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Clinical, Antimicrobial and Phenotypic Profile of Klebsiella pneumoniae from a Tertiary Care Hospital in Western Maharashtra

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Prajakta S. Pawar, Satyajeet K. Pawar, Satish R. Patil, Tanaya P. Pawar
» doi: 10.31838/ecb/2023.12.si4.152

Abstract

Klebsiella pneumoniae has been observed to develop resistance to antimicrobials more effectively than most bacteria through the synthesis of enzymes such as Extended Spectrum β-Lactamase (ESBLs) and Carbapenemase. They are also able to pass this resistance mechanism to other bacteria in a rapid time. Antimicrobial resistance (AMR) has become a global health problem. The study has tried to address the gaps in understanding the resistant mechanism of K. pneumoniae isolates. Objective: To study the antimicrobial profile of Klebsiella pneumoniae along with the phenotypic detection from various clinical specimens from a tertiary care hospital in Western Maharashtra. Methods: 100 isolates of Klebsiella pneumoniae obtained from patients admitted in various medical, surgical and intensive care unit and patient attending outpatient department were studied. Identification of K .pneumoniae was done by microscopic, biochemical testing. For the testing of antimicrobial susceptibility Kirby-Bauer disk diffusion method was used. Phenotypic tests for ESBL, MBL and AmpC detection was done for the isolates. Results: A total 100 isolates of Klebsiella pneumoniae were tested from different clinical specimens. Most of them were from 31-40 age group (26%) containing 8 females and 18 males and 30.77% were from ICU while remaining were from other departments like Medicine ward, Emergency department, OBGY, Surgery ward, Oncology ward. Maximum isolates were from urine 25% followed by ETT (22%), pus (22%), blood (18%). Maximum sensitivity was seen to nitrofurantoin 61 (61%) whereas maximum resistance was seen to ceftazidime 88 (88%).Out of total isolates of Klebsiella pneumoniae 27% were ESBL, 53% MBL and 24% AmpC producers. Multidrug resistance was seen in 88% of the Klebsiella pneumoniae. Conclusion: The study reflects higher prevalence of MBL compared to ESBL and AmpC among the K. pneumoniae isolates. Nitrofurantoin, fosfomycin are to some extent useful drugs against this bug, but has to be used judiciously

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