In vitro antibiotic susceptibility testing of Brucella isolates from Egypt between 1999 and 2007 and evidence of probable rifampin resistance

Abstract

BackgroundBrucellosis poses a significant public health problem in Mediterranean countries, including Egypt. Treatment of this disease is often empirical due to limited information on the antibiotic susceptibility profiles of Brucella spp. in this region of the world. The aim of this study was to determine the antibiotic susceptibility profiles of Brucella blood isolates in Egypt, a country endemic for brucellosis.MethodsBrucella spp. isolates were identified from the blood cultures of acute febrile illness (AFI) patients presenting to a network of infectious disease hospitals from 1999–2007. Minimum inhibitory concentrations were determined for tetracycline, gentamicin, doxycycline, trimethoprim-sulfamethoxazole, streptomycin, ceftriaxone, ciprofloxacin and rifampin using the E-test. Interpretations were made according to Clinical and Laboratory Standards Institute (CLSI) guidelines.ResultsA total of 355 Brucella spp. isolates were analyzed. All were susceptible to tetracycline, doxycycline, trimethoprim-sulfamethoxazole, streptomycin and ciprofloxacin; probable resistance to rifampin and ceftriaxone was observed among 277 (64%) and 7 (2%) of the isolates, respectively. Percentages of isolates showing probable resistance to rifampin were significantly lower before 2001 than in the following years (7% vs. >81%, p < 0.01).ConclusionsDespite the high burden of brucellosis in Egypt and frequent empirical treatment, isolates have remained susceptible to the majority of tested antibiotics. However, this is the first report of high rates of probable resistance to rifampin among Brucella isolates from Egypt. Patients should be closely monitored while following standard treatment regimens. Continued surveillance, drug susceptibility studies and updated CLSI interpretive criteria are needed to monitor and update antibiotic prescribing policies for brucellosis.

Identification and In Vitro Antimicrobial Susceptibility ofBrucellaSpecies Isolated from Human Brucellosis

“…The main factor that preludes its wider use is probably the side effect and the parenteral mode of administration. In this study gentamicin showed a good in vitro activity against all the tested Brucella isolates as reported previously in other countries [18, 28, 33]. Similar finding [34] as well as lower [29] and higher [8] MIC values were reported in Turkey for gentamicin.…”

In vitro antimicrobial susceptibility testing of human Brucella melitensis isolates from Qatar between 2014 – 2015

“…However, when compared with CLSI reference values for H.influenzae [8], in the present study, 48 % of Brucella strains showed elevated MIC’s of rifampicin (>1 mg/L). Higher MIC’s to rifampicin has been reported previously from Egypt (64 %) [9] and Malaysia (70 %) [15]. However, the impact of high MIC’s on clinical outcome in these countries is not known.…”

Otolaryngology/head and neck region manifestations of Brucella

“…Antibiotics administrated were oral doxycycline and either intravenous gentamycin or oral rifampin. Multidrug antimicrobial regimens are the mainstay of therapy because of high relapse rates reported with monotherapeutic approaches …”