Efflux -Mediated Resistance in Isolated from Patients with Healthcare Associated Infections.

Today, one of the most important challenges for physicians is the adequate treatment of infections due to multidrug resistant organism (MDR). is considered an opportunistic organism causing different types of healthcare associated infections (HAIs). We aimed to investigate the MDR and pandrug resistance (PDR) rate in in our region and detect efflux-pump genes and the proposed binding interactions of five different categories of antimicrobial agents with the pump. A total of 180 non-duplicated were isolated from patients with HAIs in the Suez Canal University Hospital. Phenotypically, minimum inhibitory concentration (MIC) was done for all MDR and PDR strains before and after addition of efflux pump inhibitor carbonyl cyanide m-chlorophenyl hydrazone (CCCP). Molecular detection of and genes was done by using polymerase chain reaction (PCR). Most of the isolated strains (126 strains) were MDR (70%); only 10 samples (5.5%) were PDR. and genes were detected in 88.2% (120 strains) and 70.5% (96 strains) of stains, respectively. All PDR strains (10 stains) carried both and genes. Efflux genes were detected in all MDR and PDR strains (136 strains). Molecular modeling studies were performed to investigate the modes of intermolecular binding interactions between the antimicrobial agents and key amino acids that resulted in MDR and PDR. The current study reported high prevalence of MDR and PDR in patients with HAIs in the Suez Canal University Hospitals.