Detection of Extended Spectrum Beta-Lactamase (ESBLs) among Urinary Tract Patients in Khartoum State, Sudan

Abstract

Background: Many different organisms can cause urinary tract infections, but Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis, and Staphylococcus saprophyticus are the most prevalent ones. 60% of all antibiotics used to treat infectious diseases around the world are beta-lactam antibiotics, one of the main classes used to fight gram-negative and gram-positive bacteria. Objective: The purpose of this study is to detect and isolate Extended-Spectrum Beta-Lactamases (ESBLs), which are responsible for urinary tract infections, as well as check for any potential medication resistance. Materials and Methods: The gram stain technique and biochemical assays were used to identify 100 urine samples from Khartoum state hospitals based on their cultural characteristics and morphological appearance. Using the disk diffusion method, the isolates were tested for antimicrobial susceptibility to third-generation cephalosporins (Cefotaxime, Ceftazidime, and Ceftriaxone). The Combination Disk Technique (clavulanic acid+third-generation cephalosporins) was used to inoculate the bacterial isolates to demonstrate their capacity to create ESBL. In comparison to non-ESBL producers, the ESBL producers were assessed. Results: E. coli, Klebsiella, S. aureus, Proteus, and Pseudomonas were among the microorganisms isolated from UTI patients. 61% of the participants in this study were female, whereas 39% were male. E. coli has an increased frequency among isolated bacteria, as it presented in 46% of urine cultures, followed by pseudomonas and Klebsiella, each with a 22% frequency. Growth of the majority of the bacteria was found among females more frequently than males, and it also seems to be among older age patients than younger. Amoxyl alone and in combination with Clavulanic Acid (AAMC) was the most medicine that bacteria were resistant to (76%), but Ceftriaxone (CTR) has higher sensitivity (45%) and resistance (50%). The growth of the bacteria in the media of antibiotics was sorted into sensitive, intermediate, and resistant. Conclusions: Tested antibiotic resistance was higher for AAMC than for CTR, which is typically taken without performing urine sample culture and sensitivity testing, which over time leads to increased resistance.