Genes of Antibiotic Resistance in Gram-Negative Bacilli causing Urinary Tract Infections in Khartoum State: A Cross-sectional study

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Abstract Background The resistance of Gram-negative bacilli against antibiotics is rapidly rising worldwide, limiting the treatment options. Gram-negative bacilli are the main cause of urinary tract infections, this study aims to determine the frequent causative organisms of UTI and the pattern of their resistance to antibiotics. Materials and Methods This was a cross-sectional hospital-based study conducted at El-Amal Hospital, Bahri teaching hospital, and Al-Baraha Hospital, Khartoum state from March to October 2022. Urine samples from patients suspected to have UTI were collected and patients with confirmed UTI by laboratory investigations and yielded culture growth were enrolled. Antibiotic sensitivity testing and PCR testing of for blaTEM, blaSHV, and blaCTX-M genes was done. Results This study included 50 patients with UTI out of 229 suspected patients (21.8%). The prominent group of patients was older than 60 years 40%, the majority were females 70%. Escherichia coli was the commonest isolated organism 50%, followed by Klebsiella oxytoca 24%, Klebsiella pneumoniae 20%, Pseudomonas aeruginosa (4%), and Citrobacter feurndii (2%). organisms showed good susceptibility to colistin (17% resistance), while resistance to the rest of the antibiotics was 77% to amikacin 97.6% to cefotaxime, 96.8% to Ceftazidime, 97.6% to Ceftriaxone, 96.8 to Cefixime, 87.6 to ciprofloxacin, 88.4% to gentamycin, 62% to imipenem, 67.6% to meropenem, 87.6% to Norfloxacin, and 95.6% to Trimethoprim. Regarding genes responsible for the resistance blaTEM was the commonest 100%, followed by blaCTX-M 94% and blaSHV 84%. Conclusion Escherichia coli and Klebsiella species were the commonest isolated uro-pathogens in this study and the majority were highly resistant to most of the antimicrobial agents tested. Resistance genes blaTEM, blaCTX-M and blaSHV are very common in uro-pathogens.

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