الفهرس 
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Abstract
This study was carried out in the Microbiology and Immunology department, Faculty of Medicine, Minia University, in the period from April 2014 to September 2014; samples were collected from neonatal intensive care units of 3 hospitals in Minia governorate which are Minia University Hospital, Minia General Hospital and Minia insurance Hospital.
Seven Klebsiella pneumoniae isolates obtained from total number of 220 samples collected as follow : 20 blood samples were withdrawn from neonates who had evidence of sepsis after 48 h of admission to the unit, 100 health care workers samples (nose, nasopharenx,nails, hands, clothes,…..) , 50 Environmental samples , ( walls, floors, windows….), 50 Instrumental samples (respiratory equipment, suction tubes…….).
present study showed that out of 20 blood samples from neonates there were 2 positive samples (10%), from 100 health care workers there were 3 positive samples (3%), from 50 environmental samples there was 1 positive sample ( 2% ), from 50 instrumental samples there was 1 sample (2% ).
All Klebsiella pneumoniae isolates (100%) were found to be susceptible to imipenem followed by amikacin ( 85.7%) then ciprofloxacin and cefotaxime (71.4 %), followed by ceftazidime ( 57.1%) then ceftriaxone (42.5%). Resistances were detected to chloramphenicol, streptomycin and rifampicin as (71.5%). All Klebsiella pneumoniae isolates (100%) were resistant to ampicillin.
All samples of Klebsiella pneumoniae were confirmed to be ESBLs producing by double disc approximation test/DDST (100%).
The plasmid DNAs were extracted from all isolates of Klebsiella pneumoniae which confirmed to be ESBLs positive by the phenotypic confirmatory test, then amplification of plasmid DNAs by polymerase chain reaction(PCR) was done using specific primers for TEM and SHV genes.
The results of molecular analysis of ESBLs producing isolates of Klebsiella pneumoniae showed that all seven isolates yielded positive results for both blaTEM and blaSHV.
Amplified PCR products for each of the blaTEM genes were sent for analysis by an automated DNA sequencing system.
The resulting DNA sequences were compared to ascertain their genetic relatedness.
The results showed that 3 samples [health care worker, neonate and instrument] from one hospital (Mynia Insurance Hospital) had identical banding patterns indicating that a single clone of Klebsiella pneumoniae was involved.
Further investigations are required to determine the prevalence of such isolates in the community and hospitals on a large scale and to identify other possible ESBLs resistance mechanisms.