Resistance Profiles of Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli in various Clinical Specimens: A One-Year Clinical Surveillance at a Tertiary Care Hospital in Bangladesh

Author(s): Mst. Junnatul Ferdus, Sanjida Khondokar Setu, Abu Naser Ibne Satter, Samia Afreen Khan, Sharmin Shanjana, Sazzad Bin Shahid

Background: The global surge of carbapenem-resistant Gram-negative bacteria—particularly Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli—poses a major public health threat, especially in low- and middle-income countries like Bangladesh, where treatment options are limited.

Objective: This study aimed to assess the in vitro antimicrobial susceptibility of carbapenem-resistant K. pneumoniae, P. aeruginosa, and E. coli isolated from clinical specimens in a tertiary care hospital in Bangladesh, to inform antibiotic selection and infection control strategies.

Materials and Methods: Seventy-five non-duplicate carbapenem-resistant Gram-negative isolates were collected from urine, blood, wound swabs, sputum, tracheal aspirates, bronchoalveolar lavage, pus, throat swabs, tissue, and endotracheal tubes. Identification was performed using colony morphology on MacConkey and chromogenic agar, followed by standard biochemical tests. Antimicrobial susceptibility was determined using the Kirby-Bauer disk diffusion method in accordance with NCCLS guidelines.

Results: K. pneumoniae was the most prevalent (53.3%), followed by P. aeruginosa (34.7%) and E. coli (12%). Urine (18.66%), tracheal aspirates (16%), wound swabs (13.33%), and blood (13.33%) were the most common sources. Notably, all isolates showed 100% resistance to amoxicillin, cefuroxime, ciprofloxacin, and amikacin.

Conclusion: The high prevalence of multidrug-resistant K. pneumoniae, P. aeruginosa, and E. coli reflects a critical healthcare challenge in Bangladesh. These findings underscore the urgent need for robust antimicrobial stewardship, improved infection control practices, and nationwide surveillance to combat antimicrobial resistance.