Microbial pattern and antimicrobial resistance, a surgeon's perspective: retrospective study in surgical wards and seven intensive-care units in two university hospitals in Cairo, Egypt.
OBJECTIVE
Significant morbidity and mortality in surgical practice is due to infection with resistant pathogens. Data from Egyptian hospitals may reflect a peculiar pattern.


METHODS
Retrospective study of antimicrobial susceptibility of 1,064 isolates from patients in surgical zones and intensive-care units (ICUs) in the largest 2 hospitals in Cairo in 2003.


RESULTS
The infection rate in surgical wards was 0.41%, mostly surgical site infections. Cardiothoracic wards showed higher rates (0.52%). In ICUs, the infection rate was 6.51%, the majority were respiratory. The highest resistance rate was shown by Staphylococcus aureus (23.8%), Pseudomonas (14.9%) and Escherichia coli (10.48%). Enterococci and Citrobacter had rates below 1%. Pseudomonas aeruginosa had the highest resistance rate with third-generation cephalosporins (Cef3) and the lowest with imipenem, while for Enterobacter and Klebsiella it was highest with Cef3 and lowest with imipenem. E. coli showed the highest rate with quinolone 2 and Cef3, but there was no resistance to imipenem. Acinetobacter demonstrated the highest resistance rate with quinolone 2 and the lowest with fourth-generation cephalosporins (Cef4), while for methicillin-resistant S. aureus it was 60%. All enterococci were sensitive to vancomycin.


CONCLUSIONS
The study provides meaningful data on a high antimicrobial resistance in Egypt. Failure of hospital hygiene and overuse of antibiotics are considered responsible.
Saied
Gamal Moustafa
GM
Department of General Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt. gamal44@hotmail.com
D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology*; D024881:Drug Resistance, Bacterial; D004534:Egypt / Q000453:epidemiology; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D013502:General Surgery; D006757:Hospital Units / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008826:Microbial Sensitivity Tests; D011549:Pseudomonas / Q000302:isolation & purification; D012189:Retrospective Studies; D013211:Staphylococcus aureus / Q000302:isolation & purification