Background:Drug-resistant isolates remain an important hospital-acquired bacterial pathogen, add significantly to hospital stays and especially problematic in high-impact medical areas such as intensive care units. Klebsiella pneumoniae is the most common cause of nosocomial respiratory tract, and the second-most frequent cause of Gramnegative bacteraemia and urinary tract infections. It is essential to detect the beta lactam resistance in K. pneumoniae for proper antibiotic therapy and to limit the spread the infection. Objectives: The study was designed to review the rates of extended-spectrum β-lactamases (ESBL), metallo beta lactamases (MBL) and Ampicillin resistance gene group C (AmpC) beta lactamases production among K. pneumoniae isolates and to assess the best phenotypic method for detection of the resistance. Methodology: This study included 200 isolates obtained from patients admitted to different Departments in Assiut University Hospital. Screening and phenotypic confirmatory tests for resistance were done. Results: The Percentages of B -Lactamase enzymes producers from 50 isolates of K. pneumoniae were11 (22%) isolates not resistant; 6 (12%) by screening with antibiotic sensitivity tests and 5(10%) by the gold standard phenotypic tests. The remaining 39of 50 isolates (78%) were resistant and distributed as follow; Ten strains (20%) were ESBL alone, 2 (4%) were ESBL and AmpC, 4(8%) were ESBL and Carbapenemases, 13(26%) were AmpC producers alone and 10 (20%) were Carbapenemases producers alone. The combined disk test showed high sensitivity and specificity for detection of ESBL and MBL, For AmpC detection; the disk approximation test showed higher sensitivity and specificity than boronic acid. Conclusion: The rate of Beta lactamases production by K.pneumoniae is seriously increased, the most common type of beta lactamases in K.pneumoniae was the ESBL32% then AmpC30 %and lastly the Metallo beta lactamase (MBL) 28%. The phenotypic confirmatory tests showed high sensitivity and specificity and proved to be reliable methods for detection ofthe beta lactamase resistance, genotypic tests are recommended to be a gold standard tests to increase the specificity of the phenotypic tests.
This research aimed at identifying the personal characteristics of rural small business owners as well as identifying their proposals to limit the problems facing them in the study area. The descriptive approach was used to conduct this study by relying on samples in an attempt to generalize the results at the village level. Luxor Governorate was chosen as a geographical area for conducting this study due to the spread of small projects in the governorate. The research included two rural respondents who received loans from the Social Fund For development of small projects in various sectors of commercial, service, industrial and animal. The overall and sample was selected according to the data obtained from the Social Fund for Development in the province by choosing the three largest centers and choosing the three largest villages Each center in terms of the preparation of projects in small have been identified the size of the sample according to the equation of Krjsy and Morgan. The interview questionnaire was used as a personal data collection tool and after selecting the validity of the survey questionnaire to achieve the objectives of the study. Data were collected from the first of July until the end of August 2018. To analyze the data of this research, the descriptive statistics were used using the periodic presentation by frequency and percentages . The following are the main findings of the research: The most important problems faced by the owners of the projects are the problems of supply, including the sale of cash and payment in cash when buying raw materials project and high interest rates in banks and frequent routine procedures for obtaining loans, while the problems related to the workers were high wages of workers and lack of workers, which have the skills and expertise needed for the project and the continuity of the project workers While the problems related to production inputs were the high prices of production inputs and the emergence of fraud in the production requirements, especially cheati ng pesticides and organic fertilizers, either marketing problems were unstable prices Volatility and lack of return of projects and finally the problems were difficult to provide administrative guarantees required by the lenders and the absence of a feasibility study to study what the market needs of the projects and the spread of the style of mediation and favoritism in obtaining loans He found that the most important proposals of the owners of projects to reduce these problems was to facilitate the installation of public facilities of the project in cooperation with the local units in villages and the work of seminars and training courses for entrepreneurs to give them advice and advice and know them the best ways in the work of small projects to give an appropriate grace period of the project to pay taxes and payment of loan installments and facilitate Special procedures for obtaining licenses for the establishment of the project The government should have a role to encourage young people to establish...
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