INCREASING INCIDENCE OF MULTIDRUG RESISTANCE Klebsiella pneumoniae INFECTIONS IN HOSPITAL AND COMMUNITY SETTINGS

Abstract

Introduction - Klebsiella pneumoniae have been identified as an important common pathogen for nosocomial pneumonia (7 to 14% of all cases), septicaemia (4 to 15% of all cases), wound infections (2 to 4% of all cases), neonatal septicaemia (3 to 30% of all cases). It also causes bacteremia and hepatic infections and have been isolated from a number of unusual infections including endocarditis, primary gas-containing mediastinal abscess, cholecyctitis, diarrhoea, peritonitis, crepitant myonecrosis, pyomyositis, necrotizing fasciitis, osteomyelitis, meningitis. beta -lactam antimicrobial agents are most common treatment option for such infections. Results and observations - 986 Clinical isolates of Klebsiella pneumonia were isolated from blood (254), urine (241), respiratory specimens (206), pus (215) and body fluids (70). Among 986 clinical isolated of K. pneumoniae 718 (72.81%) isolates were from inpatients (IPD) admit-ted in various wards of hospital and 268 (27.18%) were found to be out patients department (OPD). A significant difference in antimicrobial susceptibility was observed with 3rd generation cephalosporins between hospital and community strains. Of the 986 isolates of K. pneumoniae 284 (28.80%) were confirmed as ESBLs producers by phenotypic detection methods of ESBLs. Among 284 ESBLs 236 (83.09%) were hospital isolates while 48 (16.90%) were from community settings. Among 986 K. pneumoniae isolates 34 (3.44%) strains showed production of KPCs by phenotypic detection methods of KPCs. Out of 34 KPCs producers 26 were from hospital isolates and 8 were from community isolates. Hospital isolates were major ESBLs and KPCs producers. Conclusion - There is a serious need to accentuate on the rational use of antimicrobials and strictly adhere to the concept of the - reserve drug - to minimize the misuse of available antimicrobials. In addition regular antimicrobials susceptibility surveillance, knowledge and its application is essential to reduced current drug resistance rate in hospital as well as in community.