Analysis of antibiotic resistance and virulence patterns in Klebsiella pneumoniae isolated from human urinary tract infections in India

In this study, 504 urine samples collected from patients suffering from urinary tract infection (UTIs) were screened for the presence of Klebsiella pneumoniae. The overall occurrence of Klebsiella spp. and K. pneumoniae was found to be 23 center dot 2% (117/504) and 16 center dot 8% (85/504) respectively. Antibiotic susceptibility testing of 85 K. pneumoniae isolates was carried out by disc diffusion which revealed alarming levels of antibiotic resistance (ABR). Antimicrobial resistance was prominently observed against cefpodoxime (76 center dot 47%) followed by ampicillin (70 center dot 59%), ceftriaxone (52 center dot 94%), cefoxitin (50 center dot 59%), amoxyclav (48 center dot 24%), ofloxacin (45 center dot 88%), cefotaxime (44 center dot 71%), cefepime (43 center dot 53%) and doxycycline hydrochloride (40%). A small percentage of strains also exhibited resistance to other antimicrobials in the range of 7-35%. Around 77 center dot 6% of the isolates were found to be resistant to three or more antibiotic classes and 66 center dot 7% of the isolates had multiple antibiotic resistance index values >0 center dot 2. Screening of virulence genes in 85 K. pneumoniae isolates revealed that uge gene was the most predominant (11/85, 12 center dot 9%), followed by rmpA (9/85, 10 center dot 5%), kfu (4/85, 4 center dot 7%) and aerobactin genes (2/85, 2 center dot 35%). Further, the overall percentage of biofilm producers were found to be 17 center dot 65% (15/85). This study warrants hospitals and health care centres to reduce misuse of antibiotics and manage UTI with appropriate treatment after performing antibiotic susceptibility testing.