Antimicrobial Susceptibility and Prevalence of Multidrug-Resistant Klebsiella Pneumoniae in Pediatric Patients in Karbala, Iraq: A Two-Year Retrospective Study

Hussein Abd Ali Mohammed Sadeq Al Her, College of Pharmacy, Karbala University, Karbala, IraqFollow
Al-Shalah Al-Shalah, College of Pharmacy, Karbala University, Karbala, Iraq
Saif A.J. Abdulrahman, Technical Institute of Babylon, Al-Furat Al-Awsat Technical University, Babylon, Iraq
Ekhlas Abdulameer Hameed Alazzawi, College of Pharmacy, Karbala University, Karbala, Iraq
Noor Hussein Abdulrahman, College of Pharmacy, Karbala University, Karbala, Iraq

Article Type

Original Study

Abstract

Background: Klebsiella pneumoniae is a major pediatric pathogen causing infections such as urinary tract infections, pneumonia, neonatal sepsis, and meningitis, with heightened risk in children due to immune immaturity and hospital exposure. Aim: This study aimed to retrospectively analyze the prevalence and patterns of antibiotic resistance in Klebsiella pneumoniae isolated from various clinical samples in pediatric cases at Karbala Children's Hospital from January 1, 2022 to December 31, 2023. Methods: This retrospective study examined 68 pediatric K. pneumoniae infection cases at Karbala Children's Hospital in Iraq from 2022 to 2023. Clinical samples, patient demographics, and antibiotic susceptibility were analyzed using Kirby-Bauer testing, revealing high rates of multidrug resistance, defined as resistance to three or more antibiotic classes. Results: In 2022, Klebsiella-associated pediatric infections had a nearly equal gender distribution (males 51.6%, females 48.4%), but in 2023, a male predominance emerged (56.8% vs. 43.2%), resulting in a male-to-female ratio of approximately 1.2:1. Most cases (47.1%) occurred in infants under one year of age, with fewer cases in older children. Urine samples, primarily from urinary tract infections, accounted for 64.7% of isolates. Antibiotic resistance testing showed high susceptibility to amikacin and nitrofurantoin, while 23% of isolates were resistant to multiple antibiotics, with some strains resistant to up to 13 antibiotics. Conclusions: Pediatric Klebsiella infections predominantly affect males, particularly infants under one year of age, with urinary tract infections being the main clinical manifestation. Although most isolates remain susceptible to amikacin and nitrofurantoin, significant antibiotic resistance persists. Continuous monitoring and effective antimicrobial stewardship are essential given the prevalence of multidrug-resistant (MDR) strains.

Keywords

Klebsiella pneumoniae, Antibiotic resistance, Pediatrics, Multidrug resistance, Antimicrobial susceptibility testing

Recommended Citation

Her, Hussein Abd Ali Mohammed Sadeq Al; Al-Shalah, Al-Shalah; Abdulrahman, Saif A.J.; Alazzawi, Ekhlas Abdulameer Hameed; and Abdulrahman, Noor Hussein (2026) "Antimicrobial Susceptibility and Prevalence of Multidrug-Resistant Klebsiella Pneumoniae in Pediatric Patients in Karbala, Iraq: A Two-Year Retrospective Study," Iraqi National Journal of Medicine: Vol. 8 : Iss. 2 , Article 11.
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