Antimicrobial resistance patterns of Klebsiella isolates from clinical samples in a Saudi hospital

Abstract

Klebsiella infection is often the leading cause of morbidity and mortality. Resistance pattern of antimicrobial susceptibility to commonly prescribed drugs were studied in Klebsiella isolates from a hospital in Madinah, Saudi Arabia. Clinical samples were collected from 6840 patients and screened for Klebsiella species over a period of 14 months. The strains were identified using microbiological and biochemical tests while the antibiotic susceptibility was performed by disk diffusion assay. Of all the positive samples isolated, only 275 samples were identified as Klebsiella species. Of these 66% were from males indicating that females are less vulnerable. Maximum isolates (66 to 70%) were collected from sputum and wound swabs of males. About 90% species were isolated from wound, sputum and catheter tips swabs. Antimicrobial sensitivity was studied using seventeen different antibiotics. Results revealed that antibiotic Imipenem has the highest sensitivity of 99.5% while Ampicillin revealed 100% resistance. The prescription of Imipenem antibiotic is recommended for the treatment of Klebsiella infections. In case of resistance to Imipenem, other antibiotics mainly Ceftazidime, Aztreonam, Ciprofloxacin, Cefoxitin and Piperacilline may be recommended. In acute cases, use of combined antimicrobial therapy may be required. Results also indicate that the intensity of Klebsiella infections is higher during summers (46.5%) than in winters (27.2%), while autumn (13.9%) and spring seasons (12.5%) showed the least recorded percentage. Our study will help in persistent and continuous monitoring of antimicrobial susceptibility and supplement the already available data on prevalence of antimicrobial resistance patterns of Klebsiella.   Key words: Klebsiella, Enterobacteriaceae, antimicrobial susceptibility pattern, antibiotic resistance, multi-drug-resistance.