Phenotypic Detection of Extended-spectrum Beta-lactamases amongst bacteria isolated from patients in Elmak Nimir Teaching Hospital- Shendy

Abstract

The resistance to the antibiotics is a world-wide health problem, Beta-lactam antibiotics are the most common used antibiotics for several systemic infections. Production of these enzymes lead to failure of treatment and longer hospital stay. The objective oh this study was to detect the production of extended-spectrum-beta-lactamases in clinical isolates from Elmak Nimir Teaching Hospital in Shendy. A total of 100 clinical specimens were collected, these specimens were 67urine specimen, 18 wound swabs and 15 ear swabs. The specimens were collected from both males and female, and the age range was from 10 to 70 years old. These specimens were cultured on MacConkey agar, mannitol salt agar and cysteine lactose electrolyte deficient (C.L.E.D) to isolate a pure clinical isolates. Then identified according to their colonial morphology, gram reaction and biochemical reactions. These isolates were tested for susceptibility for several antibiotics by disc diffusion technique. And then double disc confirmatory test to detect the production of extended-spectrum-beta-lactamases. These specimens showed an isolation of 66 E.coli, 23 Ps. Aeruginosa, 8 K. pneuominae, and 3 S. aureus. The most frequent organisms from urine specimens were E. coli 48/67 (71.6%), Ps. Aeruginosa 14/67 (20.8%), K. pneuominae 4/67 (6%), and S. aureus 1/67 (1.5%). The most common isolate in the wound swabs were the Ps. Aeruginosa 8/18 (44.4%), E. coli 7/18 (39%), K. pneuominae 1/18 (5.5%) and the S. aureus 2/18 (11%). In the ear swabs the E. coli frequent was 11/15 (73%), Ps. Aeruginosa frequent was 3/15 (20%) and the K. pneuominae frequent was 1/15 (7%). The isolates were 100% sensitive to impeniem, 92% sensitive to gentamycin, 82% sensitive ciprofloxacin, 77% sensitive to nitrofurantion and 37% sensitive to ceftazidime. 34 out of the 100 isolates were identified as extended-spectrum-beta-lactamases by the double disc confirmatory test. This study concluded that there is high rate of antibiotic resistance, so the appropriate drug prescriptions by the physicians based on susceptibility testing, and appropriate dose uptake by the patients become necessary to decrease the evolution of antibiotic resistance.