Trends in Antibiotic Resistance among Gram-Negative Rods in a Tertiary Care Hospital, Rawalpindi

Abstract

Background: A global health concern, antimicrobial resistance (AMR) results from the overuse and misuse of antibiotics over the past 60 years, leading to more resistant microorganisms and limited treatment options, imposing significant societal costs.

Objective: To evaluate the patterns of antibiotic resistance in common Gram-negative rods isolated from the clinical samples during the study period from January 2021 to December 2023, according to CLSI guidelines 2023.

Materials and Methods: The data was collected from retrospective record review and prospective data from October 2023 to December 2023 of commonly isolated Gram-negative rods with confirmed 4486 cases from various clinical samples.

Results: According to descriptive statistics in 2021, 2022, and 2023, the percentage of E. coli is 35.01% to 30.03% to 34.96%. Klebsiella spp. was 16.54%, 40.96%, 42.51% respectively. Pseudomonas spp. dropped from 29.13% to 21.47% and rose to 49.40% in 2023. Proteus spp. 4.10%, 41.9%, and 53.0%. Resistance to E. coli and Klebsiella spp. decreased in response to frontline antibiotics 60%, 57%, 28% for E. coli and 30.60%, 27.70%, 17% for Klebsiella spp., respectively, suggesting potential efficacy. The Penicillin like Amoxicillin demonstrated a marked rise in resistance levels, 87.20% in 2023. The resistance to aminoglycosides in Pseudomonas spp. decreased significantly in 2023, 37.50% and 14.50%, respectively; yet resistance to Ciprofloxacin increased to 50.60%.

Conclusion: The dynamic evolution of resistance among bacterial species to various drugs advocates for selective antibiotic use and continuous surveillance to control the spread of resistant diseases.

Keywords: Gram-Negative Bacteria; Drug Resistance; Microbial Sensitivity Tests; Escherichia coli; Klebsiella; Proteus