Molecular Insights into Antibiotic Resistance: BLACTX-M and BLANDM in Klebsiellapneumoniae UTI Isolates

Abstract

This study investigated the prevalence and antibiotic resistance patterns of Klebsiellapneumoniae isolated from urinary tract infection (UTI) patients in Peshawar. A total of 200 urine samples were collected, of which 50 (25%) were culture-positive for K. pneumoniae while 150 (75%) showed no bacterial growth. Gram staining and biochemical profiling confirmed the isolates as Gram-negative, oxidase-negative, citrate-positive, urease-positive, and non-motile bacilli, with 95% demonstrating uniform biochemical reactions. Socio-demographic analysis revealed that infections were more common in females (65%) than males (35%), with the highest prevalence in the 21–40 years age group (40%), followed by patients above 60 years (25%) and children under 15 years (10%). Antibiotic susceptibility testing using the Kirby–Bauer disc diffusion method showed alarming resistance levels: penicillin (≥90%), third-generation cephalosporins (65–70%), fluoroquinolones (45–55%), aminoglycosides (gentamicin 55%, amikacin 30%), sulfonamides (60%), tetracycline (45%), and nalidixic acid (70%). Lower resistance was observed to nitrofurantoin (35%), fosfomycin (25%), and carbapenems (imipenem 10%, meropenem 15%). Overall, 70% of isolates were multidrug-resistant (MDR), with 15% classified as extensively drug-resistant (XDR), leaving colistin and fosfomycin as last-line agents. These findings confirm that K. pneumoniae is both a prevalent and highly resistant uropathogen, posing significant clinical and public health risks. The results underscore the urgent need for surveillance, rational antibiotic use, infection control strategies, and exploration of alternative therapeutic approaches.