STUDYON CHANGE IN THE TREND OF ANTIBIOTIC SUSCEPTIBILITY PATTERN OF KLEBSIELLA PNEUMONIAE ISOLATES FROM VARIOUS CLINICAL SAMPLES IN A TERTIARY CARE HOSPITAL

Background:Klebsiellapneumoniae colonizesskin,nasopharynx,gastro-intestinal tract,and oropharynx of hospitalized individuals.KlebsiellacausesPneumonia,Meningitis(neonates),Urinarytractinfections,Intra-abdominal infections,Skin and Soft tissue infections in both community and health-caresettings.It became a challenge to the ID(Infectious Disease) physicians to treat Klebsiella infections due to increasing resistance to various antibiotics which led to significant morbidity and mortality. This study was done to know the change in the trend of antibiotic susceptibility pattern of K. pneumoniae for a period of 2 years and to identify Extended Spectrum β-lactamase and AmpCβ-lactamase producing organisms. Materials and Methods:This is a prospective study done in the Department of Microbiology,Siddhartha Medical College,Vijayawada for a period of 2 years(August 2019- July 2021).Blood,pus, andurine specimens received from both Out-patients and In-patients of Government General Hospital,Vijayawada during the study period weresubjected to culture according to CLSI guidelines.Antibioticsusceptibility testing was done by modified Kirby-Bauer disc diffusion method on Muller-Hinton agar.ESBL and AmpC β-lactamase producing organisms were identified using Cefotaxime(30µg), Ceftazidime + Clavulanic acid (30µg/10µg) and Cefoxitin(30µg) discs respectively. Results: Out of the 3021 and 3558 samples received during period 1(August 2019 – July 2020) and period 2(August 2020 to July 2021),254 and 320 K.pneumoniae were isolated respectively.167(65%) isolates toPiperacillin-Tazobactam(PIT), 13(5.1%)isolates to Amikacin(AK)and 6(2.36%)isolates to Meropenem(MR) were resistant during period 1.240(75%)isolates to PIT,40(12.5%)isolatesto AK and 28(8.75%)isolates to MR were resistant during period 2.More than 50% resistance was observed toCefoxitin,Co-trimoxazole, and Ciprofloxacin during both periods 1 and 2.57 ESBL,8 AmpC β-lactamase producing organisms were identified during period 1 and 108 ESBL,25AmpCβ-lactamaseproducing organismsduring period 2. Conclusion:Antibiotic resistance has increased during period 2 when compared withperiod 1.It isimportant to monitor and optimize antibiotic use through antibiotic stewardship programmes.The collaboration of Microbiologists and clinicians is also necessary fortheeffective management of infectious diseases.