PHENOTYPIC ANTIMICROBIAL RESISTANCE PATTERNS AND RESISTANCE GENE DISTRIBUTION ACROSS CLINICAL SPECIMENS: ASSOCIATIONS WITH PATIENT CHARACTERISTICS AND CLINICAL OUTCOMES
Keywords:
Antimicrobial resistance, phenotypic susceptibility, resistance genes, clinical specimens, clinical outcomes
Abstract
Antimicrobial resistance represents an increasing clinical and microbiological challenge, requiring integrated assessment of phenotypic susceptibility, resistance genes, and patient-related outcomes. This study evaluated phenotypic antimicrobial resistance patterns and resistance-gene distribution across clinical specimens and examined their associations with demographic characteristics and clinical outcomes using secondary data from 2,200 records. Susceptibility to amoxicillin, ciprofloxacin, meropenem, vancomycin, and colistin was classified as sensitive, intermediate, or resistant, while resistance burden was defined as the number of antibiotics classified as resistant. Descriptive statistics, Pearson chi-square tests, Cramer's V, Kruskal-Wallis testing, and multivariable binary logistic regression were applied. Meropenem showed the highest resistance proportion (34.3%), whereas colistin showed the lowest (31.9%). VIM was the most frequently recorded resistance gene (21.0%), followed by OXA-48 (20.5%). Resistance-gene distribution was not significantly associated with specimen type, and resistance burden did not differ significantly across recovered, ICU, and deceased groups. Multivariable analysis identified no significant independent predictors of adverse clinical outcome. The findings support integrated phenotypic, molecular, and clinical surveillance for antimicrobial resistance assessment.
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References
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11.Farrukh, E., Malik, L. A., Noor, M., Ajmal, A., Ahmed, H. A., Rais, A., & Butt, M. A. (2026). Prevalence, antimicrobial resistance profiles, and virulence determinants of Staphylococcus aureus isolated from hospitalized patients. Pakistan Journal of Medical & Cardiological Review, 5(1), 5875-5903.
12.Gurung, R. R., Maharjan, P., & Chhetri, G. G. (2020a). Antibiotic resistance pattern of Staphylococcus aureus with reference to MRSA isolates from pediatric patients. Future Science OA, 6(4), FSO464.
13.Gurung, S., Kafle, S., Dhungel, B., Adhikari, N., Thapa Shrestha, U., Adhikari, B., ... & Ghimire, P. (2020b). Detection of OXA-48 gene in carbapenem-resistant Escherichia coli and Klebsiella pneumoniae from urine samples. Infection and Drug Resistance, 2311-2321.
14.Hamada, S., Matthews, B. G., McDonald, A. C., Joseph, R., Lin, J. M., Roberts, S., ... & Straub, C. (2026). Resistance or virulence: Which Staphylococcus aureus genes are associated with poor clinical outcomes in pediatric acute hematogenous osteomyelitis? Clinical Orthopaedics & Related Research.
15.Handa, V. L., Patel, B. N., Bhattacharya, D. A., Kothari, R. K., Kavathia, D. G., & Vyas, B. R. M. (2024). A study of antibiotic resistance pattern of clinical bacterial pathogens isolated from patients in a tertiary care hospital. Frontiers in Microbiology, 15, 1383989.
16.Hashem, Y. A., Abdelrahman, K. A., & Aziz, R. K. (2021). Phenotype-genotype correlations and distribution of key virulence factors in Enterococcus faecalis isolated from patients with urinary tract infections. Infection and Drug Resistance, 1713-1723.
17.Heiden, S. E., Hübner, N. O., Bohnert, J. A., Heidecke, C. D., Kramer, A., Balau, V., ... & Schaufler, K. (2020). A Klebsiella pneumoniae ST307 outbreak clone from Germany demonstrates features of extensive drug resistance, hypermucoviscosity, and enhanced iron acquisition. Genome Medicine, 12(1), 113.
