Dr.Abebe, Tamrat (PhD, Assistant Professor)Dr. Mihret, Adane(DVM, PhD, Associate Professor)Dr.Aseffa, Abraham effa (MD, PhD, Senior Scientist)Teka, Brhanu (MSc, PhD Fellow)Yeshitela, Biruk(MSc, PhD Fellow)Awoke, Tewachew2020-05-252023-11-052020-05-252023-11-052019-10http://etd.aau.edu.et/handle/123456789/21304Background: Klebsiella pneumoniae is a cause of mild to life threatening infections. The bacterium poses an urgent public health threat because it has the potential to become resistant to virtually all categories of antimicrobials available. Multidrug resistant K. pneumoniae has caused nosocomial outbreaks in different continents. Little is known concerning the antimicrobial resistance profiles of K. pneumoniae in Ethiopia. Objective: The aim of this study was to determine the phenotypic anti microbial resistance profiles of K. pneumoniae isolated from patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methodology: A cross-sectional study was conducted on antimicrobial resistance profiles of 132 K. pneumoniae, isolated from patients from September 2018 to February 2019. Identification of K. pneumoniae was done by examining gram stain, colony characterstics on MacConkey agar, 5% sheep blood agar and biochemical tests. Antimicrobial susceptibility testing was done by Kirby-Bauer disc diffusion technique. Extended spectrum -lactamase (ESBL) and carbapenemase production was confirmed by combined disc test and modified carbapenemase inactivation method, respectively. Data was double entered using Epidata 3.1 and exported to SPSS version 25 software for analysis. Binary logistic regression and Chi-Square or Fisher's exact test were used to measure the association. P-value less than 0.05 was considered as statistically significant. Results: Among the total K. pneumoniae isolates high frequency of resistance was observed to cefotaxime and ceftriaxone 128 (97%), trimethoprim sulfamethoxazole 124 (93.9%) and cefepime 111 (84.1%). Most frequent susceptibility was observed to amikacin 123 (93.2%), imipenem 107 (81.1%), meropenem 96 (72.7%) and ertapenem 93 (70.5%). Majority 130(98.5%) of the isolates were multidrug resistant (MDR). Two isolates showed complete nonsusceptibility to all antimicrobial agents tested. The magnitude of ESBL and carbapenemase production was 77.3% and 21.2%, respectively. Of the total (n=30) non-ESBL producers, 73.3% were carbapenemase producers. Non-ESBL producers showed high resistance to imipenem (53.3%), meropenem (80%) and ertapenem (83.3%). Higher proportion of ESBL production was observed in those aged below 5 years than those 18 to 45 years and among those admitted to the intensive care units and pediatric wards than those in medical wards. Previous use of carbapenems was associated with carbapenemase production (P<0.001). Conclusion: All K. pneumoniae isolates showed appreciably high frequency of resistance to most of the tested antimicrobials. The magnitude of ESBL and carbapenemase production as well as MDR K. pneumoniae was very alarming in the study area. Of particular concern is that the majority of non-ESBL producers were carbapenemase producers. Therefore, strengthening antimicrobial stewardship programs together with effective infection control and antimicrobial surveillance practices is strongly recommended in Tikur Anbessa Specialized Hospital.en-USKlebsiella pneumoniae, extended spectrum -lactamase, carbapenemase, multidrug resistanceThesis