Abstract
Background: Carbapenems are used as antibiotics of last resort for treating infections due to multidrug-resistant Gram-negative bacilli, but emergence of Carbapenem resistant Gram-negative bacilli have been reported due to the production of Carbapenemase enzymes that significantly limits treatment options for life-threatening infections.Objective: This study aimed to detect Carbapenem resistant Gram-negative bacilli from patients attended to different hospitals in Khartoum state and to detect Carbapenemase enzymes production by phenotypic and genotypic methods.Methods: A hospital based cross sectional study was conducted in Khartoum state in the period from February to August 2016. Hundred and forty nine Gram-negative bacilli bacteria were isolated from different clinical specimens. Blood agar, Chromogenic agar media, MacConkey agar, XLD mediaandstandard biochemical tests were used for isolation and identification of Gram-negative bacilli from different samples. Standard antimicrobial susceptibility testing to Carbapenem antibiotic was performed for all isolates, then detection of Carbapenemase enzymes production for the resistant isolates was performed usingModified Hodge Test and PCR.Results: Hundred and forty nine Gram-negative bacilli were isolated from 147 different clinical specimens. The most predominant Gram-negative bacilli isolates was E.coli(54.4%), followed byKlebsiellaspecies (29.5%). More than fifty percent of the isolates were Carbapenem resistant. Fifty six percent of the resistant isolates were positive by Modified Hodge Test. By using PCR, 17.3% of resistant organisms were harbored blaOXA48gene, and 6.7% harbored blaIMPgene.E.coliwas the most bacteria that harbored the blaoxa48followed byKlebsiellaspecies. blaIMPgene was harbored only byE.coli.Conclusion: The percentage of resistance to Carbapenems due to production of Carbapenemase enzymes is very high in Sudan.BlaOXA48gene is more predominant than blaIMPin this study.
Highlights
The percentage of resistance to Carbapenems due to production of Carbapenemase enzymes is very high in Sudan.BlaOXA48 gene is more predominant than blaIMP in this study
Carbapenems are beta-lactam antibiotics often used as last resort antibiotics for treating infections caused by multidrug resistant Gram-negative bacilli, since they have the broadest spectra among all beta-lactams1,2. carbapenemases represent the most versatile family of beta-lactamases[3]
One hundred and forty nine Gram-negative bacilli were isolated from 147 different clinical specimens that were collected from patients attending different hospitals in Khartoum state
Summary
Carbapenems are beta-lactam antibiotics often used as last resort antibiotics for treating infections caused by multidrug resistant Gram-negative bacilli, since they have the broadest spectra among all beta-lactams1,2. carbapenemases ( known as carbapenem hydrolyzing enzymes) represent the most versatile family of beta-lactamases[3]. Carbapenems are beta-lactam antibiotics often used as last resort antibiotics for treating infections caused by multidrug resistant Gram-negative bacilli, since they have the broadest spectra among all beta-lactams. Carbapenemases ( known as carbapenem hydrolyzing enzymes) represent the most versatile family of beta-lactamases[3]. Broad-spectrum OXA enzymes are able to hydrolyze carbapenems. Objective: This study aimed to detect Carbapenem resistant Gramnegative bacilli from patients attended to different hospitals in Khartoum state and to detect Carbapenemase enzymes production by phenotypic and genotypic methods. Hundred and forty nine Gram-negative bacilli bacteria were isolated from different clinical specimens. Standard antimicrobial susceptibility testing to Carbapenem antibiotic was performed for all isolates, detection of Carbapenemase enzymes production for the resistant isolates was performed using Modified Hodge Test and PCR. E.coli was the most bacteria that harbored the blaoxa[48] followed by Klebsiella species. blaIMP gene was harbored only by E.coli
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