Detection of Extended-spectrum β-lactamases amongst Bacteria Isolated from Patients in Atbara Teaching Hospital

Abstract

Resistance to beta lactam antibiotics considered a big world health problem worldwide. The objective of this study was to detect the production of extended-spectrum beta-lactamases in clinical isolates in Atbara Teaching hospital. A total of 100 clinical specimens were collected. These specimens were cultured on Cysteine lactose electrolyte deficient (C.L.E.D), MacConkey agar, blood agar, mannitol salt agar for primary isolate of pathogenic bacteria. Then identified depending on their colonial morphology, Gram reaction and biochemical reactions. These isolates were tested for susceptibility for several antibiotics by disc diffusion technique, seventy bacterial isolated, 50 isolates from urine specimens and 20 isolates from wound swabs, collected from both gender males and females and their age ranged from 10-70 years old. These specimens showed an isolation of 28 E. coli, 12 K. Pneumoniae, 20 S. aureus and 10 P. aeruginosa. The most frequent isolated organism from the urine specimens was E. coli with (56%=28/50), K. Pneumoniae (14%=7/50), S. aureus (30%=15/50) and P. aeruginosa (0%) The most common isolates in the wound swabs was the P. aeruginosa (50%=10/20), K. Pneumoniae (25%=5/20), S. aureus (25%=5/20) and E. coli (0%). In this study, imipenem was found to be the most effective antibiotic against all tested isolates where the resistant level (0%), and sensitive level (100%), then amikacin have sensitive level (92.9%) and resistant level (7.1%), gentamicin have sensitive level (57.1%) and resistant level (42.9%), ciprofloxacin have sensitive level (41.4) and resistant level (58.6%). The highest level of drug resistant by bacterial isolates was observed with cephalosporins, cefixime (94. %) ceftazidime (91.4%) and ceftriaxone (77.1%). The isolates were tested for extended-spectrum-beta–lactamases production by the Modified Double Disc Synergy test (MDDST) Result were 23(57.5%) positive to ESBL production and by CLSI Confirmatory disk diffusion method, 21(52.5%) were positive result. The ESBL producing bacteria showed an in significant relation with the gender and specimens by two methods. This study concluded that there is a high resistance is a common phenomenon with a high percentage, must be taken in consideration by the ministry health of Sudan, and any large organization that can help in the control and prevention of β lactamases production such as the World Health organization.