18.Jain, P., Bepari, A. K., Sen, P. K., Rafe, T., Imtiaz, R., Hossain, M., & Reza, H. M. (2021). High prevalence of multiple antibiotic resistance in clinical E. coli isolates from Bangladesh and prediction of molecular resistance determinants using WGS of an XDR isolate. Scientific Reports, 11(1), 22859.
19.Kamali, E., Jamali, A., Ardebili, A., Ezadi, F., & Mohebbi, A. (2020). Evaluation of antimicrobial resistance, biofilm forming potential, and the presence of biofilm-related genes among clinical isolates of Pseudomonas aeruginosa. BMC Research Notes, 13(1), 27.
20.Koch, R. E., Barth, J., Clark, A. E., Desai, D., Kim, J., Pybus, C. A., ... & Greenberg, D. E. (2025). Antibiotic resistance genotype, phenotype, and clinical outcomes in patients with Gram-negative infections at Rabin Medical Center in Israel. Microbiology Spectrum, 13(1), e00383-24.
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23.Mirzaei, B., Bazgir, Z. N., Goli, H. R., Iranpour, F., Mohammadi, F., & Babaei, R. (2020). Prevalence of multi-drug resistant (MDR) and extensively drug-resistant (XDR) phenotypes of Pseudomonas aeruginosa and Acinetobacter baumannii isolated in clinical samples from Northeast of Iran. BMC Research Notes, 13(1), 380.
24.Nusrat, S., Aliyu, M., & Zohora, F. T. (2025). Mechanisms of antimicrobial resistance: From genetic evolution to clinical manifestations. AIMS Microbiology, 11(4), 1007.
25.Reyes, J., Komarow, L., Chen, L., Ge, L., Hanson, B. M., Cober, E., ... & Satlin, M. (2023). Global epidemiology and clinical outcomes of carbapenem-resistant Pseudomonas aeruginosa and associated carbapenemases (POP): a prospective cohort study. The Lancet Microbe, 4(3), e159-e170.
26.siam, Morsalin sarker; Faiza, Ariya Tasnim (2025), “Antibiotic Resistance Tracking Dataset ”, Mendeley Data, V2, doi: 10.17632/h4byb28gcv.2
27.Taha, R., Mowallad, A., Mufti, A., Althaqafi, A., Jiman-Fatani, A. A., El-Hossary, D., ... & Jawi, N. H. (2023). Prevalence of carbapenem-resistant Enterobacteriaceae in Western Saudi Arabia and increasing trends in the antimicrobial resistance of Enterobacteriaceae. Cureus, 15(2).
28.Wang, M., Earley, M., Chen, L., Hanson, B. M., Yu, Y., Liu, Z., ... & Zhang, F. (2022). Clinical outcomes and bacterial characteristics of carbapenem-resistant Klebsiella pneumoniae complex among patients from different global regions (CRACKLE-2): a prospective, multicentre, cohort study. The Lancet Infectious Diseases, 22(3), 401-412.
29.Wu, C., Xiong, L., Liao, Q., Zhang, W., Xiao, Y., & Xie, Y. (2024). Clinical manifestations, antimicrobial resistance and genomic feature analysis of multidrug-resistant Elizabethkingia strains. Annals of Clinical Microbiology and Antimicrobials, 23(1), 32.
Published
2026-08-29
How to Cite
Prof. Ayodele Oluwaseun Ajayi, Prof. Dwij Raj Bhatta, Ayush Kumar, & Dr. Inshad Ali Khan. (2026). PHENOTYPIC ANTIMICROBIAL RESISTANCE PATTERNS AND RESISTANCE GENE DISTRIBUTION ACROSS CLINICAL SPECIMENS: ASSOCIATIONS WITH PATIENT CHARACTERISTICS AND CLINICAL OUTCOMES. IJRDO - JOURNAL OF BIOLOGICAL SCIENCE, 12(3), 152-167. https://doi.org/10.69980/bs.v12i3.6819
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