الفهرس 
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Abstract
Nowadays hospital-acquired infections (HAIs) in intensive care units (ICUs) caused by Acinetobacter calcoaceticus–baumannii complex (Acb) is emerging as one of the commonest causes all over the world which is frequently resistant to multiple classes of antibiotics including carbapenems thus, complicating treatment. Acinetobacter baumannii infection takes place when the immune barriers of the host are breached (e.g. indwelling medical device) therefore it is considered an opportunistic pathogen which causes various types of HAIs, including bacteraemia, ventilator-associated pneumonia (VAP), urinary tract infection, infections complicating wounds and meningitis. Acinetobacter baumannii seems to have a tendency for developing antimicrobial resistance tremendously rapidly. Additionally this resistance is multiple, causing serious therapeutic problems. Aim : This work was carried to estimate the prevalence rates Acb complex responsible for nosocomial infection from different ICUs of MUH, determination of their antimicrobial resistance pattern with selection of MDR and XDR strains, identification of risk factors associated with acquisition of these infections and to end with phenotypic detection of carbapenemase production by MHT and isolation of blaOxA-23-like genes by PCR. Setting: Microbiology Diagnostics and Infection Control Unit (MDICU), in the Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University. Results: This study included 1564 patients with clinically suspected nosocomial infections as VAP, UTIs, BSIs and SSIs. Out of the 1564 non duplicated clinical samples collected, pathogenic organisms were detected in 1151 samples. Acinetobacter was isolated from 44 non repetitive samples representing 2.8% prevalence in ICUs of MUH, corresponding to 3.5% of isolated pathogenic organisms Acinetobacter was considered the fifth most common Gram-negative organism isolated during the study period (6.9%). A. baumannii showed the highest resistance to imipenem (81%), 28/44 were MDR (63.636%) and 8/44 were XDR (18.181%). We observed no PDR strains. Among the 34 imipenem-resistant A. baumannii isolates detected by E-test, 29 isolates (85.3%) showed positive results, 31/34 of IR isolates (94%) carried the blaOXA-23 like gene by PCR. On the other hand two out of IMP sensitive isolates showed positive results for blaOXA-23 like gene. Conclusion: The observed imipenem resistance is due to the spread of blaOXA-23 like genes. The clinical significance of these isolates is of great concern as it stresses on the importance of conducting effective infection control measures in Egyptian hospitals with firm adherence to these measures is required to prevent the spread of this resistant organisms.