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. 2014 Oct 21:19:177.
doi: 10.11604/pamj.2014.19.177.4307. eCollection 2014.

Prevalence of extensively drug-resistant gram negative bacilli in surgical intensive care in Egypt

Ahmed Hasanin  1 , Akram Eladawy  1 , Hossam Mohamed  1 , Yasmin Salah  1 , Ahmed Lotfy  1 , Hanan Mostafa  1 , Doaa Ghaith  2 , Ahmed Mukhtar  1
Affiliations

Prevalence of extensively drug-resistant gram negative bacilli in surgical intensive care in Egypt

Ahmed Hasanin et al. Pan Afr Med J. .

Abstract

Introduction: The prevalence of extensively drug resistant gram negative bacilli (XDR-GNB) is rapidly progressing; however in Egypt data are sparse. We conducted the present study to quantify the incidence, risk factors and outcome of patients harboring XDR-GNB.

Methods: A one year prospective study was done by collecting all the bacteriological reports for cultures sent from the surgical intensive care unit, Cairo university teaching hospital. XDR-GNB were defined as any gram negative bacilli resistant to three or more classes of antimicrobial agents. Patients with XDR-GNB compared with those sustaining non extensively drug-resistant infection. A multivariate logistic regression model was created to identify independent predictors of multi-resistance.

Results: During one-year study period, a total of 152 samples (65%) out of 234 gram negative bacilli samples developed extensively drug resistant infection. XDR strains were significantly higher in Acinetobacterspp (86%), followed by Pseudomonas (63%), then Proteus (61%), Klebsiella (52%), and E coli (47%). Fourth generation cephalosporine (Cefipime) had the lowest susceptibility (10%) followed by third generation cephalosporines (11%), Quinolones (31%), Amikacin (42%), Tazobactam (52%), Carbapinems (52%), and colistin (90%). Relaparotomy was the only significant risk factor for acquisition of XDR infection.

Conclusion: Extensively drug-resistant gram negative infections are frequent in our ICU. This is an alarming health care issue in Egypt which emphasizes the need to rigorously implement infection control practices.

Keywords: Extensive drug resistance; critically ill patients; gram negative bacilli.

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Figures

Figure 1
Figure 1
Prevalence of XDR strains among different sites of isolates. P value = 0.003
See this image and copyright information in PMC

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