ABSTRACT:

This study evaluated patient characteristics, antimicrobial resistance patterns, and BlaSHV carriage among clinical isolates from sepsis patients, as despite the global spread of ESBL-producing Enterobacteriaceae, Sepsis remains a major cause of mortality in hospitalized patients, with BlaSHV contributing to cephalosporin resistance. Also, Sepsis increases energy expenditure and protein catabolism, making adequate energy, protein, vitamins, and minerals essential for immune function and tissue repair. Twenty-nine clinical isolates (12 Escherichia coli and 17 Klebsiella pneumoniae) were recovered from blood cultures of hospitalized patients with Sepsis, of whom 55.2% were male, in intensive care and medical wards. The isolates were identified using eosin methylene blue (EMB) agar and biochemical tests. We performed antimicrobial susceptibility testing according to the Clinical and Laboratory Standards Institute (CLSI) M100 guidelines. We extracted genomic DNA using the phenol-chloroform method and screened for the blaSHV gene by PCR, yielding a 208-bp amplicon. Statistical comparisons were performed using Fisher’s exact test. Results showed that resistance to cefotaxime and ceftriaxone was universal (100%) among K. pneumoniae isolates and high among E. coli isolates (84% and 79%, respectively). BlaSHV was detected in 5 of 29 isolates (17.24%), comprising 23.53% (4/17) of Klebsiella pneumoniae and 8.33% (1/12) of Escherichia coli. Of the 29 samples screened for Bla-SHV, only five were positive (17.24%). Resistance to cefotaxime was seen in all Bla-SHV-positive isolates (5/5, 100%) and in Bla-SHV-negative isolates (25/29, 86.2%), with the remaining 4 samples remaining susceptible. Resistance to ceftriaxone and ceftazidime was universal among all 29 isolates, whether Bla-SHV positive or negative. Results differed notably for Meropenem between the two groups: among Bla-SHV-positive isolates, only 2 of 5 (40%) were resistant, while the remaining 3 (60%) were sensitive; in contrast, all Bla-SHV-negative isolates (100%) were resistant to Meropenem. Cefepime was not included in the susceptibility testing panel; that’s why it is not compared between the

The difference in BlaSHV positivity between species was not statistically significant (p = 0.362), while Meropenem (80–95% susceptibility) and tigecycline retained strong activity. BlaSHV-mediated resistance circulates in clinical sepsis isolates, and molecular screening and stewardship are crucial to guide targeted therapy.

Keywords:   Sepsis, BlaSHV gene,  Antibiotic Resistance, PCR

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