Prospective evaluation of antimicrobial resistance and multidrug resistance in respiratory tract infections: Insights from a tertiary care hospital | ||
| Microbes and Infectious Diseases | ||
| Articles in Press, Accepted Manuscript, Available Online from 14 November 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/mid.2025.430767.3302 | ||
| Authors | ||
| Sowmya Mathew* 1, 2; Nirmala Sankardoss3 | ||
| 1Department of Pharmacy Practice, Sree Balaji Medical College and Hospital Campus, Bharath Institute of Higher Education and Research Centre, Chennai-600073, India | ||
| 2Department of Pharmacy Practice, East Point College of Pharmacy, Bangalore-560049, Karnataka, India | ||
| 3Department of Pharmacognosy, Sree Balaji Medical College and Hospital Campus, Bharath Institute of Higher Education and Research Centre, Chennai, India | ||
| Abstract | ||
| Background: Respiratory tract infections (RTIs) are a leading cause of global morbidity and mortality, increasingly compromised by antimicrobial resistance (AMR) and multidrug resistance (MDR). This prospective study evaluated the prevalence and resistance profiles of bacterial pathogens isolated from respiratory specimens in a tertiary care hospital. Methods: From January to December 2024, 323 culture-positive sample isolates were identified and tested for antimicrobial susceptibility following CLSI guidelines. The study was set in India. Logistic regression was used to assess factors associated with MDR. Results: Gram-negative bacteria predominated (80.5%), with Klebsiella pneumoniae (39%) as the most frequent pathogen, followed by Pseudomonas aeruginosa (14.9%) and Streptococcus pneumoniae (7.7%). K. pneumoniae exhibited high resistance to ampicillin (92%) but retained sensitivity to aminoglycosides and carbapenems. S. pneumoniae showed high resistance to co-trimoxazole (81%) and macrolides (62–80%). Overall, 27.6% of isolates were MDR, 13.9% extensively drug-resistance (XDR), and 12.7% pan-drug resistance (PDR). Acinetobacter spp. displayed the highest resistance burden, with 85% classified as PDR. Logistic regression revealed that Gram-positive organisms were significantly associated with MDR (AOR = 2.504, p = 0.003). Conclusion: The study revealed clear clustering of MDR, XDR, and PDR strains with an inverse relationship to non-MDR isolates, underscoring the escalating threat of antimicrobial resistance. The high burden of MDR, XDR, and PDR pathogens—particularly K. pneumoniae and Acinetobacter spp.—highlights the urgent need for antimicrobial stewardship, periodic antibiogram surveillance, and evidence-based empirical therapy. | ||
| Keywords | ||
| Bacterial Infections; Pathogen Susceptibility; Emerging Resistance; Public Health | ||
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