الفهرس 
Introduction & aim of the workOnly 14 pages are availabe for public view
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Abstract
During the past decades, health care associated outbreaks of p.aeruginosa have been described with increased frequency mostly in ICUs. Epidemic strains of pseudomonas spp. are often resistant to several antimicrobial drugs which reduce the treatment effectiveness, and lead to development of MDR strains. Carbapenems are the most dependable last option for treating MDR pathogens infections. The exponential growth of carbapenem-resistant P. aeruginosa poses a major public health risk and has emerged as a prominent global public health issue in the past 10 years.
This study was aimed to address the prevalence of carbapenem resistant Pseudomonas aeruginosa (CRPA) isolated from clinical specimens at Minia university hospitals and detection the presence carbapenemase encoding genes bla IMP and bla VIM among them.
During six month duration study, 167 P. aeruginosa isolates were collected at Minia university hospital microbiology laboratory. Most of these isolates were from urine specimens (37.7%), followed by blood (12.0%), surgical wound swabs (12.0%), sputum (10.8%) and endotracheal aspirates (9.0%). Most of isolates were from nephrology departments (43%), ICUs (19%) and surgical departments (11.8%).
All isolates were subjected to routine culture on blood agar and MacConkey agar media for 24 to 48 hours incubation at 37oc. Identification of the isolates was done by Gram stains morphology, Vitek-2 and AST by Vitek-2 according to manufacturer’s instructions.
It was found that, the most effective antibiotics against P. aeruginosa were amikacin (76.6%), carbapenems (73.1%), colistin (67.1%), and gentamicin (64.1%). Seventy three (43.7%) out of 167 P. aeruginosa isolates were MDR.
Forty five out of 167 (26.9%) of isolates were carbapenem resistant. Which were commonly obtained from ICU patients (55.5%), urine specimens (44.4%), and sputum (17.8%). Phenotypic detection of carbapenemase in CRPA isolates was done by mCIM. Which was positive in 43 (95.5%) out of the 45 carbapenems resistant isolates.
CRPA isolates were tested for the presence of bla IMP and bla VIM genes using conventional PCR. Bla VIM was detected in 25 (55.6%) and bla IMP in 8 (17.8%) of resistant isolates. Of the carbapenemase-positive isolates, 21 (46.6%) carried one gene and 6(13.9%) carried both.
Overall, this study found a considerable rate of multidrug-resistant P. aeruginosa among clinical isolates, with carbapenem resistance mediated predominately by acquisition of blaVIM metallo-ß-lactamase genes, signaling a major public health threat in this setting. Infection control efforts should focus on containment of transmission among critically ill and high-risk patients.