Comparison of genotypic features between two groups of antibiotic resistant Klebsiella pneumoniae clinical isolates obtained before and after the COVID-19 pandemic from Egypt

Klebsiella pneumoniae is a common pathogen capable of causing a wide range of infections. Antibiotic resistance makes treatment of these infections particularly challenging. We are comparing resistance levels and genotypes among two collections of Klebsiella pneumoniae clinical isolates from Alexandria Main University Hospital, Egypt . We used disc diffusion and Minimum Inhibitory Concentration by microbroth dilution to assess resistance levels and performed whole genome sequencing to describe multilocus sequence types and resistance gene presence. Among a collection of 56 carbapenem resistant Klebsiella pneumoniae clinical isolates (19 from 2019 and 37 from 2021), multidrug resistance was 33% and 10%, extended drug resistance was 24% and 46% and pan-drug resistance was 43% and 43%, respectively. Ampicillin/sulbactam , amikacin, cefepime, ceftriaxone and ertapenem Minimum Inhibitory Concentration were significantly higher in 2021. The increasing resistance levels and the persistence of some multi drug resistance and extensive drug resistance strains genotypes is concerning. Understanding mechanisms of resistance will inform infection control and antimicrobial stewardship plans to prevent evolution and spread of extended drug resistance and pan drug resistance strains.