VacciMonitor (Jul 2019)
Distribution of extended-spectrum beta-lactamase TEM and CTX-M resistance genes among Proteus species Isolated in Sudan
Abstract
Proteus species are found in the human intestinal tract as part of normal flora. Proteus species are also found in multiple environmental habitats, including long-term care facilities and hospitals, and can cause both community and nosocomial infections. For a long time Proteus was known to be susceptible to beta-lactam antibiotics but nowadays they become resistant. The aim of this study was to detect the Extended-spectrum beta-lactamase (ESBL) TEM and CTX-M genes in 90 Proteus species isolated from urine and wound swabs, obtained from different hospitals in Khartoum state, Sudan, from January to August 2018. Antimicrobial sensitivity was carried out using the following set of antibiotics: amoxiclav, ceftazidime, gentamicin, meropenem, cefotaxime, ciprofloxacin, amoxicillin, ceftriaxone and cotrimoxazole. ESBL producing strains were detected by double disc diffusion synergy test and the resistance genes TEM and CTX-M were detected by Polymerase Chain Reaction (PCR). Antibiotic resistance was found: amoxicillin 40%, ceftazidime 25.6%, ceftriaxone 23.3%, gentamicin 22.2%, cotrimoxazole 21.1%, and cefotaxime 18.9%. Most of the isolates were sensitive to meropenem 92.2% and ciprofloxacin 86.7%. In double-disk diffusion synergy test, 20 isolates (22.2%) were found to be positive for ESBL. The PCR demonstrated that TEM gene was present in 18 isolates (90%). It was present alone in 11 isolates (55%) and in combination with CTX-M gene in seven isolates (35%). The percentage of ESBL producing strains of Proteus was 23.5%. This percentage is a bit lower than in previous studies in Sudan. In conclusion; it seems that the CTX-M gene is emerging among Proteus species in Sudan.
