Investigating the Occurrence and Antimicrobial Resistance Patterns of Hospital-Acquired Klebsiella Pneumoniae Bloodstream Infections in Paediatric Patients at Victoria Chitepo Provincial Hospital from January 2023 to February 2025

Abstract

Hospital-acquired bloodstream infections (BSIs) caused by Klebsiella pneumoniae are a significant public health challenge, particularly in pediatric populations, due to their association with high morbidity, mortality, and antimicrobial resistance (AMR). This study investigated the prevalence, AMR patterns, and environmental contamination of hospital acquired Klebsiella pneumoniae (HA-KP) at Victoria Chitepo Provincial Hospital, Zimbabwe, from January 2023 to February 2025. The aim was to provide evidence-based insights to inform infection control strategies and antimicrobial stewardship.A hybrid retrospective and prospective cross-sectional methodology was employed. Data was collected from 170 pediatric patients (aged 0–12 years) admitted to the hospital during the study period. Blood culture samples were analyzed for the presence of Klebsiella pneumoniae, and antimicrobial susceptibility testing was performed on isolates using standard microbiological techniques. Additionally, environmental samples were collected from various hospital surfaces to assess contamination levels. Patient demographic data were also reviewed to identify potential risk factors.The results showed that 44.1% of the pediatric patients tested positive for hospital acquired Klebsiella pneumoniae, with infants (1–12 months) being the most affected age group. Antimicrobial susceptibility testing of 110 Klebsiella pneumoniae isolates revealed high resistance rates to ceftazidime (80.9%) and amoxicillin-clavulanate (76.4%), while ciprofloxacin exhibited a lower resistance rate of 40%. Alarmingly, 44% of environmental samples tested positive for Klebsiella pneumoniae, highlighting significant environmental contamination within the pediatric ward.Analysis of the data revealed no statistically significant association between infection prevalence and sex or older age groups, although infants were disproportionately affected. The high resistance rates observed suggest that multidrug-resistant (MDR) strains are prevalent in this setting, complicating treatment options and increasing the risk of poor clinical outcomes. Environmental contamination was identified as a likely reservoir for infection transmission, emphasizing the critical need for improved infection prevention measures. This study underscores the urgent need for robust infection control protocols, including enhanced hand hygiene practices, routine cleaning and disinfection of hospital surfaces, and targeted antimicrobial stewardship programs to curb the spread of MDR Klebsiella pneumoniae. Routine AMR surveillance is also essential to monitor resistance trends and guide empirical treatment strategies.