high prevalence of antimicrobial resistance genes in multidrug-resistant-esbls-producing klebsiella pneumoniae post-covid-19 pandemic

Background and objectives: klebsiella pneumoniae is a common pathogen associated with healthcare-related infections. it is particularly notable for its ability to develop resistance to multiple antibiotics, making treatment challenging. during the covid-19 pandemic, increased antibiotic use to manage critically ill patients was contributed to the rise of multidrug-resistant klebsiella pneumoniae. this study evaluated the antibiotic resistance patterns of multidrug-resistant, esbl-producing klebsiella pneumoniae in northern iran after the covid-19 pandemic.materials and methods: this cross-sectional study was conducted between september 2022 and october 2023. clinical samples were collected from patients with nosocomial infections at hospitals in sari. this study included 114 multidrug-resistant esbls-producing klebsiella pneumoniae isolates. antimicrobial susceptibility was assessed using broth macro-dilution, and resistance genes were detected by multiplex pcr.results: gentamicin, ampicillin-sulbactam, co-amoxiclav, and ceftazidime displayed the lowest activity against multidrug-resistant klebsiella pneumoniae. in contrast, piperacillin-tazobactam showed the highest activity. the prevalence of resistance genes was as follows: blatem (99.12%), blashv (74.56%), blactx (88.60%), blaimp (64.04%), acra -b (92.98%), and oqxa -b (67.54%).conclusion: this study identified over 50% of antibiotic-resistance genes. over half of multidrug-resistant klebsiella pneumoniae isolates showed resistance to antibiotics except piperacillin-tazobactam, which is recommended for treating multidrug-resistant klebsiella pneumoniae infections.