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

Abstract Background: Antimicrobial resistance (AMR) poses a complex threat to global health security and universal health coverage. Over recent decades, there has been an increase globally in reports of nosocomial infections caused by carbapenem-resistant Gram-negative bacilli (GNB). We aimed to explore the molecular characterization and detection of genes associated with carbapenem producing Gram negative bacteria isolated from hospitalized patients in Soba University Hospital (SUH) in Khartoum State, Sudan. Results: A total of 206 GNB clinical specimens were collected between October 2016 and February 2017 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%). Others included 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. NDM1 was the most frequent subtype observed in 75 (70 %) blaNDM producing isolates.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.