Are Egypt hospitals linked
to deadly E. coli outbreaks?
As Egypt officially denied that exports of contaminated fenugreek seeds were behind ferocious E. coli outbreaks in Europe, a decade-old report surfaced warning that Cairo hospitals appeared to be hotbeds of antibiotic resistant super-bugs.

Researchers were sufficiently alarmed to call for "a nationwide surveillance programme to monitor microbial trends and antimicrobial resistance patterns in Egypt."

Writing in the Journal of Antimicrobial Chemotherapy, Amani El Kholy and others said:

"The percentage of bloodstream isolates of Escherichia coli susceptible to common antimicrobial agents was as follows: ampicillin (6%), ampicillin–sulbactam (38%), co-trimoxazole (38%) and aminoglycosides (52%). The susceptibility of isolates of E. coli, Klebsiella and Enterobacter spp. to ceftazidime was 62%, 40% and 46%, respectively. This suggests a potentially high rate of extended-spectrum β-lactamase (ESBL) and/or Amp-C enzyme production. These results call for a nationwide surveillance programme to monitor microbial trends and antimicrobial resistance patterns in Egypt."

The report, "Antimicrobial resistance in Cairo, Egypt 1999–2000: a survey of five hospitals," was written by El Kholy, Hadia Baseem, Geraldine S. Hall, Gary W. Procop and David L. Longworth.

Concerning the probability of contamination, Egyptian Agriculture Minister Ayman Abu Hadeed said, "These claims are sheer lies, which have no scientific basis," adding: "The strain of E. coli in Europe is not found in Egypt. Secondly, all Egyptian farm produce and exports undergo complicated measures to be approved as fit for human consumption in line with international standards."

The El Kholy report abstract does not mention the O104:H4 strain.

Though investigators have found no contaminated seeds, experts say that random sampling may easily bypass a contaminated lot.

Fenugreek, according to a Wikipedia entry, is used both as a herb (the leaves) and as a spice (the seed, often called methi). The plant is cultivated worldwide as a semi-arid crop and is a common ingredient in many curries.

How the rare strain of E. coli, O104:H4, which breeds only in human intestines, acquired genetic resistance to a wide range of antibiotics is not known, though one expert suggested that a hospital or hospitals were the breeding ground.

Nor is it clear how the microbe could have come to contaminate the seeds, which were reportedly resold by a German firm, AGA SAAT GMBH. A British firm, Thompson & Morgan, had been identified as a source of some seeds sold to individuals near Bordeaux, but at this point it is unclear whether any fenugreek spice seeds came from that firm.

Meanwhile, French authorities reported that no link could be established between the death of a 78-year-old man, who had acquired an E. coli infection, and the virulent O104:H4 strain.

However, authorities said seven persons who had contracted the O104:H4 strain remained hospitalized in Bordeaux, France, in stable condition.

In all, ten people have been hospitalized in Bordeaux with E. coli infections.

In Germany, the death toll from the violent O104:H4 strain was put at 47. Many others will be afflicted by lifelong health problems related to kidney failure.