Detection of Extended Spectrum Beta-lactamase amongst Bacteria Isolated from Patients in El Obaied Teaching Hospital

Abstract

Antimicrobial resistance was recognized as an increasingly global problem. The objective of this study was to detect the extended spectrum βeta-lactamas )ESBLs) among pathogenic bacteria isolated from El-obied Teaching Hospital. A total of 100 clinical specimens were collected. These were 24 wound swabs and 76 urine. The specimens were collected from both males and females. The age of participants was range from 4-65 years. The specimens were cultured on MacConkey agar, Cystine-Lactose-electrolyte deficient agar (CLED) and Blood agar media. The isolates were identified by colonial morphology, Gram stain and biochemical tests. The isolated bacteria were subjected to antimicrobial sensitivity testing. The presence of ESBLs production was detected by Double Disk Synergy Test and Combined Disk Method. The specimens that gave growth were 60 (60%); while 40 (40%) showed no bacterial growth. 40/60 organisms (66.7%) were isolated from urine specimens, and 20/60 organisms (33.3%) were isolated from wound swabs. Klebsiella pneumoniae was the commonest pathogen (15.7%) among urine isolates; while Proteus species was the predominant pathogen (37.5%) in wound isolates. Out of 28 bacterial isolates resistant to third generation cephalosporin, only ten (35.7%) were found to be positive for ESBL when tested by Double Disk Synergy Test (DDST) and 15(53.6%) by Combined Disc Method (CDM). The majority of ESBL producers were isolated from urine (n=13/ 86.6%) followed by wound swabs (n=2/13.3%) and E. coli was the most ESBLs producers. of the positive ESBLs producer (16%) were obtained from males and (31.4%) from females, the frequency of ESBLs producer among the age groups were 37.5% in Children, 29.7% in Adult and 6.7% in Elderly. The study concluded that there is high ratio of ESBLs among isolated bacteria in El-obied, Sudan. The most ESBLs producer is E. coli. All ESBLs producers are sensitive to impenem. Further studies using large number and advanced techniques are required to validate the result of this study.