Antibiotic resistance patterns of Klebsiella Pneumoniae isolates obtained from microbiology laboratory Makerere University Uganda

Abstract

Antimicrobial resistance has become a major public health concern worldwide, with increasing morbidity and mortality rates associated with resistant infections. Klebsiella pneumoniae is a common cause of nosocomial infections, and resistance to multiple antibiotics has been reported, posing a significant challenge to clinicians. The aim of this retrospective study was to determine the antibiotic resistance patterns of Klebsiella pneumoniae isolates obtained from the microbiology laboratory at Makerere University in Uganda from January 2020 to December 2022. A retrospective review of laboratory records was conducted to identify all clinical samples that tested positive for Klebsiella pneumoniae from 2020 to 2022. Patient and sample information, as well as antibiotic susceptibility test results, were collected from the records. The susceptibility of K. pneumoniae isolates to a range of antibiotics from different classes, including carbapenems, beta-lactams, aminoglycosides, imipenems, quinolones, folate inhibitors, and nitrofurantoin, was analyzed. The data were analyzed using descriptive statistics to determine the prevalence and patterns of antibiotic resistance. In this study, a total of 195 Klebsiella pneumoniae isolates were analyzed. The majority of the isolates (60%) were collected from male patients. The most frequently encountered sample type was urine (15%), followed by pus swabs (50%), pus aspirates (25%), and blood (10%). The results revealed high levels of resistance among the isolates. Carbapenem resistance was observed in 30% of the isolates, indicating a significant concern for the emergence of multidrug-resistant strains. Beta-lactam antibiotics, including amoxicillin/clavulanic acid, ampicillin, cefotaxime, cefoxitin, and ceftriaxone, exhibited high resistance rates of 80-90%. However, imipenem and meropenem demonstrated relatively lower resistance rates, ranging from 20-25%. Aminoglycosides, such as amikacin and gentamicin, showed resistance in 40-50% of the isolates, further highlighting the growing issue of resistance among this class of antibiotics. Quinolones, specifically ciprofloxacin, exhibited a high resistance rate of 70%. Folate inhibitors, represented by trimethoprim sulfamethoxazole, displayed resistance in 50% of the isolates. Notably, nitrofurantoin had the lowest resistance rate at 10%. The findings of this study highlight the alarming prevalence of antibiotic resistance among Klebsiella pneumoniae isolates. High resistance rates were observed for beta-lactams, aminoglycosides, quinolones, and trimethoprim-sulfamethoxazole, posing significant challenges for treatment options. The emergence of carbapenem resistance is particularly concerning. Effective antimicrobial stewardship programs and infection control measures are crucial to combat this growing threat. Continued surveillance, research, and development of new treatment strategies are essential to address the issue of antibiotic resistance in Klebsiella pneumoniae effectively.