JAC Advance Access published online on January 28, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg101
© 2003 by The British Society for Antimicrobial Chemotherapy
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Original article
1 Department of Clinical
Pathology, Cairo University Medical School and Dar Al Fouad Hospital,
Cairo
* Corresponding author. E-mail: hallg{at}ccf.org.
Received 24 September 2002
; revised 19 October 2002
; accepted 24 November 2002
Antimicrobial resistance among bacterial pathogens
is a global problem, but in Egypt data are sparse. We reviewed the
antimicrobial susceptibility patterns of bloodstream isolates of
Gram-positive cocci and Gram-negative bacilli in five hospitals
in Cairo, Egypt, from 1999 to 2000. In addition, susceptibilities
of non-bloodstream isolates of Streptococcus pneumoniae and Enterococcus spp. were analysed. High rates of
resistance were found in most of the bacteria studied. In the hospitals,
a variety of methods were used for identification and susceptibility
testing, but in the laboratories quality controlled strains were
utilized routinely, to ensure accurate performance of the assays.
Only 29% of Staphylococcus aureus isolates
and 23% of coagulase-negative staphylococcal isolates were
oxacillin susceptible. Both groups of staphylococci were also highly
resistant to erythromycin, co-trimoxazole, clindamycin and doxycycline;
all isolates were susceptible to vancomycin. Susceptibility of S. pneumoniae isolates to penicillin, ceftriaxone
and fluoroquinolones was 63%, 84% and 82%,
respectively. Vancomycin susceptibility of the enterococci was 96%;
susceptibility to high-level gentamicin and streptomycin was 54% and
48%, respectively. Resistance to most relevant antimicrobials
was commonplace among the Gram-negative bacilli; however, most remained
susceptible to imipenem. The percentage of bloodstream isolates
of Escherichia coli susceptible to common antimicrobial
agents was as follows: ampicillin (6%), ampicillin-sulbactam
(38%), co-trimoxazole (38%) and aminoglycosides
(52%). The susceptibility of isolates of E.
coli, Klebsiella and Enterobacter spp.
to ceftazidime was 62%, 40% and 46%,
respectively. This suggests a potentially high rate of extended-spectrum
Keywords: resistance, Egypt, bacterial susceptibility
testing, Gram-negative bacilli, Gram-positive cocci
Antimicrobial resistance in Cairo, Egypt 1999-2000:
a survey of
five hospitals
2 Department of Clinical
Pathology, Ain Shams Medical School, Cairo, Egypt
3 Section of Microbiology,
Department of Clinical Pathology, The Cleveland Clinic Foundation,
9500 Euclid Avenue, Cleveland, OH 44195
4 Department of Medicine, Baystate Medical Center
and Tufts University School of Medicine, Springfield, MA, USA
-lactamase (ESBL) and/or Amp-C enzyme
production. These results call for a nationwide surveillance programme
to monitor microbial trends and antimicrobial resistance patterns
in Egypt.
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