Frequency and Antimicrobial Resistance Pattern among Bacterial Clinical Isolates Recovered from Different Specimens in Egypt
Central African Journal of Public Health
Volume 5, Issue 1, February 2019, Pages: 36-45
Received: Dec. 5, 2018;
Accepted: Jan. 2, 2019;
Published: Jan. 29, 2019
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Rania Ibrahim Shebl, Microbiology and Immunology Department, Faculty of Pharmacy, Ahram Canadian University, Cairo, Egypt
Yasser Omar Mosaad, Pharmacology, Toxicology and Biochemistry Department, Faculty of Pharmaceutical Sciences & Pharmaceutical Industries, Future University in Egypt, Cairo, Egypt
Antimicrobial resistance (AMR) is a global public health threat resulting in high mortality rates. Current study aimed to identify the most prevalent pathogens among variable infection sites and their AMR pattern. Data concerning cultures and antibiotic susceptibilities were retrieved from Microbiology Department’s records and statistically analyzed. Out of 554 bacterial isolates, Gram negative isolates (68.4%) were predominant. Urine specimens showed the highest incidence of recovery of total isolates (41.5%, n=230) followed by blood (23.1%, n=128), while sputum specimens exhibited the least frequency (17%, n=94). E. coli (30.7%, n=170), S. aureus (21.1%, n=117) and Klebsiella spp (20.9%, n=116) were the most frequently isolated pathogens. Recovery of isolates was significantly more frequent among males (P<0.05) except in case of urine specimens. Highest incidence of resistance in both Gram positive and Gram negative isolates was recorded in case of cephalosporins and penicillin/β-lactamase. Gram positive isolates exhibited the least resistance to linezolid (10.8%) and vancomycin (9.5%) whereas colistin was the most effective against Gram negative isolates as it recorded 16.4% resistance. Higher frequency of multiple drug resistance (MDR) was also observed in Gram negative isolates compared to Gram positive ones. Resistance to uropathogens and MDR were significantly more frequent in males. Although E. coli was the most prevalent uropathogen but it showed the least incidence of MDR however Pseudomonas spp exhibited the highest MDR rate. The high incidence of resistance in the current study is alarming and highlights the necessity of routinely monitoring the local prevalence of resistance for selecting the best antimicrobial treatment and as a guide for empirical therapy.
Rania Ibrahim Shebl,
Yasser Omar Mosaad,
Frequency and Antimicrobial Resistance Pattern among Bacterial Clinical Isolates Recovered from Different Specimens in Egypt, Central African Journal of Public Health.
Vol. 5, No. 1,
2019, pp. 36-45.
Akova M. (2016): Epidemiology of antimicrobial resistance in bloodstream infections. Virulence 7(3): 252-266.
Paul R, Ray J, Sinha S, Mondal J 2017. Antibiotic resistance pattern of bacteria isolated from various clinical specimens: an eastern Indian study. International Journal of Community Medicine and Public Health 4(4): 1367-1371.
Prestinaci F, Pezzotti P, Pantosti A 2015. Antimicrobial resistance: a global multifaceted phenomenon. Pathogens and global health 109(7): 309-318.
Tom F 2013. Antibiotic resistance threats in the United States. Centres for Disease Control and Prevention. US Department of Health and Human Services. Available at: https://www.cdc.gov/drugresistance/pdf/ar-threats-2013-508.pdf.
El Kholy A, Baseem H, Hall GS, Procop GW, Longworth DL 2003. Antimicrobial resistance in Cairo, Egypt 1999–2000: a survey of five hospitals. Journal of Antimicrobial Chemotherapy 51(3): 625-630.
Laxminarayan R, Duse A, Wattal C, Zaidi AK, Wertheim HF, Sumpradit N, Greko C 2013. Antibiotic resistance-the need for global solutions. The Lancet infectious diseases 13(12): 1057-1098.
Pakyz AL 2007. The utility of hospital antibiograms as tools for guiding empiric therapy and tracking resistance: insights from the Society of Infectious Diseases Pharmacists. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy 27(9): 1306-1312.
Ansari S, Nepal HP, Gautam R, Shrestha S, Neopane P, Gurung G, Chapagain ML 2015. Community acquired multi-drug resistant clinical isolates of Escherichia coli in a tertiary care center of Nepal. Antimicrobial resistance and infection control 4(1): 15.
Anderson DJ, Engemann JJ, Harrell LJ, Carmeli Y, Reller LB, Kaye KS 2006. Predictors of mortality in patients with bloodstream infection due to ceftazidime-resistant Klebsiella pneumoniae. Antimicrobial agents and chemotherapy 50(5): 1715-1720.
Saravanan R, Raveendaran V 2013. Antimicrobial resistance pattern in a tertiary care hospital: an observational study. Journal of basic and clinical pharmacy 4(3): 56.
Ntirenganya C, Manzi O, Muvunyi CM, Ogbuagu O 2015. High prevalence of antimicrobial resistance among common bacterial isolates in a tertiary healthcare facility in Rwanda. The American journal of tropical medicine and hygiene 92(4): 865-870.
