Introduction
The high prevalence of urinary tract infections (UTIs) and rising resistance to beta-lactam antibiotics, which is a global therapeutic concern, are caused by
Escherichia coli
(
E. coli
) extended-spectrum beta-lactamases (ESBLs) producers. It is unclear how
E. coli
that produces ESBLs spreads throughout Gezira state, Sudan. The study aimed to evaluate the dissemination of class A and class D resistance genes among
E. coli
and to recognize the antibacterial activity of the locally used cephalosporins and carbapenems.
Methods
One hundred and fifteen isolates of uropathogenic
E. coli
were collected from patients who attended a tertiary hospital. The isolates were identified using colony morphology, gram staining, and biochemical tests and checked for 16S rRNA using PCR. The multidrug-resistant (MDR) testing was conducted using agar disk diffusion. Finally, the class A and D resistance genes were analyzed by multiplex PCR.
Results
The study enrolled 200 patients with UTIs.
E. coli
isolates were found in 115 (57.5%) urine specimens examined, and 60 (52.2%) of them produced resistance to most locally used antibiotics. The antibiotic resistance pattern was higher against cefepime (100%), ceftizoxime (90%), cefuroxime (81.7%), and ceftriaxone (81.7%) and had lower activity against meropenem (13.3%). The genotypic characterization of class A cephalosporinases was 85% for
bla
CTX-M
, 70% for
bla
SHV
, and 33.3% for
bla
TEM
, while for class D carbapenemases, it was 10% for both
bla
OXA-23
and
bla
OXA-51
.
Conclusion
The considerable antibiotic resistance to the cephalosporins and meropenem and the increased predominance of the
bla
CTX-M
and
bla
SHV
genes are serious concerns for the health authorities. Meropenem could still be used as the drug of choice for ESBL-producing
E. coli
.