A large increase in the antibiotic resistance of Klebsiella pneumoniae causing urinary tract infections after the Coronavirus pandemic

Document Type : Research Paper


1 Imam Khomeini Hospital, Shirvan, North Khorasan University of Medical Sciences, Bojnurd, Iran

2 Biotechnology Department, Iranian Research Organization for Science and Technology (IROST), Tehran, Iran.


Urinary tract infection (UTI) is one of the most common bacterial infections caused by several species of Enterobacteriaceae around the world. Due to the lack of accurate information on the bacterial agents of UTIs and to evaluate possible changes in their prevalence of antibiotic resistance, this descriptive cross-sectional study was conducted in the Bojnourd - Shirvan region of North Khorasan, Iran from April to March 2019 and 2021. In this regard, urine samples were collected from outpatients and inpatients referred to Imam Khomeini Shirvan Hospital, and their bacteria were isolated. The Isolates were identified using biochemical and microbiological tests, and their antibiotic susceptibility was determined using the disk diffusion method based on the standard protocols provided by the CLSIs. In the two years studied, the main infectious agents were Escherichia coli and Klebsiella sp, respectively. However, slight differences were found in the prevalence of other agents, such as Enterobacter, Staphylococcus saprophyticus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Proteus mirabilis, and Citrobacter sp. A comparison of the results of the two-period points showed that the pattern of prevalence and the type of infectious agents did not show any unexpected changes; however, there was a large increase in the resistance of Klebsiella sp. isolates causing UTIS to three antibiotics, including ceftriaxone (CRO), imipenem (IPM) and gentamicin (GEN) after the pandemic coronavirus disease in 2021. This could have been due to the preventive and therapeutic use of antibiotics in Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) patients during this short period. A clear pattern was unfortunately found in Shirvan, Tehran, and possibly other regions. Although we noticed the pattern for just one of the bacterial agents involved in UTIs, it could be considered a real threat to general health.