Original Articles

Prevalence of Drug-Resistant Klebsiella pneumoniae Strains in Hospitalized Patients in Mashhad, Iran: A Cross-Sectional Study

Abstract

Background:   Klebsiella pneumoniae is one of the important bacilli of the Enterobacteriaceae family and is considered as the primary pathogen in nosocomial infections, especially septicemia, pneumonia, etc. Widespread resistance to antibiotics is currently a major concern worldwide. The aim of this study is to determine the prevalence of antibiotic resistance and its association with variables such as age, gender, and department.

Methods:   90 strains of Klebsiella pneumoniae were identified by the phenotypic method and BD Phoenix M50, and the Phoenix system determined their antibiotic resistance according to the manufacturer's procedures. Then, a statistical relationship between antibiotic resistance and variables, including age, gender, and patient department, was obtained.

Results:   The findings indicated that the Multidrug-resistant (MDR) and Extended-Spectrum Beta-Lactamase (ESBL) resistance in patients had a high prevalence (above 80%). The intensive care units (ICUs) and burn wards had the highest prevalence of these antibiotic resistance. Comparing drug resistance with gender showed that total drug resistance (TDR) was significantly higher in men. However, no statistically significant relationship was found between them and age.

Conclusion:   Based on the findings, the high prevalence of antibiotic resistance in Klebsiella pneumoniae requires special attention to their control and prevention, especially in critical departments such as ICU and burn units, and therapeutic stewardships may need to be revised accordingly.

1. Ashurst JV, Dawson A. Klebsiella pneumonia. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright © 2024, StatPearls Publishing LLC.; 2024.
2. Abbas R, Chakkour M, Zein El Dine H, et al. General Overview of Klebsiella pneumonia: Epidemiology and the role of siderophores in its pathogenicity. biology (Basel). 2024; 13(2):78.
3. Lin JY, Zhu ZC, Zhu J, et al. Antibiotic heteroresistance in Klebsiella pneumoniae: Definition, detection methods, mechanisms, and combination therapy. Microbiol Res 2024; 283:127701.
4. Singh AN, Singh A, Singh SK, et al. Klebsiella pneumoniae infections and phage therapy. Indian J Med Microbiol 2024; 52:100736.
5. Di Pilato V, Pollini S, Miriagou V, et al. Carbapenem-resistant Klebsiella pneumoniae: the role of plasmids in emergence, dissemination, and evolution of a major clinical challenge. Expert Rev Anti Infect Ther 2024; 22(1-3):25-43.
6. Cosentino F, Viale P, Giannella M. MDR/XDR/PDR or DTR? Which definition best fits the resistance profile of Pseudomonas aeruginosa? Curr Opin Infect Dis 2023; 36(6):564-71.
7. Magiorakos AP, Srinivasan A, Carey RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012; 18(3):268-81.
8. Ardebili A, Izanloo A, Rastegar M. Polymyxin combination therapy for multidrug-resistant, extensively-drug resistant, and difficult-to-treat drug-resistant gram-negative infections: is it superior to polymyxin monotherapy? Expert Rev Anti Infect Ther 2023; 21(4):387-429.
9. Hong JS, Kim D, Kang DY, et al. Evaluation of the BD phoenix m50 automated microbiology system for antimicrobial susceptibility testing with clinical isolates in Korea. Microb Drug Resist 2019; 25(8):1142-8.
10. Farhadi M, Ahanjan M, Goli HR, et al. High frequency of multidrug-resistant (MDR) Klebsiella pneumoniae harboring several β-lactamase and integron genes collected from several hospitals in the north of Iran. Ann Clin Microbiol Antimicrob 2021; 20(1):70.
11. Mirzaei B, Ebrahimi A, Keshavarzi S, et al. Antibiotic susceptibility, biofilm-forming ability, and prevalence of extended-spectrum beta-lactamase (esbl)- and biofilm-associated genes among Klebsiella pneumoniae isolates from hospitalized patients in northwest of Iran. Curr Microbiol 2023; 80(5):175.
12. Davoudabadi S, Goudarzi M, Hashemi A. Detection of virulence factors and antibiotic resistance among Klebsiella pneumoniae isolates from Iran. Biomed Res Int 2023; 2023:3624497.
13. Haghighifar E, Norouzi F, Kamali Dolatabadi R. Molecular detection of Extended-Spectrum β-lactamases (ESBLs) and biofilm formation in uropathogen Klebsiella pneumoniae in Iran. Med J Islam Repub Iran 2021; 35:72.
14. Kazemian H, Heidari H, Ghanavati R, et al. Phenotypic and genotypic characterization of esbl-, ampc-, and carbapenemase-producing Klebsiella pneumoniae and Escherichia coli isolates. Med Princ Pract 2019; 28(6):547-51.
15. Abbasi E, Ghaznavi-Rad E. High frequency of NDM-1 and OXA-48 carbapenemase genes among Klebsiella pneumoniae isolates in central Iran. BMC Microbiol 2023; 23(1):98.
IssueVol 13 No 3 (2025) QRcode
SectionOriginal Articles
Keywords
Antimicrobial drug resistance Infection Klebsiella pneumoniae Resistance patterns.
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Rohani Yazdi S, Esmaeili Z, Ghazvini K. Prevalence of Drug-Resistant Klebsiella pneumoniae Strains in Hospitalized Patients in Mashhad, Iran: A Cross-Sectional Study. J Med Bacteriol. 2025;13(3):77-82.