الفهرس 
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Abstract
Introduction: The quinolone antibiotics arose in the early 1960s, with the first examples possessing a narrow spectrum of activity with unfavorable pharmacokinetic properties. Over time, the development of new quinolone antibiotics has led to improved analogues with an expanded spectrum and high efficacy. Nowadays, quinolones are widely used for treating a variety of infections. Quinolones are broad-spectrum antibiotics that are active against both Gram-positive and Gram-negative bacteria, including mycobacteria, and anaerobes. Bacteria have acquired resistance to quinolones, similar to other antibacterial agents, due to the overuse of these drugs. Mechanisms contributing to quinolone resistance are mediated by chromosomal mutations and/or plasmid gene uptake that alter the topoisomerase targets, modify the quinolone, and/or reduce drug accumulation by either decreased uptake or increased efflux. Escherichia coli is a Gram-negative, facultative anaerobic, rod-shaped, bacterium that is commonly found in the lower intestine of warm-blooded organisms. Uropathogenic E. coli (UPEC) is the most common cause of both community acquired and hospital acquired UTI. Catheter-associated urinary tract infection (CAUTI) is the most common healthcare-associated infection and cause of secondary bloodstream infections. Despite many advances in diagnosis, prevention and treatment, CAUTI remains a severe healthcare burden, and antibiotic resistance rates are alarmingly high. Aim of the work: To determine common pathogens , associated risk factors, antibiotics susceptibility of hospital acquired urinary tract infection and to characterize the quinolone resistance phenotypes and genotypes in E. coli isolated from UTI in intensive care units (ICU) patients. Subjects & methods: Urine samples were collected from Intensive care units at Mansoura University Main Hospital over a period of two years. Samples were then transferred to microbiology lab, Mansoura University Main Hospital for culture, identification and sensitivity. 50 E coli Cultures resistant to ciprofloxacin isolated from ICU patients with CAUTI according to CDC 2018 definition were then transferred to molecular biology lab in microbiology unit, clinical pathology department, Mansoura faculty of medicine for DNA extraction, polymerase chain reaction (PCR) for Qnr A, Qnr B and Qnr S genes using multiplex PCR techniques. Results: Quinolones resistance rate was 64.7 % and prevalence of PMQR genes was 92%. Significant association was found between number of PMQR genes and increased MIC level. The extensive misuse of quinolones antibiotics has increased rate of resistance worldwide and within our medical settings. Great efforts should be exerted to decrease this pattern of increased antibiotics resistance. Key Words ( not more than 10 ) Escherichia coli. Urinary tract infection. Quinolone.