title: Antimicrobial resistance in pathogens causing nosocomial bloodstream infections in university hospitals in Egypt.
abstract: BACKGROUND
  Nosocomial bloodstream infections (BSIs) and antimicrobial resistance (AMR) are worldwide health care problems causing substantial patient morbidity and mortality. This study was conducted to identify bacterial pathogens isolated from nosocomial BSIs and determine their AMR patterns.
  
  
  METHODS
  An active surveillance program for BSIs was conducted in intensive care units in 3 large university hospitals in Egypt between September 1, 2006, and June 30, 2007. Infection prevention and control teams and link nurses in collaboration with intensive care physicians were looking actively to identify patients who acquired BSIs based on Centers for Disease Control and Prevention standard case definitions. Blood cultures were obtained from patients with suspected BSIs and processed to isolate bacteria and test their antimicrobial resistance.
  
  
  RESULTS
  During the 10-month active surveillance period, a total of 600 pathogens were isolated from blood cultures of 1,575 patients (38%). Of these 600 isolates, 386 (66%) were gram-negative, 178 (30%) were gram-positive, and 24 (4%) were budding yeasts. The gram-negative organisms included 162 (27%) Klebsiella pneumoniae and 23 (3.8%) Escherichia coli. Extended-spectrum β-lactamase enzymes were detected in 79% of the K pneumoniae isolates and 39% of the E coli isolates. Methicillin-resistant Staphylococcus aureus accounted for 60% of S aureus infections.
  
  
  CONCLUSIONS
  High rates of β-lactamase resistance and methicillin-resistant S aureus were found in the 3 Egyptian university hospitals studied. This study highlights the need for strengthening infection prevention and control programs, monitoring AMR at each facility, and developing policies for antibiotic use.
authors.affiliation: Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt. tamer.saied.ctr.eg@med.navy.mil
authors.forename: Tamer
authors.initials: T
authors.lastname: Saied
authors.forename: Amany
authors.initials: A
authors.lastname: Elkholy
authors.forename: Soad F
authors.initials: SF
authors.lastname: Hafez
authors.forename: Hadia
authors.initials: H
authors.lastname: Basim
authors.forename: Momtaz O
authors.initials: MO
authors.lastname: Wasfy
authors.forename: Waleed
authors.initials: W
authors.lastname: El-Shoubary
authors.forename: Ahmed
authors.initials: A
authors.lastname: Samir
authors.forename: Guillermo
authors.initials: G
authors.lastname: Pimentel
authors.forename: Maha
authors.initials: M
authors.lastname: Talaat
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000382:microbiology*; D001419:Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D004534:Egypt; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008826:Microbial Sensitivity Tests; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents