الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
During the period from November 2009 to April 2010, 84 out of 560 extended spectrum β-lactamase (ESBL) producing negative bacteria were isolated from patients in different departments of Ahmadi Hospital in Kuwait. The isolates were collected from urine, catheter, wound, sputum, blood and other different samples. The ESBL infection rate in the hospitalized patients was (62%) and most of them were in the intensive care unit (19%). All the isolated bacteria were identified and tested for antimicrobial susceptibility using an automated system (VITEK 2) and different antibiotic discs (15) by standard disc diffusion. The number of the recorded isolated multi-resistant Gram’s negative bacteria were 54 isolates of Escherichia coli, 18 of Klebsiella pneumoniae, 11 of Pseudomonas aeruginosa, 6 of Proteus mirabilis, 5 of Enterobacter cloacae, 4 of Acinetobacter baumanii and one of Enterobacter aerogenes. They were resistant to the third generation of cephalosporins; Ceftazidime, Cefotaxime and Ceftriaxone. Meropenam was the highest effective antibiotic against all the isolated bacteria (86%). The production of the ESBL was detected by phenotypic methods using E-test (96.4%), double disk synergy test (95%) and VITEK 2 (84.5%) in all multi-resistant isolates except Ac. baumanii and Ps. aeruginosa. All ESBL producing isolates were extracted and subjected to PCR using bla-SHV, bla-CTX-M and bla-TEM primers. The bla-CTX-M (63.1%) was the most predominant ESBL genes that produced in abundance by 42 isolates of E. coli. The most predominant ESBL isolates producing bla-TEM, bla-CTX-M and bla-SHV genes were successfully identified by16 S rDNA. The conjugation and cloning assays showed that the blue-CTX-M gene was able to be transferable suggesting that it is plasmid mediated. Chlorox has found to be the most effective detergent and Marjoram was the most inhibitor essential oil on ESBLs.