Background: Gram-negative pathogens are an important cause of community and hospital-acquired infections throughout the world. Klebsiella pneumoniae has become one of the more common causes of these infections and one of the important aspects of Klebsiella associated infections is the emergence of multi-drug resistant strains particularly those involved in nosocomial infections or hospital settings. This study was done to determine the isolation rate of Klebsiella, their antibiogram and the presence of resistant strains from sputum samples. 

Aims and Objective: Isolation and Antimicrobial Susceptibility Pattern of Klebsiella Pneumoniae in a sputum sample with Lower Respiratory Tract infection suspected patients that are study were undertaken to detect the incidence of K. Pneumoniae isolated from different clinical specimens in the Department of Microbiology in NIMS Medical College Jaipur.

Materials & Methods: A total number of 270 sputum samples were included in the 6-month study. Klebsiella was identified by standard microbiological techniques and antibiotic susceptibility testing was done by Kirby-Bauer disc diffusion method and interpreted as per CLSI guidelines. 

Results: A total of 270 cultures from sputum samples and a total of 41 Klebsiella pneumoniae were isolated thus culture positivity was 35.65%, and other organisms were 64.35%. A total of Klebsiella pneumonia isolates, 25 (60.9%) were from males and 16 (39.1%) were from females. Isolation rate was highest in the male patient then female patients were low rate found in this study. The more sensitive to Amikacin (90.24%), Meropenem (85.35%), Imipenem (80.48%). Isolates showed high resistance to Ceftriaxone (73.17%), Levofloxacin (70.73%), and Aztreonam (52.9%) and Ampicillin (100%) because it is intrinsic resistance.

Conclusion: The data of this study may be used to determine trends in antimicrobial susceptibilities to formulate local antibiotic policies and overall to assist clinicians in the rational choice of antibiotic therapy. 

Keywords: Klebsiella pneumoniae, Antibiotic resistance, Antibiotic susceptibility testing, Antibiotic policy.

1. Podschun, R., Ullmann, U. 1998. Klebsiella spp. As nosocomial pathogens: epidemiology, taxonomy, typing methods, and pathogenicity factors. Microbiol. Rev., 11(4): 589– 603.
2. Steinmann J, Kaase M, Gatermann S, Popp W, Steinmann E, Damman M, Paul A, Saner F, Buer J, Rath P M; Outbreak due to Klebsiella pneumonia strain harbouring KPC-2 and VIM-1 in a German university hospital. Euro Surveill 2011; 16(33): 19944.
3. Chaudhary B.L., Srivastava Shailja, Singh Brij Nandan and Shukla Snehanshu; Nosocomial Infection due to Multidrug Resistant (MDR) Escherichia coli and Klebsiella pneumoniae in Intensive Care Unit. International Journal of Current Microbiology and Applied Sciences 2014; 3(8):630-635.
4. Sikarwar Archana Singh and Batra Harsh Vardhan; Prevalence of Antimicrobial Drug Resistance of Klebsiella pneumoniae in India. International Journal of Bioscience, Biochemistry and Bioinformatics 2011; 3(1): 211-215.
5. Paterson DL, Bonomo RA. Extended‑ spectrum beta‑lactamases: A clinical update. Clin Microbiol Rev 2005;18: 657‑86.
6. Patrick R Murray, Barry Holmes, Hazel M. Aucken. 2005. Topley & Wilson s Microbiology & Microbial Infections. Volume 2. 10th edition. Salisbury, UK: Edward Arnold Ltd.
7. N.Ravichitra, P.Hema Prakash, S. Subbarayudu and U. Sreenivasa Rao; Isolation and antibiotic sensitivity of Klebsiella pneumonia from pus, sputum and urine samples. Int. J. Curr. Microbiol. App. Sci 2014; 3(3): 115-119.
8. Bauer, AW., Kirby, WMM., Sherris, JC., and Turck, M. 1966. Antibiotic susceptibility testing by a standardized single disk method. J. Clin. Pathol., 45: 493-496.
9. Asati Rakesh Kumar; Antimicrobial Sensitivity Pattern of Klebsiella Pneumoniae isolated from Sputum from Tertiary Care Hospital, Surendra nagar, Gujarat and Issues Related to the Rational Selection of Antimicrobials. Scholars Journal of Applied Medical Sciences (SJAMS) 2013; 1(6):928-933.
10. Shashidhar Vishwanath, Kiran Chawla, Anusha Gopinathan; Multidrug resistant Gram-negative bacilli in lower respiratory tract infectons. Iranian Journal of Microbiology 2013; 4(5):323-327.
11. Osazuwa F, 1Mordi RM, Osazuwa E, Taiwo SS, Alli OAT, Ogbolu DO, Akanni EO, Anukam; Klebsiella has taken lead among uropathogens in University of Benin Teaching Hospital, Benin City, Nigeria-An observation. New York Science Journal. 2010; 3(11):61-64.
12. Shah RK, Singh YI, Sanjana RK, Chaudhary N, Saldanha D et al.; Study of extended spectrum beta-lactamases (ESBLs) producing Klebsiella species in various clinical specimens: A preliminary report. Journal of College of Medical Sciences Nepal 2010; 6(3): 19-23.
13. Sahly H., Aucken H., Benedi V.J., Forestier C., Fussing V., Hansen D.S., Ofek I., Podschun R., Sirot D., Tomas J.M., Sandvang D., and Ullmann U. Increased Serum Resistance in Klebsiella pneumonia Strains Producing Extended-Spectrum beeta-Lactamases. Antimicrob Agents Chemother 2004; 9(48):3477-3482.
14. Shukla I, Tiwari R, Agrawal M; Prevalence of extended spectrum β-lactamse producing Klebsiella pneumoniae in tertiary care hospital. Indian Journal Medical Microbiology 2004; 22(2): 87-91.
15. Ali Abdel Rahim KA, Ali Mohamed AM; Prevalence of extended spectrum β-lactamaseproducing Klebsiella pneumoniae in clinical isolates. Jundishapur Journal of Microbiology 2014; 7(11): e17114.
16. Kitara LD, Anywar AD, Acullu D, Odongo-Aginya E, Aloyo J, and Fendu M, Afr Health Sci. 2011; (l1): S34–S39.

Bhawani Shankar Verma

Department of Microbiology, National Institute of Medical Science and Research (NIMSR), Jaipur