Frequency of Metallo-β-lactamase amongst Gram-negative Bacteria Isolated from Patients with Urinary Tract Infection in Hospitals, Khartoum State

Abstract

The resistance to Beta-lactam antibiotics is considered a big health problem worldwide. The objective of this study was to determine frequency of metallo-beta lactmase producer bacteria among patients with urinary tract infection. A total of 100 urine specimens were collected from both male and female patients admitted to Royal Care International Hospital with symptoms of urinary tract infection. The age of patients is more than 20 year old. The specimens were cultured on Cysteine lactose electrolyte deficient agar, MacConkey agar, blood agar and mannitol salt agar for primary isolation of pathogenic bacteria. The identification of the isolates was done by colonial morphology, Gram stain and biochemical tests. Identified bacteria were tested for susceptibility to antibiotics by disc diffusion technique. Metallo-Beta-lactmase was detected by combined disk diffusion method. Out of 100 urine specimens 65 (65%) were yielded bacterial growth and 35(35) were failed to yield any bacterial growth. The frequency of bacteria isolated were as follows Escherichia coli 34 (52%), Klebsiella pneumoniae 12 (19%), Pseudomonas aeruginosa 8 (16%), Proteus spp 4 (6%), Staphylococcus aureus 2 (3%), Serratia marcescens 2 (3%), Acinetobacter baumannii 2 (3%) and Klebsiella oxytoca 1 (1%). In this study, imipenem was found to be the most effective antibiotic (94%) against all the tested bacteria, followed by Amikacin (52%), Tobramycin (52%), Ciprofloxacin (45%), Ceftriaxone (77%), Nitrofurantin (78%), Amoxicillin/ clavulanic acid (17%) and Ceftazidim (25%). The frequency of metallo-beta lactmase bacteria was 5 (8%). This study concluded that there is high rate of multi-drug resistance bacteria. The most common bacteria that cause UTI were Gram negative (e.g. Escherichia coli). The frequency of metallo-beta lactmase among isolated bacteria was low. Further studies with large sample size is required to validate the result of the present.