title: Carbapenem Susceptibility and Multidrug-Resistance inPseudomonas aeruginosaIsolates in Egypt.
abstract: BACKGROUND
  ResistantPseudomonas aeruginosais a serious concern for antimicrobial therapy, as the common isolates exhibit variable grades of resistance, involving beta-lactamase enzymes, beside native defense mechanisms.
  
  
  OBJECTIVE
  The present study was designed to determine the occurrence of Metallo-β- Lactamases (MBL) and Amp C harboringP. aeruginosaisolates from Suez Canal university hospital in Ismailia, Egypt.
  
  
  METHODS
  A total of 147P. aeruginosaisolates, recovered from 311 patients during a 10-month period, were collected between May 2013 and February 2014; the isolates were collected from urine, wound and sputum. Minimum inhibitory concentration (MIC) determined by agar dilution methods was ≥2 μg/mL for meropenem and imipenem. Identification ofP. aeruginosawas confirmed using API 20NE. Metallo-β- Lactamases and Amp C were detected based on different phenotypic methods.
  
  
  RESULTS
  Overall, 26.5% ofP. aeruginosaisolates (39/147) were carbapenem resistant isolates. Furthermore, 64.1% (25/39) were MBL producers, these isolates were screened by the combined disc and disc diffusion methods to determine the ability of MBL production. Both MBL and Amp C harboredP. aeruginosaisolates were 28% (7/25). Sixty-four percent ofP. aeruginosaisolates were multidrug resistant (MDR) (16/25). The sensitivity toward polymyxin, imipenem, norfloxacin, piperacillin-tazobactam and gentamicin was 99%, 91%, 88%, 82% and 78%, respectively. The resistance rate towards cefotaxime, ceftazidime, cefepime, aztreonam and meropenem was 98.6%, 86%, 71.4%, 34% and 30%, respectively.
  
  
  CONCLUSIONS
  Multidrug resistance was significantly associated with MBL production inP. aeruginosa. Early detection of MBL-producingP. aeruginosaand hospital antibiotic policy prescription helps proper antimicrobial therapy and avoidance of dissemination of these multidrug resistance isolates.
authors.affiliation: Departement of Microbiology and Immunology, Faculty of Pharmacy, Suez Canal University, Egypt.
authors.forename: Hany
authors.initials: H
authors.lastname: Hashem
authors.affiliation: Departement of Microbiology and Immunology, Faculty of Pharmacy, Suez Canal University, Egypt.
authors.forename: Amro
authors.initials: A
authors.lastname: Hanora
authors.affiliation: Departement of Microbiology and Immunology, Faculty of Pharmacy, Qassim University, KSA.
authors.forename: Salah
authors.initials: S
authors.lastname: Abdalla
authors.affiliation: Departement of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Egypt.
authors.forename: Alaa
authors.initials: A
authors.lastname: Shawky
authors.affiliation: Departement of Clinical Pathology, Faculty of Medicine, Suez Canal University, Egypt.
authors.forename: Alaa
authors.initials: A
authors.lastname: Saad
keywords: Amp C; MBLs; MDR; Pseudomonas aeruginosa