الفهرس 
Enterobacteriaceae and type of infections
Carbapenem mode of actionOnly 14 pages are availabe for public view
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Abstract
The rapid spread of carbapenem resistant Enterobacteriaceae (CRE) all over the world represents a matter of concern. This study aims to investigate the prevalence of CRE in Egypt. A total of 112 clinical isolates were obtained from different patients in Al-Kasr Al-Aieny hospital. Most clinical isolates were obtained from urine 37.5% followed by wound 27.7% and sputum 18.8%. Patients suffered from different types of infections, urinary tract infections 26.8% followed by respiratory tract infections 18.8%. Bacterial isolates identification revealed that 75% of the clinical isolates were Klebsiella spp., 22.3% E. coli and 2.6% Enterobacter spp.
The antimicrobial susceptibility test of CRE isolates was performed against various classes of antibiotics. It was observed that the isolates were highly resistant to piperacillin (96.1%) and four cephalosporins generations (96%-100%). However, they showed sensitivity towards tetracycline (19.2%), levofloxacin (19.2%), and nitrofurantoin (17.3%).
In this study, detection of CRE was performed using phenotypic method and molecular assay. According to Modified Hodge test (MHT), it was estimated that 63.3% were carbapenemase producers, 15% were non producers while 21.6% did not confirmed. So, Representative isolates were selected for
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genotyping using Polymerase chain reaction (PCR). It was found that 76.6% of the isolates had NDM (New Delhi metallo-β- lactamase), 60% had OXA- 48 (Oxacillinase like-48) and 6.6 % VIM (Verona integron encoded metallo-β- lactamase). On the other hand, KPC (Klebsiella pneumoniae carbapenemase) and IMP (imipenemase) had not been detected in any isolate. On screening for ESBLs (Extended spectrum β- lactamase), 96.6% of the isolates were found to harbor CTX-M (cefotaximase β- lactamase), 90% TEM (Temoneira β- lactamase) and 73.3% SHV (sulfhydryl variable β- lactamase). This study highlighted the prevalence of carbapenem resistant Enterobacteriaceae in some Egyptian hospitals.