الفهرس 
Escherichia ColiOnly 14 pages are availabe for public view
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Abstract
Urinary tract infections (UTIs) are one of the most common types of infections , Uropathogenic Escherichia coli (UPEC) are one of the main bacteria causing UTIs(Abou Heidar et al., 2019).
In Egypt, Escherichia coli is among the most common pathogens isolated from patients with urinary tract infections and it has a high prevalence of resistance to antibiotics (Abdelhamid and Abozahra , 2017).
Active efflux pumps have been considered as one of the most important intrinsic and acquired antibiotics resistance mechanisms in bacteria (Rosner and Martin ., 2013).
The main efflux pump of E. coli is the AcrAB-TolC that pumps out many antibiotics as tetracycline,chloramphenicol, ẞ-lactams, novobiocin, fusidic acid, nalidixic acid and fluoroquinolones among antibiotics and chemotherapeutic agents,Triton X-100 and bile salts among detergents, various cationic dyes and disinfectants and even solvents (Yu et al.,2003).
The aim of this study is :
Investigation of antibiotic resistance pattern of Escherichia coli strains isolated from patients with urinary tract infection admitted to Benha University Hospital.
Detection of the relationship of antibiotic resistance with the presence of efflux pump genes (AcrA-AcrB-TolC).
This study included 50 strains of E. coli isolated from 80 urine samples taken from patients attending urology out patient clinic of Benha
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University hospital suffering from UTI.Mid stream urine samples were collected in sterile screw capped containers. The patients were 37 females and 13 males and their ages ranged from 20-50 years old. Written consent was taken from each patient.
Mid stream urine samples were collected in sterile screw caped containers from patients with UTI.
Each collected urine sample was quantified for bacterial count and those ≥ 105 were then centrifuged and the deposit was used for isolation and identification of E.coli.
Antimicrobial susceptibility was done by Vitek 2 compact system,biomerieux,france then DNA extraction and Detection of acrAB tolC genes by conventional PCR.
The result of the study showed the following: 1. higher prevalence of urinary tract infections in female patients than in males.
2. The prevalence of MDR is 70 %.
3. The highest level of resistance of UPEC is against ampicillin(94%) ,nalidixic acid(84%), ticacillin (82%),ciprofloxacin(76%) and trimethoprim / sulfamethoxazole.
4. The antibiotics of choice for the treatment of E.coli associated infections with efflux pump genes were imipenem,amikacin and nitrofurantoin that shwed the lowest level of resistance.
5. The prevalence of efflux pump genes acr AB tol C in UPEC is 50%, 66% and 68% respectively.
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6. There is significant correlation between acr A gene and resistance to amoxicillin / clavulinic acid , piperacillin / tazobactam , gentamicin , nalidixic acid , ciprofloxacin , ofloxacin and trimethoprim / sulfamethoxazole.
7. There is significant correlation between acr B gene and resistance to ampicillin , piperacillin / tazobactam , cefoxitin, gentamicin,nalidixic acid,ciprofloxacin,ofloxacin and trimethoprim / sulfamethoxazole.
8. There is significant correlation between tol C gene and resistance to amoxicillin / clavulinic acid,piperacillin / tazobactam, cafalotin , cefoxitin , cafotaxime , ceftazidime , gentamicin , tobramycin , nalidixic acid , ciprofloxacin,ofloxacin and trimethoprim / sulfamethoxazole.
9. There is significant correlation between tol C gene and MDR phenotype.