Antimicrobial susceptibility profile of Pseudomonas aeruginosa isolates in Egypt

Purpose: Pseudomonas aeruginosa is a leading cause of nosocomial respiratory tract, urinary tract and skin infections. Data are sparse on the antimicrobial resistance of P. aeruginosa in Egypt. We sought to detect and compare the antimicrobial susceptibility of P. aeruginosa isolates from respiratory tract, urinary tract and skin infections at 3 Egyptian hospitals. Materials and Methods: Minimum inhibitory concentrations of antibiotics were determined by the agar dilution method. Results: P. aeruginosa respiratory tract infections isolates were 100% resistant to ampicillin, ampicillin/sulbactam, amoxicillin, amoxicillin/clavulanate and chloramphenicol, highly resistant to cefuroxime (89%), tetracycline (89%) and azithromycin (84%), and susceptible to norfloxacin (89%), amikacin (84%) and meropenem (68%). P. aeruginosa urinary tract infection isolates were 100% resistant to ampicillin, amoxicillin, chloramphenicol, cefuroxime and tetracycline, highly resistant to amoxicillin/clavulanate (95%), azithromycin (95%), cefalexin (91%) and ampicillin/sulbactam (82%), and susceptible to amikacin (82%), meropenem (73%) and norfloxacin (64%). P. aeruginosa skin infection isolates were 100% resistant to ampicillin and amoxicillin, highly resistant to tetracycline (95%), amoxicillin/clavulanate (95%), cefalexin (87%) and azithromycin (84%), and susceptible to amikacin (87%), norfloxacin (71%) and meropenem (68%). The anti-pseudomonal effect of antibiotics varied among different infection sites only for ampicillin/sulbactam, cefoperazone or chloramphenicol but not with the other tested antibiotics. Conclusions: Norfloxacin and amikacin could be used for initial therapy for P. aeruginosa mediated respiratory tract infections. Amikacin, meropenem and norfloxacin could be used for P. aeruginosa mediated urinary tract and skin infections. Such studies are essential to determine the current guidelines for empirical therapy regimens, which vary by location, and help with the establishment of effective infection control measures