Dissemination of Class A Cephalosporinases and Class D Carbapenemases in Escherichia coli Isolates From a Tertiary Hospital in Sudan.

Abstract

Introduction The high prevalence of urinary tract infections (UTIs) and rising resistance to beta-lactam antibiotics, which is a global therapeutic concern, are caused by Escherichia coli (E. coli) extended-spectrum beta-lactamases (ESBLs) producers. It is unclear how E. coli that produces ESBLs spreads throughout Gezira state,Sudan. The study aimed to evaluate the dissemination of class A and class D resistance genes amongE. coliand to recognize the antibacterial activity of the locally used cephalosporins and carbapenems. Methods One hundred and fifteen isolates of uropathogenicE. coliwere collected from patients who attended a tertiary hospital. The isolates were identified using colony morphology, gram staining, and biochemical tests and checked for 16S rRNA using PCR. The multidrug-resistant (MDR) testing was conducted using agar disk diffusion. Finally, the class A and D resistance genes were analyzed by multiplex PCR. Results The study enrolled 200 patients with UTIs.E. coliisolates were found in 115 (57.5%) urine specimens examined, and 60 (52.2%) of them produced resistance to most locally used antibiotics. The antibiotic resistance pattern was higher against cefepime (100%), ceftizoxime (90%), cefuroxime (81.7%), and ceftriaxone (81.7%) and had lower activity against meropenem (13.3%). The genotypic characterization of class A cephalosporinases was 85% forblaCTX-M, 70% forblaSHV, and 33.3% forblaTEM, while for class D carbapenemases, it was 10% for bothblaOXA-23andblaOXA-51. Conclusion The considerable antibiotic resistance to the cephalosporins and meropenem and the increased predominance of theblaCTX-MandblaSHVgenes are serious concerns for the health authorities. Meropenem could still be used as the drug of choice for ESBL-producing E. coli.