Phenotypic and Genotypic Detection of Extended-Spectrum β-Lactamase (ESBL) among Gram-Negative Bacteria Isolated from ICUs and Surgical Operating Rooms, Khartoum- Sudan
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2026
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Abstract
Background: Extended-spectrum β-lactamase (ESBL)-producing Gram-negative bacteria are an important cause of hospital environmental contamination and antimicrobial resistance. Critical care areas such as intensive care units (ICUs) and surgical operating rooms may act as reservoirs for resistant organisms and facilitate their spread in healthcare settings.
Methods: This descriptive cross-sectional study was conducted from April to August 2021 in seven hospitals in Khartoum State, Sudan. A total of 246 environmental swabs were collected from high-touch surfaces in ICUs and surgical operating rooms. Isolates were identified using standard microbiological methods, antimicrobial susceptibility was assessed by disk diffusion, ESBL production was confirmed phenotypically by modified double-disk synergy test, and blaTEM, blaSHV, and blaCTX-M genes were detected by touchdown multiplex polymerase chain reaction.
Results: Of the 246 swabs, 86 (35%) yielded bacterial growth, producing 99 isolates, including 50 Gram-negative bacteria. Pseudomonas aeruginosa was the most common isolate (30/50, 60%), followed by Providencia spp. and Serratia spp. (each 6/50, 12%). ESBL production was confirmed in 10/50 Gram-negative isolates (20%). ESBL-positive isolates were mainly P. aeruginosa (3), Providencia spp. (3), and Serratia spp. (2), with smaller numbers of E. coli and Acinetobacter spp. Resistance among ESBL producers was highest to cefotaxime, ceftazidime, and aztreonam. Molecular testing detected blaTEM in 3/10 ESBL-positive isolates, while blaSHV and blaCTX-M were not detected.
Conclusions: ICU and operating-room surfaces in Khartoum hospitals were contaminated with ESBL-producing Gram-negative bacteria, particularly P. aeruginosa, indicating that the hospital environment may serve as a reservoir for multidrug-resistant organisms. Strengthened environmental cleaning, routine ESBL surveillance, and improved antimicrobial stewardship are needed to reduce transmission risk.
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| Authors | Abdelhakam Hassan Ibrahim Ali, Sara Adam, Hanan Sheikh, Bothaina Toom, Susan Ali Zroog, Maha Baballa |
| Journal | Yemen Journal of Medicine |
| Year | 2026 |
| DOI |
10.63475/yjm.v5i1.0360
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| URL | |
| Keywords | Keywords not found |
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