الفهرس 
?-lactam antibioticsOnly 14 pages are availabe for public view
 |  | from | 214 |  |  |
| | | from | 214 | | |
Abstract
ESβLs are enzymes that confer significant resistance to most β-lactam antibiotics like penicillins, cephalosporins, and the monobactam aztreonam. ESβLs producing bacteria were first detected in Western Europe in mid-1980s. Since then, their incidence has been increasing sharply and have become recognized as a major worldwide cause of antimicrobial β- lactamase mediated resistance in gram negative bacteria. ESβLs-producing bacterial species in hospitals and intensive care units (ICU) are commonly multidrug resistant, which possess a particular challenge for the treatment of nosocomial infections, especially in critically ill patients.This study aims at determining the prevalence of ESβLs-producing members of the Gram negative isolates which are isolated from samples collected from different Departments at Damanhur National Medical Institute by means of phenotypic and genotypic methods, evaluation of the clinical laboratory methods used for ESβLs detection, and studying the efficiency of some essential oil on ESβL- producing bacteria. The following summarizes the main points and results of the present study:• A total of 184 non-repetitive isolates from various clinical samples specimens including blood culture, bed sores, sputum, urine, wound and burn received in the clinical bacteriology laboratory at Damanhur Teaching Hospital. • Out of 184 sample, 129 were Gram negative bacteria.Biochemical identification was done for all Gram negative isolates. Pseudomonas aeruginosa were the most prevalent organism it was detected in 54.26% of Gram –ve isolates followed by Escherichia coli 18.6%, Klebsilla pneumonia14.73%, Proteus mirabilis8.53%), Enterobacter cloacae 2.33% and Actinobacter baumanni 1.55%. • Antibiotic sensitivity test was done for Gram negative and Mar index were calculated for every sample. MDR were assessed for ESβLs. • About 81.4% of Gram –ve bacteria were MDR. • ESβL enzyme were detected by initial screening test and phenotypic confirmatory test. ESβL- producing isolates incidence were 18.6% by IST test, and was raised to 55.8% by PCT. Female specimens represented 56.9% and males were 34.1%. • Antibiotic sensitivity test was done for ESβL-producing species and Mar index were calculated for every sample. MDR were assessed for ESβLs. • About 86.11% of ESBLs species were MDR. • Pseudomonas aeruginosa was the most prevalent organism it was detected in 55.56% of ESβLs strains followed by Escherichia coli 19.44%, Klebsilla pneumonia15.28%, Proteus mirabilis 6.94%, Enterobacter cloacae1.39% and Actinobacter baumanni 1.39%. • Pseudomonas aeruginosa represent the highest percentage (55.56%) among ESβL-producing Gram –ve isolates and there are 7 different ESβL bacteria resistant patterns. So, a seven Pseudomonas aeruginosa isolates were selected for further molecular investigations, one from each resistant pattern. • ESβL- producing isolates were identified by VITEK2 test.