الفهرس 
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Abstract
Background: Urinary tract infections (UTIs) are considered one the most common bacterial infections faced in clinical practice. Antibiotic resistance is increasing worldwide among Gram negative bacteria, which is commonly responsible for UTIs. In Gram-negative organisms, β-lactamase production is the most significant causative factor to β-lactam resistance. The spread of ESBL producing isolates in hospital settings is a main public health problem. Early detection and reporting is vital to offer adequate therapy and to obtain appropriate outcomes. The ESBL NDP (Nordmann/Dortet/Poirel) test has been recently developed for the early detection of ESBL producing organisms. It is based on the biochemical detection of the hydrolysis of the β-lactam ring of cefotaxime (a broad spectrum cephalosporin). Aim: This work was carried out to evaluate NDP test for rapid detection of Extended-Spectrum β-Lactamase Producing Enterobacteriaceae directly from infected urine samples. Setting: Microbiology Diagnostics and Infection Control Unit (MDICU), in the Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University. Results: This study was conducted over a period of 12 months from August 2016 till July 2017, a total of 342 urine samples were collected from patients with clinically suspected UTIs in different departments in MUHs. Among these urine samples, 100 were considered non-duplicate Enterobacteriaceae isolates after being processed and cultured on CLED agar. K. pneumoniae was the most frequently isolated pathogen of the family Enterobacteriaceae during the study period (46.0 %), followed by E. coli (38.0 %). The urine samples were submitted to ESBL NDP test for phenotypic detection of ESBL producing strains. Thirty isolates (30.0%) were positive for ESBL production, while Thirty six isolates (36.0%) were positive for ESBL production by DDST. There was higher prevalence of resistance to Cefotaxime, Ceftazidime, Cefipime, Ceftriaxone, and Amoxicillin–clavulanate detected in ESBL isolates in comparison to non-ESBL ones. NDP test performed directly from the urine samples was sensitive (83.3%) and highly specific (100%) with a PPV of (100%), and a NPV of (91.4%). It is inexpensive and the results can be obtained within 1 h. ESBL NDP test also showed positive result for ESBL in 30 samples (30.0 %) with the same sensitivity, specificity, PPV and NPV as when performed directly from the urine samples Conclusion: We conclude that ESBL NDP test is a reliable, cost effective phenotypic method to confirm screening of positive ESBL isolates. This inexpensive ESBL NDP test may optimize rapid choices of antibiotics for treating infections. It may also contribute to avoidance of overuse of carbapenems.