Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Clinical and Chemical Pathology

Backgroung: The global spread of Carbapenem resistance organisms (CRO) has become a major public health concern especially regarding limited treatment options. Ceftazidime-avibactam (CZA) is a promising therapy for CRO causing infections Aim of work: we aimed to determine the prevalence of carbapenem resistant Enterobacteriaceae and Pseudomonas aeruginosa among clinical isolates and to investigate the in vitro antimicrobial susceptibility of CZA. Methods: Our study was conducted at Cairo university specialized pediatric hospital over one year. A total of 320 isolates were included. CZA.susceptibility testing was done disk diffusion method.The presence of carbapenemases was detected in 170 isolates by modified carbapenem inactivation method (mCIM) and multiplex PCR tests. Results: Prevalence of the prevalence of carbapenem resistant Enterobacteriaceae and Pseudomonas aeruginosa clinical isolates was 72.6%. Among our isolates, 78.8% were Klebsiella pneumoniae. The most frequently detected carbapenemase genes were blaNDM in 70.0% isolates, followed by blaOXA-48 in 67.6% and blaKPC in 16.5% isolates. CZA active against 30.0% of isolates Conclusion: multiplex PCR is sensitive and specific method for carbapenamase detection. CZA exhibited a fairly susceptible rate among our CRO

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