A Survey of Antimicrobial Resistance in a Tertiary Referral Hospital in the United Arab Emirates

Jumaa, P.; Neringer, Rune

doi:10.1179/joc.2005.17.4.376

Cited by 15 publications

(17 citation statements)

References 6 publications

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“…Earlier, Jumaa & Neringer (2005) had reported a 50 % fluoroquinolone-resistance rate among the Campylobacter spp. isolated from humans between 1999 and 2002, from the same hospital laboratory.…”

Section: Resultsmentioning

confidence: 99%

“…However, data on the incidence of fluoroquinolone resistance and on the type of strains present in the region are very limited (Sjogren et al, 1989;Albert et al, 2005;Jumaa & Neringer, 2005). The aim of the current study was to investigate the variety of C. jejuni strains isolated between 2002 and 2004 in a tertiary care hospital in Abu Dhabi Emirate, United Arab Emirates (UAE), and to determine the frequency and the genetic background of fluoroquinolone resistance among the local isolates.…”

Section: Introductionmentioning

confidence: 99%

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High level of ciprofloxacin resistance and its molecular background among Campylobacter jejuni strains isolated in the United Arab Emirates

Sonnevend

Rotimi

Kolodziejek

et al. 2006

Journal of Medical Microbiology

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The antibiotic sensitivity and the serotype and molecular type (MT) distribution of 41 Campylobacter jejuni strains isolated from individual patients in Tawam Hospital, Al Ain, United Arab Emirates, were investigated. While all strains were sensitive to erythromycin (MIC 0?5-4 mg l "1 ), 35 isolates (85?4 %) exhibited resistance to ciprofloxacin (MIC 8-64 mg l "1 ). All resistant strains carried the Thr-86 to Ile mutation in the gyrase A (gyrA) gene, as shown by mismatch amplification mutation assay (MAMA) and confirmed by sequencing. Based on the partial sequences of gyrA, resistant isolates carried 10 distinct alleles, eight of them representing new variants. Strains were assigned to 30 MTs based on the combined results of PFGE and flaA PCR-RFLP typing. Eight of the 35 ciprofloxacin-resistant strains, isolated over a period of more than 1 year, represented the largest MT, also carrying the same allelic variant of the gyrA gene. These results show that the local incidence of fluoroquinolone resistance among C. jejuni is one of the highest reported worldwide. It was also demonstrated that stable MTs could persist for a relatively long time among the clonally unrelated antibiotic-resistant isolates of C. jejuni. The data also emphasize the need to replace fluoroquinolones as empirical therapy for diarrhoea of undiagnosed aetiology. INTRODUCTIONFluoroquinolone resistance in Campylobacter jejuni, a leading cause of gastrointestinal infections worldwide and one of the most important causes of travellers' diarrhoea, is rapidly increasing. Resistance is commonly due to point mutations in the quinolone resistance determinant region (QRDR) of the gyrase A (gyrA) gene involving the Thr-86 for high, and the Asp-90 and Ala-70 amino acid residues for lower-level resistance (Engberg et al., 2001).While C. jejuni infections usually present as acute selflimiting gastrointestinal illnesses, in severe or prolonged cases antibiotic therapy is indicated, with macrolides as the primary drug of choice (Butzler, 2004). However, particularly if the causative agent is not identified, as is often the case in travellers' diarrhoea, fluoroquinolones are frequently used empirically (Guerrant et al., 2001;Yates, 2005). In such cases, resistance to ciprofloxacin can result in therapeutic failure (Guerrant et al., 2001;Sanders et al., 2002). Moreover, by mechanisms yet to be elucidated, fluoroquinolone resistance appears to coincide with increased fitness of the organism. In humans, fluoroquinolone-resistant strains are shed longer than sensitive isolates (Nelson et al., 2004;Engberg et al., 2004), and they have been reported to out-compete their sensitive counterparts, at least in certain genetic backgrounds, when colonizing poultry, i.e. the natural reservoir of the pathogen (Luo et al., 2005). All these findings underscore the necessity for close monitoring of the incidence and spread of fluoroquinolone-resistant clones of C. jejuni. Campylobacter isolates recovered from the 3389 stool samples tested during this period of time. Seven of th...

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

High level of ciprofloxacin resistance and its molecular background among Campylobacter jejuni strains isolated in the United Arab Emirates

Sonnevend

Rotimi

Kolodziejek

et al. 2006

Journal of Medical Microbiology

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“…MRSA constituted 35% of all S. aureus isolated in a Northern Indian hospital [15] and 47-55% of S. aureus in US hospitals [17] . In the Gulf countries, MRSA constituted 5% of S. aureus isolated in a tertiary hospital in the United Arab Emirates [18] but 38.9% of S. aureus in Saudi Arabian hospitals [16,19] and 38.8% of S. aureus isolated in an Omani hospital [20] . Bell and Turnidge [21] reported an even higher prevalence of MRSA in other Asian and Western Pacific region countries.…”

Section: Discussionmentioning

confidence: 99%

Surveillance of Antibacterial Resistance in <i>Staphylococcus aureus </i>Isolated in Kuwaiti Hospitals

et al. 2008

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Objective: To investigate the prevalence of antibiotic resistance among Staphylococcus aureus isolated in Kuwaiti hospitals. Materials and Methods:S. aureus were isolated and identified following standard microbiological methods. Antibacterial susceptibility test was performed by disk diffusion and the measurement of minimum inhibitory concentration with E-test strips. Results: A total of 1,846 S. aureus isolates were analyzed from 13 hospitals between 1 March and 30 October 2005. They were isolated from 1,765 (95.6%) inpatients and 81 (4.4%) outpatients. Methicillin resistance was detected in 588 (32.0%) of the isolates. The methicillin-resistant S. aureus (MRSA) consisted of 461 (78%) multiresistant and 127 (22%) nonmultiresistant isolates. The nonmultiresistant MRSA consisted of epidemic MRSA-15 and community-associated MRSA. The community-associated MRSA was detected in all hospitals with MRSA, indicating its establishment in Kuwaiti hospitals. The proportion of isolates resistant to gentamicin, kanamycin, erythromycin, tetracycline, ciprofloxacin, fusidic acid and trimethoprim was higher among MRSA than methicillin-susceptible S. aureus (MSSA) isolates. Twenty-four and 22% of MRSA and MSSA isolates, respectively, expressed reduced susceptibility to vancomycin (minimum inhibitory concentration = 3–4 mg/l). Conclusion: The study revealed the presence of methicillin resistance in 32% of S. aureus isolated in Kuwaiti hospitals and revealed an increase in the number of MRSA and MSSA with reduced susceptibility to vancomycin.

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“…High rates of resistance were recently reported for Escherichia coli, Shigella sonnei, Campylobacter spp., and also Streptococcus pneumoniae in a tertiary UAE hospital [7]. In another study, 4.1% of Salmonella spp.…”

Section: Introductionmentioning

confidence: 97%

Over-the-counter sales of antibiotics from community pharmacies in Abu Dhabi

2010

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A Survey of Antimicrobial Resistance in a Tertiary Referral Hospital in the United Arab Emirates

Cited by 15 publications

References 6 publications

High level of ciprofloxacin resistance and its molecular background among Campylobacter jejuni strains isolated in the United Arab Emirates

High level of ciprofloxacin resistance and its molecular background among Campylobacter jejuni strains isolated in the United Arab Emirates

Surveillance of Antibacterial Resistance in <i>Staphylococcus aureus </i>Isolated in Kuwaiti Hospitals

Over-the-counter sales of antibiotics from community pharmacies in Abu Dhabi

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