Antibiotic susceptibility profiles of archived Klebsiella pneumoniae isolated from rectal swabs of hospitalized patients in selected hospitals from Greater Masaka, Uganda

Abstract

Klebsiella pneumoniae is a significant cause of hospital-acquired infections and is increasingly associated with antibiotic resistance particularly in low-resource settings, which is a threat to public health. Understanding the resistance patterns and prevalence of multidrug-resistant (MDR) strains is crucial for effective management and treatment of these infections. This study aimed at determining the antibiotic susceptibility profiles of archived Klebsiella pneumoniae isolated from rectal swabs of hospitalized patients from selected hospitals in Greater Masaka, Uganda. The Klebsiella pneumoniae isolates (n=56) recovered from rectal swabs of the hospitalized patients were subjected to antibiotic susceptibility testing using the Kirby-Bauer disc diffusion method. Susceptibility to a range of antibiotics including ceftazidime (CAZ), cefotaxime (CTX), erythromycin (E), cefuroxime (CXM), meropenem (MEM), cefoxitin (FOX) and colistin (CT), was evaluated following the Clinical and Laboratory Standards Institute (CLSI) guidelines 33rd edition. The isolates exhibited 100% resistance to CAZ, CTX, E and CXM. Conversely, all isolates were fully susceptible to MEM, indicating its potential as an effective antibiotic for treatment. Susceptibility rates were 76.79% for FOX and 55.36% for CT. A high prevalence of multi-drug resistant (MDR) Klebsiella pneumoniae was observed, with 100% of isolates being resistant to more than three antibiotics. These findings highlight a critical resistance scenario with Klebsiella pneumoniae isolates showing complete resistance to several antibiotics while remaining fully susceptible to meropenem. The 100% prevalence of MDR strains underscores the urgent need for stringent infection control and effective antimicrobial stewardship in the hospital settings of Greater Masaka, Uganda. Therefore, it is important to implement stringent infection control measures, enhance antibiotic stewardship programs and conduct regular surveillance of antibiotic resistance in the healthcare facilities.