Background: One of the biggest threats to world health is antibiotic resistance, especially in areas with little resources. In this work, bacterial isolates from Hayatabad Medical Complex (HMC), Peshawar, were molecularly profiled for resistance genes in order to assess the incidence of antibiotic resistance.

Objectives: The research aimed to ascertain the prevalence of multidrug-resistant (MDR) bacterial isolates and to detect the presence of important antibiotic resistance genes in these isolates.

Methods: A one-year cross-sectional investigation containing 210 bacterial isolates from different clinical samples (blood, urine, sputum, and wound swabs) was carried out, concluding in March 2024. To test for antibiotic susceptibility, the Kirby-Bauer disk diffusion technique was used. PCR was used to do molecular profiling of resistance genes, such as blaCTX-M, blaNDM-1, mecA, and others. To assess the relationship between resistance genes and phenotypic resistance patterns, statistical analysis was done.

Results: According to the research, 42% of the bacterial isolates were MDR and 65% of the isolates showed resistance to at least one class of antibiotics. The most prevalent kind of resistance was to β-lactams, especially in Klebsiella pneumoniae and Escherichia coli. Using molecular profiling, it was possible to identify blaNDM-1 in 10% of Klebsiella pneumoniae and 7% of Pseudomonas aeruginosa, and blaCTX-M in 48% of E. coli and 40% of Klebsiella pneumoniae. Antibiotic resistance patterns and the existence of resistance genes were shown to be significantly correlated (p < 0.01).

Conclusion: The high frequency of multidrug resistance and the significance of molecular diagnostics in the treatment of antibiotic resistance are highlighted by this research. Improved antibiotic stewardship and ongoing molecular monitoring are desperately needed.