# Antimicrobial Susceptibility Profile of Klebsiella pneumoniae Isolates From a Tertiary Care Hospital: A Retrospective Study

## TL;DR

This study analyzed antibiotic resistance patterns in Klebsiella pneumoniae from a hospital, finding high resistance to some drugs and better sensitivity to others.

## Contribution

The study provides updated antimicrobial susceptibility data for K. pneumoniae isolates in a specific hospital setting.

## Key findings

- Tigecycline showed the highest susceptibility among K. pneumoniae isolates.
- Hospital-acquired infections were four times more common than community-acquired infections.
- High resistance was observed against ciprofloxacin, cefuroxime, and ceftriaxone.

## Abstract

Background and objectives: Globally, drug resistance has been growing in number and severity. Klebsiella pneumoniae is one of the multidrug-resistant organisms (MDROs) found in healthcare settings, especially in intensive care units (ICUs). We mapped this study to determine the antimicrobial susceptibility testing (AST) patterns of K. pneumoniae isolates found in our hospital. We also determined the AST findings of the ICU and non-ICU patients and those with hospital-acquired infection (HAI) and community-acquired infection (CAI).

Methods: This retrospective study was conducted from October 2022 to September 2024 at Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, India. We included adult inpatients with positive culture reports for K. pneumoniae. All specimens (blood, urine, endotracheal tube (ETT), body fluid, sputum, pus, wound, and skin swabs) from the eligible participants were analysed for their AST findings. The subgroup analyses of the AST findings were performed based on the location (ICU or non-ICU) and infection type (HAI or CAI). We presented the findings through a mosaic plot and a chord diagram. We employed the VITEK 2 system for AST. R software (version 4.4.3) was leveraged for data analysis.

Results: We assessed 7,942 different samples in our study. The study population comprised 2,994 (37.70%) females and 4,948 (62.30%) males. The median age was 53.50 (39.75-63.25) years. The majority of samples were obtained from blood (2591, 32.62%), urine (1975, 24.87%), ETT (1887, 23.76%), and body fluid (462, 5.82%). A total of 3,523 (44.36%) participants were hospitalized in ICUs. This study's CAI and HAI cases were 1,541 (19.40%) and 6,401 (80.60%). Among the 7,942 K. pneumoniae isolates found among all participants, the maximum susceptibility was observed towards tigecycline (5,940, 74.79%), followed by gentamicin (3,133, 39.45%), meropenem (2,727, 34.34%), and piperacillin-tazobactam (2,576, 32.44%). The resistance was the highest against ciprofloxacin (6,227, 78.40%), followed by cefuroxime (5,809, 73.14%), and ceftriaxone (5,397, 67.96%). The resistance was the lowest against tigecycline (999, 12.57%). The subgroup analyses were similar.

Conclusion: Blood, urine, and ETT specimens contributed most of the samples. In our study, HAI was four times more common than CAI. K. pneumoniae isolates showed good sensitivity for tigecycline, gentamicin, meropenem, and piperacillin-tazobactam. The resistance was higher against ciprofloxacin, cefuroxime, and ceftriaxone than against other antibiotics.