Antibiotics Profile, Prevalence of Extended-Spectrum Beta-Lactamase (ESBL), and Multidrug-Resistant Enterobacteriaceae from Different Clinical Samples in Khartoum State, Sudan

Abstract

One of the global requirements for controlling the occurrence of resistance to antimicrobial drugs is to understanding the resistivity profile of various clinical isolates. Therefore, this study aimed to deliver the indication of different resistant profiles of clinically isolated Enterobacteriaceae from different sources of samples from Khartoum state, Sudan, and to determine the prevalence rate of extended-spectrum beta-lactamase (ESBL), multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) bacteria. A total of 144 Gram-negative bacteria were collected from different sources (vaginal swab, urine, catheter tip, sputum, blood, tracheal aspirate, pus, stool, pleural fluid, and throat swab). Samples were subcultured and identified according to their cultural characteristics and biochemical tests. Antimicrobial susceptibility test was performed for twenty-four antibiotics from eleven categories against all isolated Enterobacteriaceae according to the recommendation of Clinical and Laboratory Standards Institute (CLSI). The result showed that out of 144 isolates, Escherichia coli and Klebsiella pneumoniae were predominant isolates with the percentage of 47.9 and 25%, respectively. The prevalence of ESBL was higher in K. pneumonia (38.9%) than E. coli (34.8%). All isolated E. coli were sensitive to nitrofurantoin and tigecycline. There was a high prevalence of MDR Enterobacteriaceae, and only one isolate was XDR, while PDR was zero for all isolated bacteria. Active antimicrobial-resistant (AMR) observation through constant data sharing and management of all stakeholders is crucial to recognize and control the AMR global burden. Also, effective antibiotic stewardship procedures would be applied to limit the unreasonable expenditure of antibiotics in Sudan.

ESBL Activity, MDR, and Carbapenem Resistance among Predominant Enterobacterales Isolated in 2019

“…In the present study, K. pneumoniae, E. coli, and P. mirabilis were the major Enterobacterales isolated during the study period. These findings are in accordance with earlier studies from Saudi hospitals and countries in the MENA region [ 20 , 26 , 27 ]. These microorganisms have achieved remarkable antimicrobial resistance and have been increasingly recovered from various clinical samples [ 27 ].…”

“…Similarly, another study from the neighboring country of Sudan reported E. coli and K. pneumoniae as the most commonly isolated Enterobacterales . E. coli was reported as a frequent MDR isolate, whereas ESBL activity was more frequent in K. pneumoniae [ 27 ]. These reports are in accordance with our results on the most common bacterial isolation and ESBL activity, with a slight variation in MDR prevalence among the two bacteria.…”

Antimicrobial Stewardship Program Implementation in a Saudi Medical City: An Exploratory Case Study

“…These should be considered when evaluating ASP outcomes. It is also important that hospitals monitor resistant rates, especially those of MDR, to target efforts to curb it [ 33 ]. Interesting perspectives are emerging, calling for a radical rethinking of what antimicrobial stewardship programs should entail, such as Vickers et al calling for innovative commercial models to stimulate novel antimicrobial development, and integrating rapid diagnostics and infection control practices within the program [ 34 ].…”

Genomic characterization of multidrug-resistant extended spectrum β-lactamase-producingKlebsiella pneumoniaefrom clinical samples of a tertiary hospital in South Kivu Province, eastern Democratic Republic of Congo

“…According to data from Asia, Latin America, Europe, and Africa, the dramatic increase in third-generation cephalosporin resistance in Enterobacteriaceae is mainly due to the spread of bla-CTXM-15 ESBL (3)(4)(5),with bla CTXM-15 being the most common ESBL gene worldwide (6,7). While most studies of MDR ESBL-producing Enterobacteriaceae have focused on Escherichia coli (8)(9)(10)(11)(12)(13)(14)(15), few studies have characterized the whole genome of MDR ESBL-producing Klebsiella pneumoniae, even though this agent is one of the most widespread MDR ESBL-producing Enterobacteriaceae associated with extra-intestinal infections both in hospital and community settings (16)(17)(18)(19)(20)(21). Moreover, several strains of K. pneumoniae have been linked to multinational epidemics all over the world (21,22).…”