Résumé:
This study investigates the antibiotic resistance of Klebsiella pneumoniae isolates
from patients in Intensive Care Units (ICUs) at the Zliten Medical Center, focusing on
detection of extended-spectrum beta-lactamases (ESBLs) and carbapenemase
resistance enzymes. The research reveals alarming resistance rates, with K.
pneumoniae exhibiting up to 96% resistance to key β-lactam antibiotics, including
Cephalothin, Cefuroxime, Ceftriaxone, and Cefepime. Colistin stands out as the only
antibiotic with 100% sensitivity among all tested isolates. Moderate sensitivity was
noted for Amikacin (38%), Gentamicin (34%), and Meropenem (36%). Statistical
analysis indicated weak associations between antibiotic response categories and
distribution, except for Tigecycline, which demonstrated a significant association (p =
0.025).
Resistance patterns varied by sample source, with high levels of resistance observed
across swabs, blood, sputum, and urine, although no significant statistical relationship
was established, aside from a near-significant trend with Nitrofurantoin (p = 0.051).
The Surgical ICU presented the highest resistance levels, particularly to Ertapenem,
Imipenem, and Ceftazidime, with Tigecycline resistance varying significantly by ward
(p = 0.028). Phenotypic testing revealed that 94% of isolates exhibited at least one
resistance phenotype, underscoring the clinical challenge posed by multidrug-resistant
K. pneumoniae. These findings highlight the urgent need for enhanced surveillance
and intervention strategies to mitigate the spread of antibiotic resistance in critical care
settings.
