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Title: Therapeutic Options for Treating Cefotaxime-Resistant Escherichia coli & Klebsiella Species in Resource-Limited Tertiary Care Setup of Rawalpindi: A Retrospective Observational Study
Authors: Uzma Mussarat, Shazia Taj, Amal Zahra, Nehaj Tariq, Amatul Naval, Saeeda Bano
Journal: Life and Science
Publisher: National University of Medical Sciences, Rawalpindi
Country: Pakistan
Year: 2025
Volume: 6
Issue: 3
Language: en
DOI: 10.37185/LnS.1.1.871
Keywords: Cephalosporin ResistanceDrug UtilizationEscherichia ColiKlebsiella PneumoniaePatient Safety
Objective: This study aimed to assess potential therapeutic options for Klebsiella pneumoniae and Escherichiacoli isolates resistant to third-generation Cephalosporins.Study Design: Retrospective observational study.Place and Duration of Study: This study was conducted at the Department of Pathology, Pakistan RailwayHospital, Rawalpindi, Pakistan from January 2021 to December 2021.Methods: Patient samples were congregated from the specified study period and processed in themicrobiology laboratory using standard protocols. Pathogens were identified through Gram staining,biochemical tests, and antibiotic susceptibility tests via the disk diffusion method following Clinical andLaboratory Standards Institute (CLSI) guidelines. Data scrutiny was accomplished using Statistical Package forSocial Sciences (SPSS) version 24.Results: Out of 1,128 clinical specimens, Escherichia coli was recognized as the most recurrently isolatedpathogen (34.66%, N=391), followed by Klebsiella pneumoniae (21.89%, N=247), with Enterococcus faecalisbeing the least common (3.10%). Escherichia coli exhibited notable decreased sensitivity to ampicillin (58%),amoxicillin-clavulanate (34%), cefotaxime (43%), ciprofloxacin (31%), and co-trimoxazole (24%). Similarly,Klebsiella pneumoniae showed resistance to amoxicillin-clavulanate (58.7%), cefotaxime (49%), and cotrimoxazole (24%). However, both pathogens remained susceptible to Carbapenems, ceftazidime,Cefoperazone-Sulbactam, tetracycline, Cloxacillin, erythromycin, Aztreonam, Nitrofurantoin, Fosfomycin,amoxicillin-clavulanate, and chloramphenicol.Conclusion: The rising resistance of Escherichia coli and Klebsiella pneumoniae to third-generationCephalosporins 92 (24%) and 89 (36%), respectively, has been revealed in the present study. Moreover,quinolones also present significant treatment challenges by showing high resistance among collected isolates.In contrast, Carbapenems, β-lactam/β-lactamase inhibitor combinations (Piperacillin–Tazobactam) (TZP),Ceftazidime, Cefoperazone-Sulbactam (SCF), Tetracycline, and Fosfomycin are found as effective alternatives tocombat cefotaxime-resistant pathogens.
How to cite this: Mussarat U, Taj S, Zahra A, Tariq N, Naval A, Bano S. Therapeutic Options for Treating Cefotaxime-Resistant Escherichia coli & Klebsiella Species in Resource-Limited Tertiary Care Setup of Rawalpindi: A Retrospective Observational Study. Life and Science. 2025; 6(3): 411-418. doi: http://doi.org/10.37185/LnS.1.1.871
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