الفهرس 
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Abstract
This study was conducted over 18 months on 45Klebsiella pneumoniae (K. pneumoniae) isolates collected from 250 samples from patients admitted to the intensive care units (ICUs), at Assiut University HospitalThe API 20E system identified 45 isolates as K. pneumoniae. polymerase chain reaction (PCR) detected blaNDM1 and plasmid-mediated quinolone resistance determinants (PMQRs) in (48.9% and 100%) of the K. pneumoniae isolates, respectively. qnrB was the most common (80 %) PMQR detected, followed by qnrS1 (77.8%), then aac(6`)-Ib-cr (22.2%), while qnrA and qepA were not detected in any of the isolates. Moreover, PMQR determinants and blaNDM1 co-existed in 22/45 (48.9%Kpneumoniae isolates. The resistance rates against imipenem andciprofloxacin in . pneumoniae isolates co-harboring blaNDM1 and PMQRs, detected by E-test, were (77.3%) and (54.5%), respectively. Furthermore, all isolates were multidrug-resistant (MDR).enotyping of K. pneumoniae isolates by pulsed-field gel electrophoresis (PFGE) showed that they belong to 15 pulsotypes or clusters (A-O). Isolates of the same cluster were recovered from the same ICU, except KP10 was from ICU, different from the other isolates in its clusteronjugation and transformation experiments revealed that PMQR genes (qnrB, qnrS1, and acc(6`)-Ib-cr) and blaNDM1 were successfully transferred from K. pneumoniae donors to E. coli recipients in all isolates.