Search

Introduction Contemporary emergence of multidrug resistance (MDR) urges regular updates on circulating pathogens and their antimicrobial resistance profiles. We aimed to identify the burden of MDR and World Health Organization (WHO) priority Gram negative pathogens among patients admitted with febrile illness to Abbassia Fever Hospital, a major Public Fever Hospital in Egypt. The carbapenemase- and extended spectrum beta-lactamases (ESBLs)-encoding genes carried by the isolates were also identified. Methods A total of 9602 clinical specimens were collected from febrile patients during 2018 and 2019. The recovered bacterial isolates were examined for antimicrobial susceptibility using disk diffusion test. Susceptibility to colistin was tested using E-test. ESBLs production was phenotypically and genotypically analyzed. Results A total of 790 bacterial isolates (612 Gram negative and 178 Gram positive) were recovered. A percentage of 77.6%, and 62.9% of the Gram negative and positive isolates showed MDR phenotype, respectively. WHO priority pathogens were abundant, including carbapenem-resistant (CR) Enterobacterales (105/187; 56.1%) and CR glucose non-fermenters (82/187; 43.8%) such as: A. baumannii (55; 29.4%), P. aeruginosa (27; 14.4%). Carbapenemase- and ESBLs-encoding genes were detected in 56.1% and 30.8% of Enterobacterales and in 43.8% and 46.3% of glucose non-fermenters, respectively. Antimicrobials such as fosfomycin and chloramphenicol retained good activities against MDR Gram negative pathogens. Conclusions This study highlights the regional burden of MDR and priority Gram negative pathogens. The obtained data are of relevant medical importance for implementation of evidence-based antimicrobial stewardship programs and for tailoring the existing empirical treatment guidelines. [ABSTRACT FROM AUTHOR]

Copyright of Egyptian Journal of Botany is the property of Egyptian National Agricultural Library (ENAL) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Fluoroquinolones (FQs) are the drugs of choice for prophylaxis of bacterial infections in immunocompromised cancer patients. This study aimed to investigate FQ resistance and the prevalence of plasmid-mediated quinolone resistance (PMQR) determinants in 239 Gram-negative isolates collected at a tertiary care cancer hospital in Cairo, Egypt. Disc diffusion and broth microdilution tests showed that 70.7% of the isolates were nonsusceptible to ciprofloxacin (MIC 50  = 64 μg/ml). Polymerase chain reaction (PCR) revealed that 53.6% of the isolates carried at least one PMQR determinant, of which 23.4% were susceptible to ciprofloxacin. The most prevalent gene, aac(6')-Ib-cr, was identified in 36.8% of the isolates, while qnr genes were harbored by 31.0% (qnrS, 24.3%; qnrB, 7.1%, and qnrA, 0.4%). The oqxAB genes were only detected in Klebsiella sp. isolates (92.5%). PMQR determinants were more likely detectable among isolates recovered from pediatric patients than adults (59.3% vs. 43.8%) and were significantly associated with ceftriaxone and gentamicin resistance. A combined genetic analysis using random amplified polymorphic DNA-PCR and enterobacterial repetitive intergenic consensus-PCR showed that most of the qnr-positive isolates were not clonal. Findings of the current study raised concerns about the efficacy of prophylactic use of FQs in cancer patients in our region. It also demonstrates the possible role of PMQR-positive ciprofloxacin-susceptible isolates in the dissemination of resistance to other antimicrobial agents and the urgent need to reconsider the existing FQ breakpoints defined by the Clinical and Laboratory Standards Institute.