The Emergence of Carbapenem Resistant Producing GIM-1 and SIM-1 Clinical Isolates in Khartoum-Sudan.

PURPOSE

The aim of this study was to detect multidrug resistant GIM-1 and SIM-1 producing clinical isolates from hospitalized patients across three Khartoum State Teaching Hospitals, Sudan.

PATIENTS AND METHODS

From May 2018 to October 2019, clinical isolates from inpatients admitted to different Khartoum state hospitals. Genes for carbapenemase (GIM-1 and SIM-1) were amplified by polymerase chain reaction (PCR). Agar dilution method was used to determine MICs for imipenem and meropenem after antimicrobial susceptibility testing.

RESULTS

Five (1.29%) isolates of [2 (0.51%) isolates produce GIM-1, 2 (0.51%) isolates (one [0.25%] of each produce of GIM-1 and of SIM-1), and 1 (0.25%) isolate produce GIM-1]. Susceptibility profiling of the isolates showed a low-level resistance to imipenem and meropenem MICs (8, 16 and 32 μg/mL). It also had resistance to ampicillin, extended-spectrum cephalosporin's, aztreonam, and amoxicillin-clavulanate and with the two strains showing resistance to colistin.

CONCLUSION

We report the emergence of four GIM-1 producing strains and one strain of SIM-1 producing genes, isolated from hospitalized patients, with a high resistance pattern to antimicrobial agents. Whole-genome sequencing (WGS) is necessary for precise identification of clonal diversity backgrounds of acquired carbapenemase genes in diagnostic laboratories as the number of cases of carbapenem resistant infection increases annually.