الفهرس 
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Abstract
Burn injury increases the patient’s susceptibility to infection. P.aeruginosa as gram negative bacteria is the most common nosºC omial infection cause burn infection. The present work was performed to isolate and identify different P.aeruginosa isolates from cases with burn wound in different sites at Minia Governorate, determine their antimicrobial resistance to different antimicrobial and the mechanism of resistance.
The patients enrolled into this study were admitted in burn unit at Minia General Hospital. Pus samples from 250 children aging from 1 to 15 years old were collected and screened by culture on suitable media for isolation of P.aeruginosa that were identified by culture characteristics, Gram stain, and biºC hemical reactions.
A total of 50 (20%) of the isolates were identified as P.aeruginosa. P.aeruginosa infection were more in children more than 10 years than children less than 10 years with burn wound P.aeruginosa was isolated from rural residents in a higher rate than urban residents (54% vs. 46%, respectively) and more frequently from females than males (70% vs. 30 %, respectively).
The susceptibility of the isolates to different antimicrobial was performed using the disc diffusion method. It was found that there was high resistance to Ceftazidime (86%), Cefotaxime (72%) isolates Cefapime (42%), Ampicillin (42%), Ofofloxacin (34%), there was low resistance to Trimethoprim-Sulphamethoxazole(28%),Ceftriaxone(26%), Choloromphenicol (46 %), Ampicilline\Sulbactam (32%), Gentamicine (18%), Streptomycine (14%). On the other hand, there was no resistance to Imipenem and Piperacillin. from the 50 P.aeruginosa isolates, 28 (56%) were resistance to at least 3 different antimicrobial groups (multi-drug resistance).
Real time PCR was used to detect role of presence of integron in increasing MDR. Recent advances in the study of integrons have been involved in the recruitment and expression of resistance genes and have been found widely distributed among resistance bacteria circulating in hospitals and in the community.
Their presence in bacterial genomes can be traced back several years. Integrons should be regarded as the major means of short term accumulation of resistance determinants in bacterial genome. In this study was shown that (71.4%) of MDR isolates was integron positive while (28.5%) were integron negative. In conclusion, there is a marked increase and a change in resistance patterns of P.aeruginosa to different antimicrobial agents over time Continuous search and constant monitoring of drug resistance are important for effective management of infection with P.aeruginosa at Minia Governorate.