Phenotypic Detection of Extended Spectrum β – Lactamases in Gram Negative Bacilli among Hospitalized Pregnant Women - Omdurman

Abstract

This study was conducted to detect Extended Spectrum β- Lactamase (ESBL) in Gram negative bacilli causing urinary tract infection in hospitalized pregnantwomen, who admitted toOmdurman Maternity Hospital, Omdurman New Hospital (Al- Saudi Hospital) and Omdurman Military Hospital (Obstetrics and Gynaecology department) between April and July 2015. One hundred and fifty (n= 150) urine samples were collected andcultured on CLED media for primary isolation. Gram stain and conventional biochemical tests were used to identify the causative agents. Antimicrobial susceptibility test was performed usingModified Kirby-Bauer method and Double Disc Synergy Test (DDST)to determine ESBL production in Gram negative bacilli isolates. Positive urine cultures were reported in 33(22%)of pregnant women,among which 7.3% were symptomatic and 14.7% were asymptomatic. Mostcommon isolateswereE. coli (36.4%) followed by Staphylococcus spp, accounting 27.3%.E. faecalis, K. pneumoniaeand K. oxytoca were less common; represented18.2%, 12.1% and 6.0%, respectively.Among Gram negative bacilli isolates, ESBL was detected in 8 isolates (44.4%). Of these;E. coliaccounted75% and K. pneumoniaeaccounted 25%. Imepemen was the most effective antibiotic for Gram negative bacilli.Thatshowed100% sensitivefollowed by a little resistance pattern for Ciprofloxacin (22.2%); while other antibiotics showed moderate antimicrobial effects.Ceftazidime, Cefotaxime, Ceftriaxone andCo-trimoxazole. Gram negative bacilli showed resistance of 55.6%, 61.1%, 61.1% and 66.7%, respectively. Cefuroxime and Amoxicillin were the lowest effective antibiotics for Gram negative isolates. Resistances were 100% and 83.3%, respectively. This study revealed that there is a need to apply urine culture and sensitivity test to assess urinary tract infection (UTI) among hospitalized pregnant women and detection of resistant bacteria like ESBL Gram negative bacilli. This will help these patients to get safe and effective treatment.