Detection of Hospital Infections Related to Septicemia Among Patients Admitted to MK Nimr Hospital in Shendi City-Sudan

Abstract

Background: hospital acquired infection has become a major issue due to increased resistance around, here in Mk Nimr Hospital, as a consequences or relocation of people due to outbreak of war around the country, and diminished resources beside increased hospitalized patients, it observed that patients’ death due to HAI as gaining infection after admission navigated thought toward this study, which was conducted as a community service in order to serve patients with outcomes of laboratory work. So blood samples were aimed to be cultured, isolated bacteria underwent to identification and sensitivity for drugs. This study was approved by Medical Laboratory Science college-Alzaeim Alazhari University-Microbiology department, as well as Hospital administration and patients. Data obtained were analyzed by statistical package of social science (SPSS) version 22. Method: 52 Whole blood samples were collected then inoculated in media of blood culture, then Macconkey, blood agar, chocolate and CLED. Laboratory work was conducted according to what market provides, Macconkey media used was contained suppressor for gram positive bacteria, so extra media used was CLED for ensuring growth of gram positive in aerobic environment. Gram stain, identification through biochemical tests and antibiotic sensitivity tests were conducted. Result: Blood samples cultured, no growth in 39 (75%) of samples and 13 (25%) with growth. Gram stain for growth bacteria revealed 3 (23.1%) gram positive cocci and 10 (76.9%) gram, negative bacilli, isolated organisms were S aureus (23.1%), E coli 7.1% and P aeruginosa 69.2%. Sensitivity test revealed s aureus was more sensitive to all drugs except resist to CXM (75%) and 100% AMC. E coli sensitive to all antibiotic except for AMC and CXM. P aeruginosa was 100 sensitive to AK, more than 75% to LEV, CIP, CN, NOR, 33% to AMC, CXM and more than 50% to CRO. Conclusion: Gram-negative bacteria, particularly P. aeruginosa, were the leading cause of bloodstream infections, emphasizing the need for routine antimicrobial susceptibility testing to guide appropriate antibiotic therapy.

Introduction

This study investigates hospital-acquired infections (HAIs), also known as nosocomial infections, which are infections acquired during medical care and are a major cause of illness, death, prolonged hospitalization, and increased healthcare costs worldwide. HAIs are commonly associated with invasive procedures, medical devices, and poor infection control practices. They also contribute significantly to antimicrobial resistance (AMR), making treatment more difficult.

The most common HAIs include hospital-acquired pneumonia, urinary tract infections, sepsis, and bloodstream infections, often caused by multidrug-resistant bacteria such as Pseudomonas aeruginosa, Staphylococcus aureus (including MRSA), Escherichia coli, vancomycin-resistant Enterococci (VRE), and Clostridioides difficile. Effective infection prevention and control (IPC), environmental hygiene, and responsible antibiotic use are essential to reduce HAIs and improve patient safety.

Methodology

A prospective cross-sectional study was conducted at MK Nimer Hospital, Sudan, involving 52 hospitalized patients who developed signs of infection 24–48 hours after admission. Blood samples were collected, cultured, and analyzed using Gram staining, biochemical identification tests, and antibiotic susceptibility testing. The antibiotics tested included ciprofloxacin, levofloxacin, norfloxacin, ceftriaxone, amikacin, amoxicillin-clavulanate, gentamicin, and cefuroxime.

Results

• Of the 52 blood cultures, 13 (25%) showed bacterial growth while 39 (75%) showed no growth.
• Among the positive cultures:
  • Pseudomonas aeruginosa was the most common pathogen (69.2%).
  • Staphylococcus aureus accounted for 23.1%.
  • Escherichia coli accounted for 7.7%.
• Most isolates were Gram-negative bacilli (76.9%), while 23.1% were Gram-positive cocci.
• No significant association was found between culture positivity and gender, age, or white blood cell count, although age was significantly associated with the type of bacteria isolated.
• Antibiotic susceptibility testing showed:
  • P. aeruginosa was highly sensitive to amikacin, ciprofloxacin, levofloxacin, gentamicin, and norfloxacin, but showed high resistance to amoxicillin-clavulanate, cefuroxime, and ceftriaxone.
  • S. aureus and E. coli were generally sensitive to most antibiotics but resistant to amoxicillin-clavulanate and cefuroxime.

Discussion and Conclusion

The findings indicate that Pseudomonas aeruginosa is the leading cause of HAIs in the study hospital, followed by Staphylococcus aureus and Escherichia coli. The high level of resistance to β-lactam antibiotics suggests antibiotic overuse and highlights the growing challenge of antimicrobial resistance. The prevalence of HAIs also points to weaknesses in infection control practices.

The study recommends:

• Expanding research with larger sample sizes.
• Strengthening hospital infection prevention and control (IPC) programs.
• Conducting routine microbiological surveillance.
• Improving cleaning and sterilization procedures.
• Promoting public awareness about the responsible use of antibiotics to reduce antimicrobial resistance.

Conclusion

-This study involved 52 patients admitted to MK NIMER hospital for detection of HAI bacteria, most of detected bacteria was P. aeruginosa, with low frequencies of s. aureus and E coli. -Resistance to drugs mostly involved CRO, AMC and CXM, indicator for overusing of antibiotics, which leading to microorganisms to adapted and developing resistance. -The pattern of hospital acquired infections among patients, indicator for corrupted infection control. Recommendation -More research with expanding sample size should be considered for cover more patients and areas inside the hospital. -Healthcare facilities should contain infection control SOPs working parallel with cleaning and sterilization routine workers, in order to maintain patients’ lives after admitting to the hospital. -Routine microbiological checkup should be addressed to ensuring applied infection control program. -Awareness program should be applied for general community members about antibiotics and usages beside hazards of un necessary or without prescription to avoid resistance in coming future to ensure confine treatment options.

References

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Copyright

Copyright © 2026 Mahasin A M Yassin, Sanaa M A. Osman, Alawia Alatta Malik Ali, Amira Eltom Fawzi Osman, Amira Hassan AbdAlrahman Arman, Ines Belaiba Aloulou, Taisseir A Ahmed G Elseed. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.