DOI: https://doi.org/10.36347/sjmcr.2026.v14i06.003

Pages: 1335-1338

Introduction: Burn patients are particularly susceptible to healthcare-associated infections. Klebsiella pneumoniae, a Gram-negative bacillus frequently isolated in this setting, poses major therapeutic challenges owing to the emergence of multidrug-resistant, carbapenemase producing strains. Objective: To characterize the antimicrobial resistance profile of K. pneumoniae isolated from burn patients at Mohammed VI University Hospital, Marrakech, and to assess the frequency of pan-drug-resistant, therapeutically untreatable situations. Methods: A retrospective descriptive study was conducted from January 2023 to December 2024, encompassing 216 K. pneumoniae isolated from 1,429 bacteriologically documented infected burn patients. Susceptibility testing was performed according to CA-SFM/EUCAST guidelines using the BD Phoenix M50 automated system. Carbapenemases were identified by immunochromatographic assay [NG-Test CARBA 5] and/or PCR. Results: K. pneumoniae accounted for 15% of documented infections. Resistance rates were high across all antibiotic classes: 73% to third-generation cephalosporins[C3G], 61% to ertapenem, 52% to imipenem, and 31% to colistin. Carbapenemase production was detected in 66% of isolates, with predominance of New Delhi metallo-β-lactamase [NDM] [45%], followed by oxacillinase 48[OXA-48] [21%] and co-production of both enzymes in 5.5% of cases. Overall, 68% of strains were multidrug-resistant [MDR], and 19% of patients faced a pan-drug-resistant situation requiring the use of high-dose carbapenems combined with colistin, despite the absence of in vitro efficiency. Conclusion: This study highlights a concerning epidemiological situation, characterized by a high prevalence of carbapenemase-producing K. pneumoniae in burn patients. The emergence of colistin resistance and the frequency therapeutic dead end situations underscore the urgent need to strengthen microbiological surveillance and antimicrobial stewardship programmes.