الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Antibiotic resistance of bacteria is on increase so the discovery of alternative therapeutic agents is urgently needed. Honey possesses therapeutic potential, including wound healing properties and antimicrobial activity. Numerous studies have reported that honey has been shown to have antibacterial, antiviral, antifungal, antiparasitic, anti-inflammatory, antitumor, anticancer, antidiabetic, antihypertensive, cardioprotective, gastroprotective and neuroprotective effects.
Honey is collected by honeybees from the nectar or blossoms of flowers or from living parts of plants and process it through repeated digestion and regurgitation. Honey is mainly composed of sugars, water and other constituents such as enzymes, amino acids, organic acids, carotenoids, vitamins, minerals and aromatic substances and also rich in flavonoids and phenolic acids.
Composition, aroma, flavor and color of honey depend mainly on the flowers, geographical region, climate and honeybee species involved on its production and also are affected by weather conditions, processing, manipulation, packaging and storage time. Cotton, clover, citrus, eucalyptus, black seed and sidr honey are the main types available in the Egyptian markets.
As microbial resistance to honey has never been reported, it is a very promising antimicrobial agent against the infection of antibiotic resistant bacteria that do not respond to antibiotic therapy. The antimicrobial properties of honey can be attributed to several factors like high sugar content, high osmotic pressure, low pH and hydrogen peroxide.
The aim of the work was to evaluate antibacterial effect of some honey types against multidrug resistant bacteria through determining the antibiogram of multidrug resistant bacterial clinical isolates and determining the antibacterial activity of different types of honey which are available in the Egyptian market on the bacterial isolates.
The present study was conducted on 79 multidrug resistant bacterial isolates during the period from September 2017 to July 2018. A total 100 different clinical specimens were collected from private laboratory and subjected to microbiological procedures for isolation and identification.103 bacterial isolates were obtained and each isolate was tested for antimicrobial susceptibility. 79 MDR isolates were selected and tested against two different concentrations (10% and 20%) of three Egyptian honeys Sidr honey, citrus fruit honey and clover honey.
The results of this study showed that:
1. P. aeruginosa, E. coli and K. pneumoniae were the predominant isolates (33%, 21.4% and 15.5% respectively).
2. The most common isolate from urine specimens was E. coli (38.9%).
3. The most common isolates from infected wounds specimens were P. aeruginosa (33.3%) and E. coli (26.7%).
4. P. aeruginosa was the major isolate from burn wound specimens (90%).
5. 62.5% of S. aureus isolates were MRSA.
6. Out of 103 bacterial isolates 79 (76.7%) were MDR.
7. All MDR S. aureus isolates were resistant to penicillin (100%) and most of them were resistant to cefoxitin (83.3%).
8. MDR S. epidermidis showed high resistance to ciprofloxacin, erythromycin, penicillin, doxycycline, rifampin and gentamycin (each 66.7%).
9. All MDR S. saprophyticusisolates were resistant toerythromycin, cefoxitin, penicillin, doxycycline, gentamycin and ciprofloxacin.
10. All MDR P. aeruginosa isolates were resistant to ceftazidime (100%).
11. All MDR E. coli isolates were resistant to ampicillin and cefazolin (100%).
12. All MDR K. pneumoniae were resistant to ceftazidime, ampicillin, cefazolin, amoxicillin-clavulanate and cefuroxime (each 100%)
13. All MDR P. mirabilis isolates were resistant to ciprofloxacin, ampicillin and amoxicillin-clavulanate (each 100%).
14. MDR C. freundii was most resistant to ciprofloxacin, ampicillin, cefazolin, cefoxitin and trimethoprime-sulfamethoxazole (each 100%).
15. MDR B. cepacia was resistant to all antibiotic used (100%).
16. MDR A. baumanniiwas resistant to all antibiotics used except to amoxicillin-sulbactam was intermediate.
17. All honey types used (sidr, citrus and clover) decreased the bacterial count of MDR bacterial isolates.
18. 20% concentration of honeys showed high antibacterial activity than 10% concentration.
19. 10% concentration of citrus fruit honey and clover honey and 20% concentration of the three honey types decreased the count of MDR Staphylococcus spp.isolates.
20. 10% concentration of sidr honey and 20% concentration of all honey types used decreased the bacterial count of MDR P. aeruginosa.
21. 20% concentration of sidr honey has more antibacterial potential on MDR P. aeruginosa than 20% concentration of citrus fruit honey and clover honey.
22. 20% concentration of the three honey types decreased the bacterial count of MDR E. coli.
23. 20% concentration of sidr honey and clover honey have more antibacterial activity than 20% concentration of citrus fruit honey against MDR E. coli.
24. Only 20% concentration of the three honey types decreased the bacterial count of MDR K. pneumoniae.
25. 10% concentration of sidr honey and clover honey and 20% concentration of the three honey types decreased the count of MDR B. cepacia and A. baumannii.
from this study, it could be concluded that:
1. High rate of MDR bacterial isolates.
2. Egyptian honeys (sidr, citrus and clover) possess antibacterial activity against MDR gram positive and gram negative bacteria.
3. Low concentrations of honeys showed antibacterial activity.
4. Antibacterial activity of honey is type and concentration dependent.
5. Susceptibility to honey differs according to different bacterial species.