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Rising Prevalence of Multidrug-Resistant Klebsiella spp. in Urinary Tract Infections: A Study from Doboj Hospital
Dragana Drakul1,2, Bojan Joksimović2,3, Ana V Pejčić4
1Department of Pharmacology, Faculty of Medicine Foča, University of East Sarajevo, 73300 Foča, Bosnia and Herzegovina.
Antibiotics (Basel, Switzerland)
|December 30, 2025
Summary
Urinary tract infections (UTIs) are common, with E. coli and Klebsiella spp. being leading causes. A concerning rise in multidrug-resistant Klebsiella pneumoniae was observed, highlighting the need for better antimicrobial stewardship.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Urinary tract infections (UTIs) represent a significant global healthcare challenge.
- The increasing prevalence of antibiotic-resistant bacteria, such as Klebsiella pneumoniae, exacerbates the UTI burden.
- Hospitalized patients are particularly vulnerable to UTIs and resistant pathogens.
Purpose of the Study:
- To determine the prevalence of UTI pathogens in hospitalized patients at Saint Apostol Luka Hospital, Doboj.
- To analyze trends in pathogen distribution and antimicrobial resistance from 2021 to 2023.
- To identify key uropathogens and assess the rise of multidrug resistance.
Main Methods:
- Retrospective cross-sectional study analyzing urine culture data (2021-2023).
- Inclusion criteria: positive urine culture (≥103 CFU/mL) with a single uropathogen.
- Bacterial identification and antibiotic susceptibility testing followed EUCAST standards; statistical analysis used SPSS v24.
Main Results:
- Escherichia coli was the most common isolate (29.2%), followed by Klebsiella spp. (24.2%) and Enterococcus spp. (19.8%).
- A significant increase in K. pneumoniae prevalence was noted.
- Substantial rise in multidrug resistance among K. pneumoniae, including resistance to β-lactams, carbapenems, aminoglycosides, and colistin.
Conclusions:
- E. coli and Klebsiella spp. are the primary causes of UTIs in the studied population.
- Significant variations in pathogen distribution were observed across sex, age, and hospital departments.
- The escalating multidrug resistance in K. pneumoniae necessitates enhanced surveillance and antimicrobial stewardship programs.
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