Comparative Evaluation of Antimicrobial Susceptibility Patterns in Klebsiella spp. and Proteus spp. Isolates from Urine Cultures in a Tertiary Care Hospital, Lahore
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Abstract
Background: Urinary tract infections caused by antimicrobial-resistant Gram-negative organisms are a growing challenge for empirical therapy, particularly in tertiary care settings. Local susceptibility data are essential for guiding antibiotic selection and supporting antimicrobial stewardship. Objective: To compare the antimicrobial susceptibility patterns of Klebsiella spp. and Proteus spp. isolated from urine cultures in a tertiary care hospital in Lahore, Pakistan. Methods: This observational, cross-sectional, laboratory-based study was conducted in the Pathology Department of Ameer Ud Din Medical College/Post Graduate Medical Institute, Lahore, from January 2024 to December 2024. A total of 8,745 midstream clean-catch urine specimens were processed using standard microbiological culture methods. Significant bacterial isolates were identified by conventional biochemical testing, and antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion method. Susceptibility patterns of Klebsiella spp. and Proteus spp. were summarized as frequencies and percentages. Results: Of 8,745 urine specimens, 3,326 (38.0%) showed significant bacterial growth. Among culture-positive samples, Klebsiella spp. were isolated in 312 (9.4%) cases and Proteus spp. in 48 (1.4%) cases. Proteus spp. showed complete susceptibility to imipenem and meropenem (100% each), while Klebsiella spp. showed lower susceptibility to imipenem (73%) and meropenem (72%). Ceftazidime-avibactam susceptibility was 81% in Proteus spp. and 64% in Klebsiella spp. Piperacillin/tazobactam susceptibility was higher in Proteus spp. (79%) than Klebsiella spp. (46%). Fluoroquinolone susceptibility was reduced in both organisms, with ciprofloxacin and levofloxacin susceptibility of 42% in Klebsiella spp. and 46% in Proteus spp. Conclusion: Proteus spp. retained high susceptibility to carbapenems, whereas Klebsiella spp. showed comparatively reduced susceptibility across several antibiotic classes. The low fluoroquinolone susceptibility in both organisms highlights the need for routine culture-based testing, updated local antibiograms, and susceptibility-guided therapy for urinary tract infections
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