Antimicrobial Resistance Patterns among Bacterial Isolates Causing Bloodstream Infections in a Tertiary Care Hospital in Khartoum State, Sudan

Abstract

Background: Bloodstream infections (BSIs) are still a cause of sickness and death all over the world and are one of the most serious types of infections. The treatment of BSIs is getting harder because of the growing problem of resistance. Objective: To detect the patterns of resistance among the bacteria that cause bloodstream infections in a tertiary care hospital in Soba locality, Sudan. Methods: A descriptive cross-sectional study was done in a tertiary care hospital in Soba locality, from September to October 2021. A total of 51 blood samples were taken from patients who were thought to have BSIs. Bacterial identification was done using the Analytical Profile Index (API) system. Antimicrobial susceptibility testing was done with the Kirby–Bauer disk diffusion method and results were read based on Clinical and Laboratory Standards Institute (CLSI) guidelines. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) version 23. Results: Out of the 51 isolates Gram-negative bacteria were the most common (94.1%) while Gram-positive bacteria were 5.9%. Acinetobacter baumannii and Enterobacter cloacae were the often-found organisms each making up 19.6% followed by Pseudomonas aeruginosa (11.8%) Klebsiella pneumoniae (9.8%) and Escherichia coli (7.8%). In total 28 (54.9%) isolates were classified as multidrug- MDR) 6 (11.8%) were classified as extensively drug-resistant (XDR) and 4 (7.8%) were classified as pandrug-resistant (PDR) while 13 (25.5%) were sensitive to all antibiotics tested. The highest resistance among the agents tested was seen with amoxicillin–clavulanate (84.0%) followed by ceftazidime (57.6%) and ceftriaxone (55.6%). Pseudomonas aeruginosa had the number of MDR isolates within the species (83.3%) while Acinetobacter baumannii and Enterobacter cloacae were main causes of the overall resistant bacterial load. Conclusion: A big problem with resistance was found among the bacteria that cause BSIs in the hospital studied. The high number of MDR plus the presence of XDR and PDR isolates and high resistance to antibiotics show the urgent need for ongoing surveillance of antimicrobial resistance, better use of antibiotics, and better ways to prevent and control infections to improve treatment and stop more resistant bacteria from spreading