Detection and characterization of carbapenem resistant Gram‐negative bacilli isolates recovered from hospitalized patients at Soba University Hospital, Sudan

• DOI: 10.1186/s12866-021-02133-1
• Publication Date: 2021-05-04T07:03:09Z
• Authors: Hana S. Elbadawi; Kamal M. Elhag; Elsheikh Mahgoub; Hisham N. Altayb; Francine Ntoumi; Linzy Elton; Timothy D. McHugh; John Tembo; Giuseppe Ippolito; Abdinasir Yusuf O...; Alimuddin Zumla; Muzamil M. Abdel ...
• Keywords: 0301 basic medicine; Sulfamethoxazole; Antibiotic resistance; Carbapenemase resistant genes; FOS: Basic medicine; Cefotaxime; Ceftazidime; Trimethoprim; Hospitals, University; Sudan; Aztreonam; Endocrinology; Antibiotics; Multidrug‐resistant; Carbapenem; Dynamics and Pathogenesis of Cholera Bacteria; Ceftriaxone; Life Sciences; Hospitalized patients; QR1-502; 3. Good health; Nosocomial Pathogens: Stenotrophomonas maltophilia and Related Bacteria; Nitrofurantoin; Pseudomonas aeruginosa; Molecular Medicine; Gram negative bacteria; Research Article; Bacilli; Microbiology; beta-Lactamases; Global Challenge of Antibiotic Resistance in Bacteria; 03 medical and health sciences; Bacterial Proteins; Biochemistry, Genetics and Molecular Biology; Drug Resistance, Bacterial; Gram-Negative Bacteria; Genetics; Humans; Biology; Bacteria; Amoxicillin; Clavulanic acid; Imipenem; Carbapenems; Genes, Bacterial; Antibiotic Resistance; FOS: Biological sciences; Drug resistance; Ampicillin; Gram-Negative Bacterial Infections

Abstract Background Antimicrobial resistance (AMR) poses a complex threat to global health security and universal health coverage. Recently, nosocomial infections with carbapenemase-producing Gram-negative bacilli (GNB) is increasing worldwide. We report the molecular characterization and detection of genes associated with carbapenemase producing Gram negative bacteria isolated from hospitalized patients at Soba University Hospital (SUH) in Khartoum State, Sudan.

Results Between October 2016 and February 2017, a total of 206 GNB clinical specimens were collected from hospitalized patients in SUH. Of 206 carbapenem resistance isolates, 171 (83 %) were confirmed as phenotypically resistant and 121 (58.7 %) isolates harboured one or more carbapenemase genes. New Delhi metallo-β-lactamase (NDM) types were the most predominant genes, blaNDM 107(52 %), followed by blaIMP 7 (3.4 %), blaOXA-48 5(2.4 %) and blaVIM 2 (0.9 %). Co-resistance genes with NDM producing GNB were detected in 87 (81.3 %) of all blaNDM producing isolates. NDM-1 was the most frequent subtype observed in 75 (70 %) blaNDM producing isolates. The highest percentage of resistance was recorded in ampicillin (98 %), cephalexin (93.5 %) amoxicillin clavulanic acid (90 %), cefotaxime (89.7 %), ceftriaxone (88.4 %), ceftazidime (84.2 %), sulfamethoxazole-trimethoprim (78.4 %) and nitrofurantoin (75.2 %), aztreonam (66 %) and temocillin (64 %). A close correlation between phenotypic and carbapenemase genes detection in all GNB was observed.

Conclusions The frequency of carbapenemase producing bacilli was found to be high in SUH. NDM was found to be the most prevalent carbapenemase gene among clinical isolates. Close surveillance across all hospitals in Sudan is required. The relative distribution of carbapenemase genes among GNB in nosocomial infections in Africa needs to be defined.