Determine of Colistin Susceptibility in MDR Klebsiella Pneumoniae Isolates from Clinical Samples of CCU Patients in a Tertiary Care Hospital Kanpur

INTRODUCTION: -Colistin is generally used to treat infections with multidrug-resistantbacteria.Failure of drugs against Klebsiella pneumoniae bacteria has led to the unprecedentedincrease in the use of colistin (one of the last-resort drugs) and subsequent emergence anddissemination of colistin resistance.AIM: -To estimate the prevalence of Colistin-Resistance Klebsiella pneumoniae (CRKp) in MDRisolates collected from different Critical care units (CCUs) and to determine the clinical outcomesof the patients.MATERIALS AND METHODS: This study was conducted at Department of Microbiologyand Medicine at RMCH&RC, Kanpur for 18 months between March 2022 to September2023.Clinical samples from CCU were collected and processed by standard procedures to isolateand identify and to perform AST for Klebsiella pneumoniae spp.MDR Klebsiella pneumoniaespecies were examined for colistin susceptibility by the Broth Microdilution (BMD)method forthe detection of Minimal Inhibitory Concentration (MIC). Data was analysed by comparingsusceptibility categories (susceptible or resistant) and minimal inhibitory concentrations (MIC).RESULT: Out of 240 Klebsiella pneumoniae isolates, 99 (41.3%) isolates were found to beColistin Resistance by Disc Diffusion (Kirby Baur’s) Method. The prevalence of ColistinResistance 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 fromMedicine 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 werefound from urine sample with CRKp strains. Prolonged hospital stay and direct antibiotic pressurein the hospital can lead to the development of CRKp variants.