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Abstract
Active efflux of antimicrobial agents is a primary mechanism by which bacterial pathogens can become multidrug resistant. The combined use of efflux pump inhibitors (EPIs) with pump substrates is under exploration to overcome efflux-mediated multidrug resistance. Phenylalanine-arginine Ý-naphthylamide (PAÝN) is a well-studied EPI that is routinely combined with fluoroquinolone antibiotics, but few studies have assessed its utility in combination with Ý-lactam antibiotics. MICs of 219 unrepeated ESBL-positive ciprofloxacin resistance Enterobactereacae isolates isolated from various clinical samples from Kasr El-Einy Hospital. The prevalence of the efflux pump genes oqxAB and plasmid mediated Quinolones resistance qnrA , qnrB, qnrS, aac(6{u2019})-Ib and qepA in a total of 33 clinical isolates which show reduction in MIC after addition of PAÝN was investigated by PCR amplification. The study indicates the necessity for the detection of overexpressing efflux pumps at diagnostic level at least in tertiary care hospitals. Extended-spectrum Ý-lactamase-producing Escherichia coli (ESBL-EC) pose a serious threat to the successful treatment of common bacterial infections. Over the past two decades, there has been an increase in the prevalence of ESBL-EC