article · Microbial Drug Resistance
An assessment of 126 clinical Gram-negative bacterial isolates collected from hospitalised patients in Egypt revealed that 93.6 percent exhibited a multidrug-resistant phenotype. Molecular testing and DNA sequencing showed extensive presence of resistance genes against common antibiotics. Extended-spectrum beta-lactamase genes were detected in 75.4 percent of the isolates, led by blaCTX-M and blaSHV variants. In addition, AmpC beta-lactamase genes were found in 7.1 percent of samples, while plasmid-mediated quinolone resistance genes occurred in 58.7 percent, predominantly as qnrS. Class 1 integrons appeared in 50.8 percent of isolates, and class 2 integrons were identified in 2.4 percent. The analysis documented multiple resistance determinants for the first time in Egypt, including specific SHV and CMY variants, demonstrating widespread genetic mechanisms driving antibiotic resistance across clinical environments.
High levels of multidrug resistance in hospital settings undermine standard treatments for common bacterial infections. By mapping the specific resistance genes present in clinical samples, healthcare systems gain essential data on how bacteria evade drugs. This evidence reinforces the urgent need to manage and restrict conventional antibiotic usage to prevent treatable hospital infections from becoming unresponsive to therapy.
The findings represent early-stage observational research that can inform diagnostic test developers and clinical surveillance programmes. Identifying prevalent resistance genes, such as specific blaCTX-M, blaSHV, and qnr variants, aids molecular diagnostic companies in designing targeted screening panels for hospital laboratories. However, the abstract indicates no direct product development or commercialisation pathway.
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This study was designed to investigate, at the molecular level, the antimicrobial resistance mechanisms of different antimicrobial resistance genes, including, extended-spectrum β-lactamases, AmpC β-lactamases, class 1 and 2 integrons, and plasmid-mediated quinolone resistance genes of Gram-negative bacteria isolated from clinical settings in Egypt. A total of 126 nonduplicate Gram-negative isolates were recovered from different clinical samples taken from hospitalized patients in Egypt in 2014. Antimicrobial susceptibility testing showed that, 93.6% (118/126) of the isolates had a multidrug-resistant phenotype. Interestingly, we reported a high level of antimicrobial resistance nearly for all tested antibiotics; to our knowledge, this is the first report from Egypt indicating very high level of antibiotic resistance in Egypt. Polymerase chain reaction screening and DNA sequencing revealed that, 75.4% (95/126) of the isolates harbored at least one extended-spectrum β-lactamase-encoding gene, with bla<sub>CTX-M</sub> being the most prevalent (65.9%), followed by bla<sub>SHV</sub> (46.8%). The AmpC β-lactamase, bla<sub>CMY</sub>, was detected in 7.1% (9/126) of bacterial isolates, with bla<sub>CMY-42</sub> being the most prevalent. Class 1 integrons were detected in 50.8% (64/126) of the isolates, and class 2 integrons were detected in 2.4% (3/126) of the isolates. The plasmid-mediated quinolone resistance gene, qnr, was detected in 58.7% (74/126) of the tested isolates, with qnrS being the most prevalent. Several antimicrobial resistance determinants were identified in Egypt for the first time, such as SHV-27, SHV-28, SHV-33, SHV-63, SHV-71, SHV-82, SHV-142, CMY-42, CMY-6, and the new CMY-72 like. This study highlights the importance of the conscious use of conventional antimicrobials to overcome the multidrug resistance problem.
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DOI: 10.1089/mdr.2018.0380
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