Prevalence, Trend, and Risk Factors of Antibiotic Resistance of <i>Klebsiella Pneumoniae</i> in the Center of Iran During the COVID-19 Pandemic

Background and aims: The emergence and spread of bacterial strains resistant to multiple antimicrobials have made the treatment of these infections increasingly challenging. This research aimed to investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on multidrug-resistant Klebsiella pneumoniae (MDR-KP) and associated factors. Methods: This ecological and case-control study was conducted at Shahid Sadoughi Hospital. Data on all positive bacterial cultures were extracted from July 2018 to March 2023. In the ecological phase, an interrupted time series analysis was performed on the monthly prevalence of MDR-KP to assess changes following the onset of the pandemic. In the case-control phase, patients with MDR-KP were compared with those with no MDR-KP. Finally, logistic regression was used to identify factors associated with MDR-KP. Results: Out of 15,181 samples with positive bacterial cultures, 6.17% (CI: 0.057, 0.065) were attributed to KP. The prevalence of MDR-KP during the COVID-19 pandemic (through March 2023) was 72.65. In addition, there was a significant immediate increase of 6.42% (P&lt;0.001) following the onset of the pandemic. Based on logistic regression analysis, a previous hospitalization (OR=2.48, 95% CI: 1.29, 4.75, P&lt;0.001), admission to the intensive care unit (OR=1.9, 95% CI: 1.02, 3.55, P=0.042), and duration of hospitalization (OR=1.02, 95% CI: 1.01, 1.04, P=0.006) were related to MDR. Conclusion: The findings revealed a high prevalence of antibiotic resistance in KP strains in Shahid Sadoughi Hospital, emphasizing the urgent need for effective strategies to combat antibiotic resistance and prevent the spread of resistant infections.