Antimicrobial resistance patterns of Klebsiella pneumoniae clinical isolates in the Qassim region, Saudi Arabia: a surveillance study (2015-2023).

BACKGROUND: Antibiotic resistance in Klebsiella pneumoniae is a major threat to global health. Despite its clinical importance, regional data from Saudi Arabia remain limited. This study analyzed the resistance patterns of K. pneumoniae isolates collected from the King Fahad Specialist Hospital in Al-Qassim between January 2015 and December 2023. METHODOLOGY: A retrospective cross-sectional analysis was conducted on 3,838 confirmed K. pneumoniae cases. Data were extracted from hospital electronic records and analyzed using R software. Descriptive and inferential statistics were used to examine resistance patterns by specimen type, age, sex, and hospital department. RESULTS: High resistance rates were observed to first-line antibiotics, particularly third-generation cephalosporins (59.18%-68.69%), amoxicillin-clavulanate (58.38%), and piperacillin-tazobactam (52.81%). Resistance to fluoroquinolones ranged from 53.85% to 56.36%. In contrast, higher susceptibility was observed for aminoglycosides and carbapenems. Resistance was more frequent in ESBL-producing strains, with limited presence of MDR strains. Age and sex were associated with an increased risk of resistance. CONCLUSION: The Klebsiella pneumoniae isolates in this study demonstrated significant resistance to commonly prescribed antibiotics. ESBL production substantially contributed to resistance patterns. Although aminoglycosides and carbapenems have shown relative effectiveness, emerging resistance trends underscore the need for continuous monitoring and strict antibiotic stewardship in hospital settings. CLINICAL TRIAL REGISTRATION: Not applicable.