الفهرس 
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Abstract
E. coli is one of the leading pathogens causing diverse community-acquired and hospital-acquired infections. Recently, the threat of antibiotic resistance among E. coli and other Enterobacteriaceae has caused a great concern. Aminoglycosides continue to be used as empirical and definitive treatment of wide-range of infections, due to their rapid bactericidal activity and relatively low rates of resistance compared to other antibiotic classes. Unfortunately, aminoglycoside resistance shows progressive increase, causing worrisome deterioration of efficacy of this precious group.
The aim of this work was to determine the prevalence of E. coli infections among different departments, ICUs and out-patient clinics of Menoufia University Hospitals, determine the antimicrobial susceptibility patterns of the isolated E. coli by phenotypic methods and verify the presence of aac(3)IIa and aac(6)Ib aminoglycoside resistance genes in the isolated E. coli spp. by real-time PCR assay.
The study included 200 patients admitted to different departments and ICUs at Menoufia University Hospitals or seeked medical advice in outpatient clinics. Different specimens were obtained and processed according to the standard microbiological methods. Fifty (50) E. coli isolates were isolated and identified by conventional methods.
Antimicrobial susceptibility test was done for E. coli isolates by disc diffusion method and MICs of gentamicin and amikacin were estimated by agar dilution method. Results were interpreted according to the Clinical and Laboratory Standard Institute (CLSI) guidelines. Extended-spectrum β-lactamases (ESβLs) production was detected by disc diffusion screening test (ceftazedime disc diffusion) and confirmed by combined disk and synergy tests.