# Antibiotic Susceptibility Profile of Carbapenem Resistant Escherichia Coli and Klebsiella Pneumoniae in Urinary Isolates from a Tertiary Care Hospital: An Observational Study

## TL;DR

This study examines antibiotic resistance in E. coli and K. pneumoniae from urinary infections, finding that carbapenem-resistant strains are susceptible to fosfomycin and nitrofurantoin.

## Contribution

The study provides current antibiotic susceptibility data for carbapenem-resistant uropathogens in a tertiary hospital setting.

## Key findings

- 17% of E. coli and 26% of K. pneumoniae isolates were carbapenem-resistant.
- Carbapenem-resistant strains showed susceptibility to fosfomycin and nitrofurantoin.
- E. coli and K. pneumoniae were the most common uropathogens in the study.

## Abstract

Urinary tract infections are common in both hospital and community settings and impose a significant financial burden. Among Enterobacterales, Escherichia coli and Klebsiella pneumoniae are the leading uropathogens. The rise of carbapenem-resistant strains is concerning due to limited treatment options, with carbapenems often being the last line resort. This study intends to determine the microbiological profile of E. coli and K. pneumoniae uropathogens obtained from a tertiary care hospital.

A prospective study was conducted from October 2023 to June 2024 in a tertiary care hospital in Eastern India. Urine samples received for routine culture in the central laboratory were processed following standard microbiological protocols. Bacterial identification and antibiotic susceptibility testing were performed using the VITEK-2 compact system. A total of 958 isolates of E. coli and K. pneumoniae were obtained. Of these, 198 were identified as carbapenem-resistant as per the Clinical Laboratory Standard Institute 2023 guidelines.

Of the, 7228 urine samples, 4336 (60%) yielded a positive culture. Among these, 1552 (36%) were gram-negative bacteria. Out of the gramnegative bacteria, 1209 (77.8%) were Enterobacterales. Escherichia coli were 562 (46.4%) and Klebsiella pneumoniae was 396 (32.7%). Carbapenem resistant E. coli was 96 (17%) and Carbapenem resistant K. pneumoniae was 102 (26%). Both the Carbapenem resistant E. coli and K. pneumoniae showed susceptibility to fosfomycin and nitrofurantoin.

Urinary tract infections caused by Escherichia coli and Klebsiella pneumoniae are frequent, but Carbapenem resistant strains pose an emerging therapeutic challenge. This study highlights the prevalence and effective antibiotic options.