الفهرس 
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Abstract
Gram-positive cocci especially staphylococcal, streptococcal and
enterococcal species are considered troublesome nosocomial opportunistic
pathogens for health care institutions around world particularly with
increasing resistance of such species t
o many commonly used antibiotics and
the continual emerging of multi
-
drug resistant strains.
The current study was carried out to investigate the prevalence of
resistance to antimicrobial agents and the most common resistance
mechanisms, particularly macr
olides (azalides) and lincosamides resistance
among
Staphylococcus
,
Streptococcus
and
Enterococcus
local isolates.
A total of 705 clinical samples were collected from patients in
Surgical Intensive Care Units (ICUs), Urology Department, Ear, Nose and
Thro
at Department (ENT) of Zagazig University Hospitals, Zagazig,
Sharkia, Egypt. The collected specimens comprised: 110 respiratory tract
specimens (throat swabs and endotracheal aspirate tubes), 270 surgical
wound swabs and 325 urine samples. The specimens w
ere used for isolation
of staphylococci, enterococci and streptococci. The samples yielded 132
(18.7%) enterococcal isolates, 129 (18.3%) staphylococcal isolates and 59
(8.4%) streptococcal isolates. The isolates were identified to species level
based on s
tandard microbiological methods.
The susceptibility profiles of staphylococcal, enterococcal and
streptococcal isolates to different antimicrobial agents were determined.
Staphylococcal isolates showed very high resistance rates to penicillin G
(93%), amox
icillin/clavulanic acid (88%), amoxicillin (88%), oxacillin
(83%), ampicillin/sulbactam (78%), cephradine (78%), gentamicin (76%-
erythromycin (70%), ceforuxime (69%), doxycycline (66%), tobramycin
(64%), cefoperazone (62%) and cefepime (60%). High percen
tages of
resistance were found for ciprofloxacin (58%), azithromycin (57%),
clarithromycin (47%), rifampin (45%), lincomycin (45%), clindamycin
(44%), chloramphenicol (40%), sulphamethoxazole/trimethoprim (36%) and
spiramycin (36%). The lowest percentages
of resistance were found for
imipenem (3.9%) while no resistance was detected for vancomycin and
teicoplanin)