Abstract

Background: Antibiotic resistance in Klebsiella pneumoniae is a growing clinical concern, largely driven by β-lactamase genes that increase multidrug resistance and limit treatment options of infections.

Methods: A cross-sectional study was conducted on 260 K. pneumoniae isolates from various clinical specimens. Bacterial identification was performed using the MALDI-TOF system, and antimicrobial susceptibility testing was carried out using the BD Phoenix M50 automated system. Common ESBL and carbapenemase genes were detected via multiplex PCR

Results: Among 260 Klebsiella pneumoniae isolates respiratory 51.1%, pus 16.5%, blood 12.3%, urine 9.6%, other fluids 8.1%). Overall susceptibility was low across most antibiotic classes: β-lactams (<25%), quinolones (21.2%), and carbapenems (≤40%). Only aminoglycosides and ceftazidime/avibactam showed susceptibility rates above 50%. ESBL genes were detected in 74.6% (bla_CTX-M 40.7%, bla_SHV 23.1%, bla_OXA-1 9.2%); carbapenemase genes in 58.1% (bla_KPC 23.1%, bla_NDM 10.0%, bla_OXA-48 6.2%), with bla_NDM -bla_OXA-48 co-carriage in 17.7% and concurrent ESBL+carbapenemase in 48.8%. Isolates harboring β-lactamase genes exhibited distinct antibiotic susceptibility profiles compared with non-harboring isolates.

Conclusion: Antibiotic susceptibility among Klebsiella pneumoniae isolates was very low and differed by resistance genotype; the high prevalence of isolates co-harbouring ESBL and carbapenemase genes is an alarming finding that warrants attention.