Background: Carbapenem family are from the recently synthesized beta-lactam antibiotics which used as last resort antibiotics for treating infections caused by multidrug-resistant Gram-negative bacilli and the resistant to them by Gram-negative bacilli have been developed, due to production of variety of carbapenemase enzymes and other mechanisms that significantly limits treatment options for life-threatening infections.
Bedsores remain a significant healthcare concern, it is one of the most dominant problems reported by patients with mobility limitations, sometimes, it can even be life threatening, its treatment imposes financial burdens on patient's family and society. The aim of this study was to determine prevalence and antimicrobial susceptibility pattern of aerobic bacteria that causes the bedsores infection in Sudanese patients. Methods: A total of 57 bedsores swabs specimens were collected from patients with bedsores infection due to prolonged bed lying in ICUs from various hospitals in Khartoum State during the period from December 2019 to February 2020. Isolation and identification of culture isolates was done using standard bacteriological techniques and antimicrobial susceptibility testing was performed using Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute guidelines. Out of 57 patients enrolled in the study, the prevalence of bedsores in ICUs patients was 50/57 (87.7%) Both Gram positive cocci and Gram negative bacilli were isolated from 50 patients out of 57 patients. Among the Gram negative isolates, Pseudomonas aeruginosa had the highest frequency 15/41 (36.5%), followed by Klebsiella spp 12/41 (29.2%) and Escherichia coli 4/41 (9.7%). The frequencies of Citrobacter freundii, Proteus spp and Salmonella spp, Acinetobacter baumannii were 3/41 (7.3%) and 2/41 (4.8%) respectively. The only gram positive cocci isolated was Staphylococcus aureus. The distribution of bedsores among the ages of the ICUs patients showed that age group within the range of 66-80 years recorded the highest incidence of bedsore infection. The most common site of bedsores was sacral region 36/50 (72%) followed by neck 5/50 (10%). All isolated Staphylococcus aureus showed 100% resistance to Penicillin and Oxacillin but showed variable susceptibility to other antibacterial used. Pseudomonas aeruginosa was resistant to Co-trimoxazole 13/15 (86.7%), Ciprofloxacin, and Ceftazidime 12/15 (80%). The results showed that all isolated bacteria considered multi-drug resistance organism (MDROs) except few strains of Pseudomonas aeruginosa 2/15 (13.3%) and Citrobacter freundii 1/3 (33.3%). The overall prevalence of bedsores in this study was relatively high with Pseudomonas aeruginosa as the major causative agents. Multi-drug resistance of 50/53 (94.3%) was observed among the isolated bacteria.
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