Antimicrobial Susceptibility Patterns of Carbapenem-Resistant Klebsiella pneumoniae Causing Lower Respiratory Infections

Open Access

Abstract

Introduction: Lower respiratory tract infectiosn (LRTIs) continue to be a significant health burden, and the most common bacterial causes include multi-drug resistant (MDR) bacteria like Klebsiella pneumoniae (K. pneumoniae) infections. The emergence of carbapenem-resistant K. pneumoniae (CRKP) has added to these concerns due to limited treatment options and poorer clinical outcomes. This study was aimed to find out antimicrobial susceptibility pattern and to detect mechanism of carbapenem resistance among K. pneumoniae isolates from LRTI patients. Methods & Materials: This cross-sectional study was performed to find out the antimicrobial susceptibility pattern of carbapenem resistant Klebsiella pneumoniae (CRKP) causing lower respiratory tract infection (LRTIs). This study was performed in the Department of Microbiology of Sylhet MAG Osmani Medical College, Sylhet, Bangladesh from July,2021 to June,2022. A total of 153 sputum samples were received from the diagnosed cases of LRTIs from adult patients (aged ≥18years). Data analysis performed by Statistical Package for Social Sciences (SPSS) version 26. Result: A total of 153 sputum samples were analyzed, with bacterial growth detected in 66.0% of cases. Klebsiella pneumoniae was isolated in 20.9% of samples, of which 25.0% were carbapenem-resistant. CRKP isolates showed high rates of multi-drug resistance, particularly against amoxicillin-clavulanic acid, ciprofloxacin, cefoxitin, azithromycin, meropenem, imipenem, and cefepime. Carbapenemase production was detected in 75.0% of CRKP isolates by Modified Hodge Test. Conclusion: This research revealed the extent of the problem of carbapenem-resistant Klebsiella pneumoniae among LRTI cases and a substantial number of isolates found to be carbapenemase producers. The isolates were multi-drug resistant to commonly used antibiotics like β-lactams, fluoroquinolones, and most of the other routinely administered drugs, and therapeutic options were almost nil.