Variation of antimicrobial susceptibility in clinical isolates of Klebsiella pneumoniae and Escherichia coli in patients

Abstract

Introduction: The presence of multidrug resistant enterobacteria in hospitals is increasingly frequent.

Objectives: To describe the variation of the antimicrobial susceptibility pattern of Klebsiella pneumoniae and Escherichia coli isolates obtained from clinical samples of patients who were hospitalized and to identify the frequency of multidrug resistant isolates.

Methods: A retrospective and descriptive study was performed between January 1, 2018 and December 31, 2021. The antimicrobial susceptibility was analyzed using the Bauer- Kirby disc diffusion method of 220 isolates (111 K. pneumoniae and 109 E. coli) obtained from clinical samples (blood, skin lesions, vascular catheters and tracheobronchial and surgical wound secretions) of patients hospitalized at the Hospital teaching surgical - clinic Aleida Fernández Chardiet, located in the province of Mayabeque, Cuba.

Results: In the K. pneumoniae isolates during the four years of the study, resistance showed a tendency to increase over time, for all antibiotic tested, except for amoxicillin / ácid clavulánic, which showed a tendency to decrease from 3.34. The percentage difference of the resistance between the year 2021 in relation to 2018 were greater for meropenem, chloramphenicol and amikacin (108.3%, 70,2% y 70.2% respectively). Even so, the data provided evidence that showed statistical significance for the antibiotics cefepime, aztreonam y meropenem (p ≤ 0,05). Regarding the E. coli isolates, resistance showed a tendency to decrease over the course of the four years of the study in eight of the investigated antibiotics. chloramphenicol and amikacin showed an increasing trend of 3.65 y 4.83 respectively. The percentage difference between the extreme years of the study in nine antimicrobials showed values lower than 50.0%. The data provide elements to suggest the presence of statistical significance (p ≤ 0.05) for cefotaxim y ampicilin/sulbactam. Finally, 83.87% of K. pneumoniae isolates and 80.73% of E. coli isolates were multidrug resistant.

Conclusions: There was variation in the susceptibility to antibiotic in the K. pneumoniae and E. coli isolates during the four years of the study. In addition, a high prevalence of multiresistant isolates was observed.