Antibiotic Resistance and its Association with Biocides Susceptibilities among Microbial Isolates in an Egyptian Hospital

Background: Recently there has been a growing concern that the indiscriminate use of antimicrobial agents in the household, food industry and in hospitals may contribute to the emergence of bacteria resistant to antibiotics. Aim of the work: To detect any possible link between the susceptibility profiles of different clinical and environmental isolates to biocides and antibiotics in an Egyptian hospital. Methods: 66 different microbial isolates were isolated from different clinical specimens and different environmental samples obtained from a University Hospital in Alexandria. These isolates were screened for their susceptibility to 22 broad spectrum antibiotics using disc agar diffusion technique. Also the susceptibility of the isolates to 6 commonly used biocides was screened through MIC determination by agar dilution technique. Correlations between the obtained data were made through Spearman’s correlation using SPSS ® Statistical program. Results: 62% of the isolates were multidrug resistant (MDR); and 11% were extremely drug resistant (XDR). On the other hand, 34% of the tested isolates were multi-disinfectant reduced susceptibility (MDRS) isolates. The statistical analysis of the obtained data revealed a moderate positive correlation between antibiotic resistance and biocide tolerance (0.376≥ρ≥0.278, p<0.05). In addition, strong significant correlations (p<0.01) were also found between reduced susceptibilities to multiple biocides such as benzalkonium chloride (BK), cetrimide (CET), chlorhexidine (CHX), povidone-iodine (PVPI) and Dettol ® . Conclusion: Cross-resistance between biocides and antibiotics can aggravate the existing problem of antibiotic resistance in hospitals.