ISSN: 0973-7510

E-ISSN: 2581-690X

Research Article | Open Access
Nouran Magdy Moustafa1,2 , Fatma M. Mahmoud2, Noor Wael Bu Khamsin3, Fatima Almomen3, Manar Alali3, Maryam Abosbaih3, Diyaa Mazen Khalaf3 and Rania A. Mohamed2
1Basic Medical Science Department, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia.
2Medical Microbiology & Immunology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
3College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia.
Article Number: 8961 | © The Author(s). 2023
J Pure Appl Microbiol. 2023;17(4):2453-2466. https://doi.org/10.22207/JPAM.17.4.43
Received: 02 September 2023 | Accepted: 11 November 2023 | Published online: 30 November 2023
Issue online: December 2023
Abstract

Antimicrobial-resistant Klebsiella pneumoniae (K. pneumoniae) constitutes a major global health warning and is significantly implicated in severe infections associated with increased morbidity and mortality. As hospitalized patients in the ICU are more vulnerable to severe infections with increased cost of treatment and prolonged hospital stays, we aimed to compare antimicrobial susceptibility of K. pneumoniae obtained from intensive care unit (ICU) and non-intensive care unit (non-ICU) patients as well as to investigate potential impact of antimicrobial resistance on patient outcome.  A retrospective, cross-sectional study conducted on ICU and non-ICU patients having K. pneumoniae infection during 2021 at Prince Mohammed bin Abdulaziz Hospital (PMAH) in Riyadh. Data regarding K. pneumoniae and their antimicrobial susceptibility, were retrieved and analyzed through R Software. 229 K. pneumoniae were isolated, 33.2% from ICU patients, and 66.8% from other departments. Most of the patients were males (66.8%) belonged to the older age group (62.9%). The isolates were obtained from endotracheal aspirate, sputum, blood, urine and wound samples. The ICU patients developed higher resistance to all examined antibiotics than non-ICU (p<0.001). More than 60% of ICU Klebsiella isolates were extended-spectrum b-lactamases (ESBL) and multidrug resistant (MDR) compared to non-ICU isolates (p<0.001). The most effective drugs were amikacin, imipenem, and meropenem, but their effectiveness substantially decreased against MDR strains. There was a statistically significant difference between the MDR, ESBL, and sensitive groups regarding hospital stay and mortality (P< 0.001).  ICUs have exhibited a remarkable increase in MDR K. pneumoniae, which has a negative impact on patient outcomes.

Keywords

Antimicrobial Susceptibility, K.pneumoniae, MDR, ESBL, ICU, Hospital Stay, Mortality

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© The Author(s) 2023. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License which permits unrestricted use, sharing, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.