Antimicrobial resistance pattern of some bacterial pathogens involved in lower respiratory tract infections in Egypt

Abstract

Background: Resistance of bacteria to the used antimicrobials has risen dramatically in the past years. Special attention has to be given to infections caused by multiple drug resistant (MDR) organisms, as the therapeutic options are usually limited. The aim of this study is to determine the susceptibility and resistance prevalence bacteria isolated from patients suffering from lower respiratory tract infections (LRTI) against different antimicrobials commonly used in Egypt. Methods and findings: A total of 235 bacterial isolates were recovered from sputum and bronchoalveolar lavage specimens obtained from patients with LRTI. The specimens were collected during the period from January 2012 to December 2012 from the microbiological diagnostic laboratory of Sadr Al-Abbassiya hospital specialized in the treatment of chest infections in Cairo, Egypt. The antimicrobial susceptibility testing showed that the lowest resistance was observed to amikacin, doxycycline and meropenem; only 19 isolates (8%) were resistant to each. While the highest resistance was observed to clindamycin; 108 isolates (45.9%) were resistant. Among the collected isolates; 62 isolates (26.4%) were found to be resistant to 6 or more antimicrobial agents; 53 isolates were Gram-negative (85.5%) while 9 isolates were Gram-positive (14.5%). Out of these 62 MDR isolates; 23 isolates were Klebsiella pneumoniae (37.1%), 15 isolates were Escherichia coli (24.2%), 10 isolates were Pseudomonas aeruginosa (16.1%), 9 isolates were Staphylococcus aureus (14.5%), 3 isolates were Enterobacter cloacae (4.8%) and 2 isolates were Acinetobacter baumannii (3.2%). Most MDR organisms showed resistance to tested penicillin derivatives, cephalosporins as well as co-trimoxazole and macrolide antibiotics, with the exception of azithromycin . Conclusion: Multiple drug resistance is a major health concern limiting the use of common antimicrobials in therapy. Guided prescription of antimicrobial agents must be implemented and controlled in Egyptian hospitals to limit further spread of antimicrobial resistance