Klebsiella pneumonie (K. pneumonie) is an opportunistic bacterium responsible for many nosocomial and community-acquired infections. The recent emergence and spread of antibiotic resistance have resulted in widespread epidemics and endemic dissemination of multidrug-resistant pathogens. A total of 145 K. pneumonie isolates were recovered from hospital wastewater effluent and subjected to antibiogram profiling. Furthermore, the antibiotic resistance determinants were assessed among phenotypic resistant isolates using polymerase chain reaction (PCR). The isolates showed a wide range of antibiotic resistance against 21 selected antibiotics under 11 classes, with imipenem (94.5%) being the most susceptible  and ampicillin (86.2%) the most resistant. High susceptibility rates were observed for other antimicrobials such as piperacillin/tazobactam (89.0%), ertapenem (87.6%), norfloxacin (86.2%), cefoxitin (86.2%), meropenem (76.6%), doripenem (76.6%), gentamicin (76.6%), chloramphenicol (73.1%), nitrofurantoin (71.7%), ciprofloxacin (79.3%), amikacin (60.7%), amoxicillin/clavulanic acid  (70.4%). Meanwhile, relatively high  resistance was also recorded against tetracycline (69%), doxycycline (56.6%), cefuroxime (46.2%), cefotaxime (48.3%), ceftazidime (41.4%). Out of the 32 resistance genes tested, 28 were confirmed, with  [tetA (58.8%), tetD (47.89%), tetM (25.2%), tetB (5.9%)],  [sul1 (68.4%), sul1I (66.6%)], and [aadA (62.3%), strA (26%), aac(3)-IIa(aacC2)^a (14.4%)] genes having the highest occurrence. Strong significant associations exist among the resistance determinants screened. The sum of 82.7% K. pneumonie isolates were multidrug-resistant (MDR) with a multiple antibiotics resistance index (MARI) range of 0.24 to 1.0. Dual presence of the resistant genes among K. pneumonie was also observed to occur more than multiplepresence. This study reveals a worrisome presence of multidrug-resistant K. pneumonie isolates and resistance genes in hospital waste effluent, resulting in higher public health risks using untreated surface water for human consumption. As a result, adequate water treatment and monitoring initiatives designed to keep track of antimicrobial resistance patterns in the aquatic ecosystem are required.
Keywords: Hospital, Antibiotics resistance, Genes, Multidrug, K. pneumonie