الفهرس 
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Abstract
Extended spectrum β-lactamase producing Enterobacteriaceae has been frequently implicated in outbreaks in intensive care units .ESBLs are often plasmid mediated and derived from mutations in the classic TEM and SHV genes by one or more amino acid substitution around the active site. TEM-1 β-lactamase producing bacteria are spread worldwide and it is now the most commonly encountered mechanism of resistance to the β-lactam group of drugs in Gram-negative bacilli. Over 100 variations and point mutations in TEM gene were reported by DNA sequencing. These mutations are the most responsible factor for resistance to beta lactams in these isolates.
The aim of this work was to assess the occurrence of ESBL producing klebsiella and E coli among patients in the National Liver Institute and to study the TEM and SHV Genes in ESBLs producing klebsiella and E coli isolated from the National Liver Institute Patients.
To achieve such target, our study was carried on a (138) patient’s specimens collected from different clinical samples (urine, sputum, blood, pus and others) those yielded Klebsiella & E coli in their cultures where they were cultured and identified then antibiogram, screening test for ESBLs using standard disc diffusion method and confirmatory tests using Cephalosporin/clavulanate combination disks were done. After which ESBLs positive isolates were subjected to molecular detection of TEM and S.