{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T20:04:04Z","timestamp":1785182644760,"version":"3.55.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2019,4,1]],"date-time":"2019-04-01T00:00:00Z","timestamp":1554076800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2019,4,1]]},"abstract":"<jats:p>\n                    This study was designed to investigate, at the molecular level, the antimicrobial resistance mechanisms of different antimicrobial resistance genes, including, extended-spectrum \u03b2-lactamases, AmpC \u03b2-lactamases, class 1 and 2 integrons, and plasmid-mediated quinolone resistance genes of Gram-negative bacteria isolated from clinical settings in Egypt. A total of 126 nonduplicate Gram-negative isolates were recovered from different clinical samples taken from hospitalized patients in Egypt in 2014. Antimicrobial susceptibility testing showed that, 93.6% (118\/126) of the isolates had a multidrug-resistant phenotype. Interestingly, we reported a high level of antimicrobial resistance nearly for all tested antibiotics; to our knowledge, this is the first report from Egypt indicating very high level of antibiotic resistance in Egypt. Polymerase chain reaction screening and DNA sequencing revealed that, 75.4% (95\/126) of the isolates harbored at least one extended-spectrum \u03b2-lactamase-encoding gene, with\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>CTX-M<\/jats:sub>\n                    being the most prevalent (65.9%), followed by\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>SHV<\/jats:sub>\n                    (46.8%). The AmpC \u03b2-lactamase,\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>CMY<\/jats:sub>\n                    , was detected in 7.1% (9\/126) of bacterial isolates, with\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>CMY-42<\/jats:sub>\n                    being the most prevalent. Class 1 integrons were detected in 50.8% (64\/126) of the isolates, and class 2 integrons were detected in 2.4% (3\/126) of the isolates. The plasmid-mediated quinolone resistance gene,\n                    <jats:italic toggle=\"yes\">qnr<\/jats:italic>\n                    , was detected in 58.7% (74\/126) of the tested isolates, with\n                    <jats:italic toggle=\"yes\">qnrS<\/jats:italic>\n                    being the most prevalent. Several antimicrobial resistance determinants were identified in Egypt for the first time, such as SHV-27, SHV-28, SHV-33, SHV-63, SHV-71, SHV-82, SHV-142, CMY-42, CMY-6, and the new CMY-72 like. This study highlights the importance of the conscious use of conventional antimicrobials to overcome the multidrug resistance problem.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2018.0380","type":"journal-article","created":{"date-parts":[[2019,1,25]],"date-time":"2019-01-25T11:33:10Z","timestamp":1548415990000},"page":"371-385","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":44,"title":["High Prevalence of Antimicrobial Resistance in Gram-Negative Bacteria Isolated from Clinical Settings in Egypt: Recalling for Judicious Use of Conventional Antimicrobials in Developing Nations"],"prefix":"10.1177","volume":"25","author":[{"given":"Hazim O.","family":"Khalifa","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Graduate School of Medicine, International University of Health and Welfare, Narita, Japan."},{"name":"Department of Pharmacology, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafr El-Sheikh, Egypt."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed M.","family":"Soliman","sequence":"additional","affiliation":[{"name":"Laboratory of Food Microbiology and Hygiene, Graduate School of Biosphere Science, Hiroshima University, Higashi-Hiroshima, Japan."},{"name":"Department of Microbiology and Immunology, Faculty of Pharmacy, Kafrelsheikh University, Kafr El-Sheikh, Egypt."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf M.","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Bacteriology, Mycology and Immunology, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafr El-Sheikh, Egypt."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshi","family":"Shimamoto","sequence":"additional","affiliation":[{"name":"Laboratory of Food Microbiology and Hygiene, Graduate School of Biosphere Science, Hiroshima University, Higashi-Hiroshima, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Nariya","sequence":"additional","affiliation":[{"name":"Laboratory of Food Microbiology and Hygiene, Graduate School of Biosphere Science, Hiroshima University, Higashi-Hiroshima, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Graduate School of Medicine, International University of Health and Welfare, Narita, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Shimamoto","sequence":"additional","affiliation":[{"name":"Laboratory of Food Microbiology and Hygiene, Graduate School of Biosphere Science, Hiroshima University, Higashi-Hiroshima, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,4,4]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkg101"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/mdr.2015.0339"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00479-16"},{"key":"e_1_3_3_5_2","first-page":"Doc07","article-title":"First report of OXA-48-producing Klebsiella pneumoniae strains in Iran","volume":"9","author":"Azimi L.","year":"2014","unstructured":"Azimi L., , Nordmann P., , Lari A.R., , and Bonnin R.A.. 2014. 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