الفهرس 
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Abstract
ntimicrobial resistance in Gram-negative bacteria, particularly among those of the Enterobacteriaceae family, has become a leading cause of morbidity and mortality and a serious public health concern worldwide.
Enterobacteriaceae are common causes of both community-acquired and hospital acquired infections including urinary tract, bloodstream, and lower respiratory tract infections.So, rapid identification of these bacteria is necessary for preventing their dissemination and decreasing mortality.
The aim of this study was to evaluate the mCIM as a new method for phenotypic detection of carbapenemase-producing CRE isolated from patients in ICU of Ain Shams University hospitals and to test the in vitro susceptibility of the isolates to ceftazidime-avibactam.
This study was conducted on 120 patients admitted to different intensive care units of surgery department of Ain Shams University Hospitals during the period from June 2018 to November 2018. The age of the patients were ranged from 22 years to 82 years from whom 25 CRE were isolated from different clinical specimens as blood, urine, endo-tracheal aspirate, and sputum and wound swabs.
Identification of these isolates was done by conventional bacteriological methods. Then detection of 25 CRE strains was done by meropenem disk diffusion test. Then phenotypic detection of carbapenemase production in CRE isolates by using modified carbapenem inactivation method. The minimal inhibitory concentration (MIC) of ceftazidime- avibactam and meropenem was detected using the E-test.
The present study revealed the good Co-ordance between Meropenem E-test and modified CIM which showed 100% sensitivity.
This study also revealed the in vitro activity of ceftazidime- avibactam against CRE isolates that showed 88% susceptibility to it.