Phenotypic Diversity and Antibiotic Resistance Pattern of Extended-Spectrum Beta-Lactamase (ESBLS) Producing Klebsiella pneumonia Isolated From Patients in Three Selected Centers in Isfahan, Iran
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Abstract
Background: Klebsiella pneumoniae is a significant pathogen responsible for a wide range of infections, particularly urinary tract infections (UTIs). We aimed to determine the prevalence of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella strains and analyze their antibiotic resistance patterns in isolates collected from patients in three hospitals in Isfahan, Iran.
Methods: This study was conducted over a 13-month period (2022–2023) in three educational hospitals in Isfahan, Iran. Out of 350 clinical specimens obtained from patients with UTIs, wounds, blood, and sputum, 142 Klebsiella isolates (40.5%) were identified and isolated according to standard methods. Antibiotic susceptibility was tested using the disk diffusion method according to CLSI standards, and ESBL production was confirmed using the combined disk method.
Results: Among the 142 isolates, 113 (31%) were derived from urine, while 29 (8.2%) were from wounds, sputum, and blood samples. Antibiotic resistance was highest against nitrofurantoin (45.5%), sulfamethoxazole (44.8%), and nalidixic acid (41.3%). In contrast, the most effective antibiotic was amikacin, with an 85.7% susceptibility rate. Additionally, 125 isolates (88%) of were identified as ESBL positive showed resistant to at least 6 antibiotics used in this study.
Conclusion: Amikacin remains the most effective antibiotic against Klebsiella species. However, the increasing prevalence of ESBL-producing strains poses a critical challenge for treating hospital-acquired infections. These findings highlight the need for rigorous antibiotic stewardship and infection control measures to mitigate the spread of resistant Klebsiella strains.
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