Multidrug Resistance in Klebsiella: Phenotypic and Genotypic Insights from a Tertiary Care Hospital in India

Abstract

Background: Antimicrobial resistance in Klebsiella species is a major global health concern, particularly in hospitals where multidrug-resistant strains are prevalent. The emergence of drug resistance has severely limited therapeutic options and increased patient morbidity and mortality.
Aim: To detect multidrug-resistant Klebsiella species from clinical specimens and determine their resistance mechanisms using phenotypic and genotypic methods.
Methods: A cross-sectional study was conducted at the Institute of Microbiology, Madras Medical College, Chennai, for 12 months. Two hundred clinically significant, consecutive, nonduplicate isolates of Klebsiella spp. were identified by standard procedures. Antimicrobial susceptibility was tested by Kirby-Bauer disc diffusion and E-test methods. Phenotypic detection of ESBL, AmpC, MBL, and KPC was performed, and resistant isolates were confirmed by PCR for the blaKPC gene.
Results: Of 200 isolates, K. pneumoniae subsp. aerogenes (48%) was most common, followed by K. oxytoca (46%) and K. pneumoniae subsp. pneumoniae (6%). ESBL production was detected in 59.5%, AmpC in 6.5%, MBL in 8%, and KPC in 6%. Enzyme co-production was observed in 12.5%. Mortality among patients with blaKPC-positive isolates was 25%.
Conclusion: Multidrug resistance in Klebsiella spp. is widespread. Early detection and strict antimicrobial stewardship are essential to prevent therapeutic failures and limit hospital transmission.