Antibiotic profile

This study indicates a high percentage of multiple drug resistance for the majority of the isolated strains with higher levels in hospitalized patients in comparison with non-hospitalized individuals.

Although high percentage of resistance against chloramphenicol, tetracycline, and erythromycin was observed, there was no significant difference in resistance levels to these agents between community and hospital isolates. This may be due to the uncontrolled use in the community and their intense use in hospitals.

High percentage of resistance against aminoglycoside, cephalosporins, quinolones, and penicillins was observed. However, there was a significant difference in resistance levels to these agents between community and hospital isolates. Resistance to ciprofloxacin was higher than reported for clinical isolates in the United Kingdom. There were significant differences in resistance levels between sources, with higher levels in hospitalized patients. This indicates the intensive and uncontrolled use of antibiotics inside hospitals. High percentage of aminoglycoside resistance was similar to rates observed in Japan  and the United States .

Linezolid has the lowest percent of resistance (2.1%) among hospitalized patients which is much lower than levels reported in clinical isolated in other studies. No resistance was observed among community enterococcal isolates. This may be due to the fact that linezolid is not in use in clinical practice in Gaza city.  Linezolid, the first agent in a new class of drugs called oxazolidinones, offers an effective alternative for infections caused by VRE, MRSA, and other antibiotic-resistant Gram-positive bacteria. Although this agent has only been used in clinical practice for a relatively short period of time, there have already been several reports of linezolid resistance in S. aureus and VRE. A relatively high rate of vancomycin resistant E. faecium not susceptible to linezolid was observed in intensive care unit patients. Linezolid-resistant isolates carried the G2576T mutation in the 23S rRNA gene .