الفهرس 
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Abstract
This work was a hospital-based cross-sectional study that was conducted over a period of two years from December 2019 to July 2022.
This study included 250 patients admitted at Assiut University Urology Hospital; 186 (74.4%) males and 64 (25.6%) females. Out of the 250 patients, 128 (51.2%) were catheterized. Urine samples were aseptically obtained from the patients.
Out of 250 urine samples examined by viable count method, 200 (80%) samples revealed significant bacteriuria.
Out of the 200 samples that showed significant bacteriuria, 44 (22%) contained Staphylococci spp. and 156 (78%) contained Gram-negative isolates.
In this study, Klebsiella spp. was identified as the most common causative agent of UTIs (33%) followed by Pseudomonas spp. (23.5%).
E.coli and Klebsiella spp. were more common in catheterized patients than non-catheterized patients. On the other hand, Pseudomonas spp. was more common in non-catheterized patients than catheterized patients.
The highest resistance of the Gram-negative bacilli was to Ampicillin (97.2%) followed by cefepime (94.9%) and Ceftriaxone (94.5%).
The highest resistance of E.coli and Pseudomonas spp. was to cefepime (97.7%) and (93.6%), respectively. The highest resistance of Klebsiella spp. was to ampillcin 98.5%.
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By using modified Kirby Bauer disc diffusion method, 100 (64.1%) of the Gram-negative isolates were carbapenem resistant. The frequency of carbapenem resistance was highest in Pseudomonas spp. (87.2%) and lowest in E.coli (44.2%).
The carbapenemase activity was detected by MHT in 48 isolates out of the 100 Carbapenem resistant Gram negative isolates.
Eighty eight of the Carbapenem resistant Gram negative bacilli isolates showed increase zone of inhibition of about 7mm or more around EDTA-IPM discs compared to IPM disc alone (positive for MßLs production).
In the current study, bla KPC was positive in 37/156 (23.7%) isolates. It was positive in 33 (33 %) of Carbapenem resistant Gram negative isolates and 4 (7.1 %) of Carbapenem sensitive isolates. Bla NDM1 was positive in 94/156 (60.2%) isolates. It was positive in 89 (89%) of Carbapenem resistant Gram negative isolates and 5 (8.9 %) of Carbapenem sensitive isolates.