Detection and characterisation of Carbapenem resistant Gram-negative bacilli isolates recovered from hospitalised patients at Soba University Hospital, Sudan

Abstract

Background: Antimicrobial resistance (AMR) poses a threat to global health security. Whilst over the past decade, there has been an increase in reports of nosocomial infections globally caused by carbapenem resistant Gram-negative bacilli (GNB). This study aimed to detect and characterize carbapenem resistance Gram negative bacteria isolated from hospitalized patients in Soba University Hospital (SUH) in Khartoum State, Sudan Results: A total of 206 GNB isolates from different clinical specimens were obtained from hospitalised patients between October 2016 to February 2017. Of 206 isolates, 171 (83%) were confirmed resistant phenotypically and 121 (58.7%) isolates were positive for the presence of one or more carbapenemase genes. New Delhi metallo-β- lactamase (NDM) types were the most predominant genes, bla NDM 107(52%). Others included bla IMP 7 (3.4%), bla OXA-48 5(2.4%), bla VIM 2 (0.9%) and bla KPC 0 (0%). Co-resistance genes with NDM producing GNB were detected in 87 (81.3%) of all bla NDM positive isolates. A significant association between phenotypic and genotypic resistance was observed (P < 0.001). NDM1 was the most frequent subtype observed in 75 (70 %) isolates which cluster to the Indian lineage. Conclusions: The frequency of carbapenemase producing bacilli was found to be improperly 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