodstream Infections in a Tertiary Care Hospital over a Period of 7 Years

Klebsiella pneumoniae is one of the top pathogens causing bloodstream infections (BSIs) worldwide. The rise of carbapenem-resistant K. pneumoniae (CRKP) and multidrug-resistant (MDR) strains is of particular concern as therapeutic options are limited. Analyzing local resistance profiles is essential for the success of antibiotic stewardship strategies. This study aims to explore the resistance profiles of K. pneumoniae strains identified in BSI in a tertiary care hospital over 7 years. Automated systems were used to test antibiotic susceptibility. Results were interpreted according to EUCAST clinical breakpoints. The rate of multidrug resistance (MDR) was 57.6%. The percentage of ESBL producers was 54.5%, and the percentage of carbapenemase producers was 43.2%. Overall resistance rates to other antibiotics were 47.1% to ciprofloxacin, 31.4% to gentamicin, 25.7% to amikacin, 20.9% to colistin, 19.6% to Fosfomycin, and 44.5% to trimethoprim/sulfamethoxazole. The highest resistance to colistin was recorded in 2023 (28%). More than half of the strains in the study were MDR and ESBL producers. K. pneumoniae resistance to colistin has increased during the last 7 years. The rates of carbapenemase-producing bacteria (CPB) are on the rise. The most frequently co-harboring carbapenemases were NDM and OXA-48. Local antibiotic resistance rates are crucial in implementing an effective antibiotic stewardship strategy.