Current Antimicrobial Susceptibility Profiles of Escherichia Coli and Klebsiella Pneumoniae Isolated from Urine Samples at Sally Mugabe Central Hospital from April to July 2025: A Prospective Study

Abstract

Antimicrobial Resistance (AMR) is a rapidly escalating global public health crisis, posing an existential threat to effective clinical care, particularly in Low- and Middle-Income Countries (LMICs) like Zimbabwe. The study’s broad objective was to determine the current susceptibility profiles of the key uropathogens, Escherichia coli and Klebsiella pneumoniae, isolated from urine samples at SMCH. A prospective study was conducted at SMCH from April to July 2025. The methodology involved the isolation, identification, and phenotypic Antimicrobial Susceptibility Testing (AST) using the disk diffusion method for E. coli and K. pneumoniae isolates from urine samples. About 162 out of 437 samples were analysed and were identified to have Klebsiella pneumoniae (58.02%) and E. coli (41.98%). The susceptibility analysis revealed an alarming resistance burden in both species. Resistance to common first-line drugs, such as Naladixic Acid for E. coli, was critically high. Furthermore, high rates of Multidrug-Resistance (MDR) were observed. Comparative analysis also confirmed that K. pneumoniae exhibited significantly higher resistance to key antibiotics like Amikacin and Ceftazidime than E. coli. In conclusion high prevalence of non-susceptibility to Carbapenems and high MDR rates confirm the emergence of Extensively Drug-Resistant (XDR) strains at SMCH, signifying an immediate threat of untreatable infections. The study provides crucial, localized, and actionable data which mandates the immediate update of empirical treatment guidelines and the reinforcement of Antimicrobial Stewardship Programs to optimize patient care and combat the local AMR crisis.