Frequency of Enterobacter cloacae in Clinical Specimens and its Antimicrobial Resistance

Abstract

This study was carried out in Khartoum State during the period from November 2008 to December 2008, to isolate Enterobacter cloacae from urine and wound specimens and to determine its antimicrobial resistance. Two hundred and two urine specimens and one hundred and twelve wound specimens were collected from patients suffering from UTI and wound infections. The specimens were cultured on MacConkey's agar and blood agar for primary isolation of the pathogen. Identification of the isolates was done by colonial morphology, Gram's stain and biochemical tests using API 20 E. Modified Kirby-Bauer disc diffusion method was adopted to determine the resistance rate of Enterobacter cloacae to antimicrobial agents. Minimum inhibitory concentrations of amoxicillin, co-trimoxazole, amoxyclav, ciprofloxacin, ticarcillin, amikacin, and ceftriaxone were determined by E.test. Out of three hundred and fourteen urine and wound specimens investigated, only 13 (4.1%) Enterobacter cloacae isolated. Out of these 7(3.5%) were isolated from urine specimens and 6(5.4%) were isolated from wound specimens. ThThe results revealed that the antimicrobial resistance profile of Enterobacter cloacae isolated from urine specimens was as follows: (100%) to amoxicillin and amoxyclav, (71.4%) to co-trimoxazole, (57.1%) to nalidixic acid and (14.3%) to nitrofurantoin. In wound specimens the resistance rate was (100%) to amoxicillin, (50%) to ticarcillin, (33.3%) to ceftriaxone and (0%) to amikacin and ciprofloxacin . The result indicated that the MIC, MIC 50 and MIC90 respectively were as follows:- co-trimoxazole (0.1->240μg/ml, >240μg/ml and >240μg/ml ), amikacin (0.1-0.5μg/ml, 0.5μg/ml and 0.5μg/ml ), ciprofloxacin (0.001-240μg/ml, 0.001μg/ml and 120μg/ml ), ceftriaxone ( 0.008- 120μg/ml, 0.008μg/ml and >60μg/ml and and 1μg/ml ), ticarcycline ( 2->240μg/ml, >60μg/ml ), amoxicillin ( 30->240μg/ml, >240μg/ml >240μg/ml ) and amoxyclav ( >240μg/ml, >240μg/ml and >240μg/ml ). The study concluded that there is a detection to the responsibility of E. cloacae as a causative agent of UTI and wound infections in Sudan. The antimicrobial resistance of E. cloacae was high.