Introduction. Klebsiella species cause pneumonia, UTI, and septicemia in human beings. Beta-lactam drugs are used extensively to treat patients infected with Klebsiella, but most of the Klebsiella species are resistant to third- and fourth-generation cephalosporins and monobactams to which data are scarce in the study area. Objective. To determine the prevalence, antimicrobial resistance, ESBL production, and associated risk factors of Klebsiella species among UTI-suspected patients in Bahir Dar City, Northwest Ethiopia. Methods. A multi-institution-based prospective cross-sectional study was conducted from January to May 2019. Midstream urines were collected from 385 patients and inoculated onto CLED and MacConkey agars. Identification of growth was done by a battery of biochemical tests. Antimicrobial resistance and ESBL production patterns were determined by using the disc-diffusion method on Mueller–Hinton agar. Quality of data was maintained by following SOPs and using Klebsiella pneumoniae (ACTT700603). Logistic regression statistical analysis was done using the SPSS, version 25, statistical package. A p value ≤ 0.05 was considered statistically significant. Results. The median age of the study participants was 32 years. Majority of them were female, urban residents, and unable to read and/or write. The total Klebsiella species detected were 38 (9.9%). Of which, 25 (65.8%) were Klebsiella pneumoniae, followed by 6 (15.8%) Klebsiella ozaenae. 20 (80%), 19 (76%), and 19 (76%) Klebsiella pneumoniae showed resistance to amoxicillin/clavulanic acid, ampicillin, and cotrimoxazole, respectively. All K. oxytoca were resistant to ampicillin, and all K. rhinoscleromatis were resistant to cefoxitin and cefotaxime. Klebsiella species that showed resistance to ≥3 antimicrobials were 26 (68%). ESBL-producing Klebsiella species were 10 (26.3%). Patients who had history of antibiotic use, hospitalization, and tight dressing habit had more risk of getting UTI ( p < 0.05 ) than their counterparts. Conclusions. Overall UTI prevalence in our study was lower than that of previous Ethiopian studies. High MDR and ESBL-producing Klebsiella species were detected. Patients’ history of antibiotic use, hospitalization, and tight dressing habit were risk factors for UTI. It calls up for improving prevention/control systems of Klebsiella species.

Background Klebsiella species are opportunistic bacteria responsible for different infections such as pneumonia, urinary tract infections (UTI) and septicemia in nosocomial and community environments. Beta-lactam drugs are used extensively to treat patients with Klebsiella infections. But today, most Klebsiella species are resistance to third- and fourth-generation cephalosporins and monobactams.Objectives To assess the prevalence, antibiotic susceptibility patterns including ESBL production and associated risk factors of Klebsiella species among UTI suspected patients attended at Bahir Dar town health institutions, Northwest Ethiopia.Methods Institutional based cross-sectional study was conducted at Bahir Dar town health institutions from January to May 2019. A simple random sampling technique was used to enroll 384 study participants. Midstream urine samples were collected and inoculated onto Cystine–lactose–electrolyte-deficient and MacConkey agars. Identification was carried out by using biochemical tests. Antimicrobial susceptibility patterns of the isolates were determined by Disc-diffusion method. ESBL-producing Klebsiella species was detected by using combined and single antibiotic disks on Mueller Hinton agar. A statistical analysis was done using SPSS version 20 statistical package. P-value < 0.05 was considered as statistically significant with 95% confidence interval.Result Out of 385 study subjects, prevalence of Klebsiella species was 38(9.9%), of them 25(65.8%) were Klebsiella pneumonia, 4(10.5%) K. oxytoca, 6(15.8%) K. ozaenae and 3(7.9%) K. rhinoscleromatis species. Moreover; 22(57.9%) of isolates were from female participants. A multi-variable logistic regression analysis showed that pervious antibiotic use, history of hospitalization and habit of tight dressing were statistically significant for getting UTI 2.618 (AOR = 2.618, 95% CI = 1.18–6.129), 5.873 (AOR = 5.873, 95% CI = 2.355–14.6) and 15.038 (AOR = 15.038, 95% CI = 1.7–139) times more at risk respectively.Conclusions The overall prevalence of UTI was lower than the previous studies conducted in Ethiopia. High ESBL producing Klebsiella species was detected. Pervious antibiotic use, history of hospitalization and habit of tight closing were significant risk factors for UTI. This result calls up for improving of the prevention and control system of Klebsiella species.