Moremi N, Claus H, Mshana SE 2016. Antimicrobial resistance pattern: a report of microbiological cultures at a tertiary hospital in Tanzania. BMC infectious diseases 16(1): 756.
Ibrahim IA, Hameed TA 2015. Isolation, characterization and antimicrobial resistance patterns of lactose-fermenter enterobacteriaceae isolates from clinical and environmental samples. Open journal of medical microbiology 5(1): 169-176.
Behzadi P, Behzadi E, Yazdanbod H, Aghapour R, Cheshmeh MA, Omran DS 2010. A survey on urinary tract infections associated with the three most common uropathogenic bacteria. Maedica 5(2): 111.
Beyene G, Tsegaye W 2011. Bacterial uropathogens in urinary tract infection and antibiotic susceptibility pattern in jimma university specialized hospital, southwest ethiopia. Ethiopian journal of health sciences 21(2): 141-146.
Sajed AN, Batool U, Iram S, Yousaf NW, Asghar MN, Khan S 2014. Prevalence of urinary tract infections and their antibiotic sensitivity in tertiary care hospital Lahore. Journal of Dental and Medical Sciences 13(12): 57-61.
Japoni A, Vazin A, Hamedi M, Davarpanah M. A, Alborzi A, Rafaatpour N 2009. Multidrug-resistant bacteria isolated from intensive-care-unit patient samples. Brazilian Journal of Infectious Diseases 13(2): 118-122.
Linhares I, Raposo T, Rodrigues A, Almeida A 2013. Frequency and antimicrobial resistance patterns of bacteria implicated in community urinary tract infections: a ten-year surveillance study (2000–2009). BMC infectious diseases 13(1): 19.
Mohammed MA, Alnour TM, Shakurfo OM, Aburass MM 2016. Prevalence and antimicrobial resistance pattern of bacterial strains isolated from patients with urinary tract infection in Messalata Central Hospital, Libya. Asian Pacific journal of tropical medicine 9(8): 771-6.
Gautam R, Chapagain, ML, Acharya A, Rayamajhi N, Shrestha S, Ansari S, Nepal, HP 2013. Antimicrobial susceptibility patterns of Escherichia coli from various clinical sources. Journal of Chitwan Medical College 3(1): 14-17.
Gupta R, Malik A, Rizvi M, Ahmed SM 2016. Incidence of multidrug-resistant pseudomonas spp. in ICU patients with special reference to ESBL, AMPC, MBL and biofilm production. Journal of global infectious diseases 8(1): 25.
Golia S, Suhani MS 2016. Isolation of Pseudomonas aeruginosa from various Clinical Isolates and its Antimicrobial Resistance Pattern in a Tertiary Care Hospital. Int. J. Curr. Microbiol. App. Sci 5(3): 247-253.
Orsini J, Mainardi C, Muzylo E, Karki N, Cohen N, Sakoulas G 2012. Microbiological profile of organisms causing bloodstream infection in critically ill patients. Journal of clinical medicine research 4(6): 371.
Al-Zoubi MS, Al-Tayyar IA, Hussein E, Al Jabali A, Khudairat S 2015. Antimicrobial susceptibility pattern of Staphylococcus aureus isolated from clinical specimens in Northern area of Jordan. Iranian journal of microbiology 7(5): 265.
Elsayed A, Mohamedin A, Ata T, Ghazala N 2016. Molecular Characterization of Multidrug Resistant Clinical Escherichia coli Isolates. Am J Bio Mol Biol 6:72-83.
Fatima A, Naqvi SB, Khaliq SA, Perveen S, Jabeen S 2012. Antimicrobial susceptibility pattern of clinical isolates of Pseudomonas aeruginosa isolated from patients of lower respiratory tract infections. SpringerPlus 1(1): 70.
Paterson DL, Bonomo RA 2005. Extended-spectrum β-lactamases: a clinical update. Clinical microbiology reviews 18(4): 657-686.
Papp-Wallace KM, Endimiani A, Taracila MA, Bonomo RA 2011. Carbapenems: past, present, and future. Antimicrobial agents and chemotherapy 55(11): 4943-4960.
Wong SC, Tse H, Chen JH, Cheng VC, Ho PL, Yuen KY 2016. Colistin-resistant Enterobacteriaceae carrying the mcr-1 gene among patients in Hong Kong. Emerging infectious diseases 22(9): 1667.
Ventola CL 2015. The antibiotic resistance crisis: part 1: causes and threats. Pharmacy and Therapeutics 40(4): 277.
Uchil RR, Kohli GS, KateKhaye VM, Swami OC 2014. Strategies to combat antimicrobial resistance. Journal of clinical and diagnostic research 8(7): ME01.
Karam G, Chastre J, Wilcox MH, Vincent JL 2016. Antibiotic strategies in the era of multidrug resistance. Critical Care 20(1): 136.