High Prevalence of Carbapenem-resistant Klebsiella Pneumoniae in Fecal and Water Samples in Dhaka, Bangladesh

We evaluated Klebsiella pneumoniae (Kp) gut carriage in healthy, unrelated adults and children living in separate households in Dhaka, Bangladesh. Average Kp prevalence in stool samples ranged from 61% in young children (15/25) to 81% in adults (21/26), with significantly higher abundance in adults (P = .03, t-test). Kp was also prevalent in household water (64%, 21/33) and standing water (85%, 23/27). The presence of Kp in household water was not strongly linked to stool Kp abundance among household members. Antimicrobial resistance was notable: 9% (6/69) of stool and 16% (7/44) of water isolates exhibited multidrug resistance. Carbapenem resistance was observed in 12% of stool isolates (8/69) and 14% of water isolates (6/44). These findings underscore the commonality of Kp in human and environmental reservoirs in Dhaka, Bangladesh, and highlight the emergence of drug-resistant Kp beyond healthcare settings.