Clinical infections caused by Staphylococcus aureus (S. aureus) will likely remain common and serious. Not only there has been an increase in antimicrobial resistance, but also the spectrum of clinical disease continues to increase. Our aim in this research is to determine the prevalence as well as to identify and characterize the pattern of resistance of S. aureus isolates recovered from pediatrics with otitis media admitted to tertiary hospitals in Alexandria, Egypt. Out of 180 clinical samples, 193 different bacterial isolates were recovered. Along with Pseudomonas aeruginosa, S. aureus was the predominant (18.6%) pathogen isolated. Antibiotic susceptibility testing among S. aureus isolates revealed that up to 27 (75%) out of the tested isolates exhibited high (> 0.2) MAR index values. Methicillin-resistant S. aureus (MRSA) isolates were determined using the minimal inhibitory concentration (MIC) of cefoxitin. The incidence of MRSA among S. aureus isolates was 44.4%. On the other hand, none of the tested isolates was linezolid resistant. The presence of methicillin resistance genes (mecA and femA) and aminoglycoside resistance genes (aac (6′)Ie/aph(2′′)Ia, aph(3′)-IIIa and ant(4′)-Ia) were detected using Polymerase Chain Reaction (PCR) technique. The incidence of aac (6′)Ie/aph(2′′)Ia, aph(3′)-IIIa and ant (4′)-Ia was 38.9%, 36.1% and 30.6%, respectively. Besides, the incidence of cap8, cap5 and lukS/F-PV virulence genes was 33.3%, 25% and 11.1%, respectively. Accordingly, we recommend the necessity of continuous surveillance and control of antimicrobial resistance and virulence level in S. aureus as one of the major pathogens of pediatric otitis media in Alexandria, Egypt.
The capability of carbapenemase production is one of the chief mechanisms for the development of multidrug-resistance (MDR) and extensively drugresistance (XDR) in Acinetobacter baumannii. The aim of this study was to detect the prevalence of different types of carbapenemases produced by carbapenem-resistant Acinetobacter baumannii in Tanta region. Out of 1223 clinical samples, collected from Tanta University teaching hospitals, a total of 69 (5.6%) Acinetobacter baumannii isolates were recovered as identified by standard biochemical tests as well as polymerase chain reaction (PCR) technique that detect the intrinsic blaOXA-51-like gene. Susceptibility to various antimicrobials was performed by disc diffusion method and revealed multiple (1-15) drug resistance of all isolates. Nevertheless, colistin was effective against all tested isolates. A total of 31 out of 69 (44.9%) isolates were imipenem resistant. These isolates, which included 6 (19.4%) MDR and 25 (80.6%) XDR, were selected for further study. Detection of carbapenemases production by both phenotypic and genotypic techniques was performed and all the imipenem resistant Acinetobacter baumannii isolates (IMRAb) were found carbapenemases producers. These carbapenemases included metallo-β-lactamases, blaOXA-23-type and blaOXA-58-type carbapenemases detected in 100% (31/31), 71% (22/31) and 13% (4/31) of these isolates, respectively. Our findings highly recommend careful monitoring for the presence of carbapenem-resistant MDR or XDR Acinetobacter baumannii among hospitalized patients especially because some of the detected resistance genes are known to be located on a plasmid which could facilitate resistance dissemination.
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