Abstract

Colistin is generally used to treat infections with multidrug-resistant bacteria. Failure of drugs against Klebsiella pneumoniaebacteria has led to the unprecedented increase in the use of colistin (one of the last-resort drugs) and subsequent emergence and dissemination of colistin resistance. AIM: -To estimate the prevalence of Colistin-Resistance Klebsiella pneumoniae (CRKp) in MDR isolates collected from different Critical care units (CCUs) and to determine the clinical outcomes of the patients. MATERIALS AND METHODS: This study was conducted at Department of Microbiology and Medicine at RMCH&RC, Kanpur for 18 months between March 2022 to September 2023.Clinical samples from CCU were collected and processed by standard procedures to isolate and identify and to perform AST for Klebsiella pneumoniae spp.MDR Klebsiella pneumoniae species were examined for colistin susceptibility by the Broth Microdilution (BMD)method for the detection of Minimal Inhibitory Concentration (MIC). Data was analysed by comparing susceptibility categories (susceptible or resistant) and minimal inhibitory concentrations (MIC). RESULT: Out of 240 Klebsiella pneumoniae isolates, 99 (41.3%) isolates were found to be Colistin Resistance by Disc Diffusion (Kirby Baur’s) Method. The prevalence of Colistin Resistance Klebsiella pneumoniae (CRKp) was found by BMD for the detection of MIC-46/240 (19.1%) in the present study. CRKp drug-resistant isolates were commonly 11/46 (23.9%) isolated from samples of respiratory tract infections and the majority 38/46 (82.6%) were from Medicine ICU. The maximum number of CRKp isolates were found from urine cultures 25/46 (54.3%) followed by ET secretion 10/46 (21.7%) and Pus cultures 08/46 (17.3%). CONCLUSION: Patients in the Medicine ICU were frequently infected and highest isolates were found from urine sample with CRKp strains. Prolonged hospital stay and direct antibiotic pressure in the hospital can lead to the development of CRKp variants.

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