Abstract
BackgroundThe increased prevalence of carbapenem-resistant Gram-negative isolates caused by Metallo-β-lactamase (MBL) is worrisome in clinical settings worldwide. The mortality rate associated with infections caused by MBLs producing organisms ranging from 18 to 67%.This study aimed to determine the prevalence of Metallo-β-lactamase genes among some Gram-negative clinical isolates (Carbapenems susceptible and resistant).MethodsThis paper describes a descriptive cross-sectional study carried out to detect MBL genes such as (blaVIM, blaIMP and blaNDM) by multiplex PCR mixture reaction among 200 Gram-negative clinical isolates (Citrobacter spp, Escherichia coli, Enterobacter spp, Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis, Proteus valgaris). Khartoum hospitals during 2015 to 2016.Limitation: The study organisms were not evaluated for non-MBL carbapenemases, such as KPC and OXA-48.ResultsThe prevalence of MBL genes by multiplex PCR assays among 200 Gram-negative clinical isolates was 72(36.1%). MBL positive genes among 100 carbapenems sensitive and 100 resistant isolates were 27(27%) and 45(45%) respectively. There was a statistically, significant association between the antimicrobial susceptibility and the presences of MBL genes (P.value = 0.008).E.coli was the predominant species possessing MBL genes 26(36.1%), with 22(30.7%) species having a combination of MBL genes.Verona integron Metallo beta-lactamase (VIM) was the most frequent genes 28(38.9%) out of 72 MBL detected genes, followed by imipenemase (IMP) was 19(26.4%), and consequently, New Delhi Metallo beta lactamase was 3(4.2%).ConclusionThis study revealed a high prevalence of MBL genes in some Gram-negative isolates from Khartoum State Hospitals which were not previously established in these hospitals.
Highlights
The increased prevalence of carbapenem-resistant Gram-negative isolates caused by Metallo-βlactamase (MBL) is worrisome in clinical settings worldwide
The MBL genes were heterogeneously distributed among the different species of Gram-negative isolates, with 22(30.7%) species having a combination of MBL genes
In general data on the dissemination of antimicrobial genes on sub-Saharan Africa is scarce, especially regarding the prevalence of MBL genes [28]. This is not the first report of the presence of MBL encoding genes in Khartoum state, Sudan, a number of studies have been carried out, including a detection of IPM types in Pseudomonas aeruginosa performed by Abdelrazig and her colleague [16], New Delhi Metallo- βlactamase (NDM) mediated carbapenem resistance was recently described by Mohamed et al [29]
Summary
The increased prevalence of carbapenem-resistant Gram-negative isolates caused by Metallo-βlactamase (MBL) is worrisome in clinical settings worldwide. This study aimed to determine the prevalence of Metallo-β-lactamase genes among some Gram-negative clinical isolates (Carbapenems susceptible and resistant). NDM-producing bacteria were first isolated from a Swedish resident who contracted a urinary tract infection caused by carbapenem-resistant K.pneumoniae while he was in New Delhi in late 2007 [11,12,13]. The NDM gene later emerged in Pakistan, Indian subcontinent and the United Kingdom. It represents a serious threat of rapid dissemination of multiple antibiotic resistance [4, 12, 14]
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