Tertiary Hospital In Egypt Research Articles

Assessing Hemodialysis Catheter Insertion Practices Against CDC Guidelines: A Closed-Loop Audit at a Tertiary Hospital in Egypt.

Background Following evidence-based guidelines during hemodialysis catheter insertion procedures is key to lowering catheter-related bloodstream infections (CRBSI) and other complications. Our aim was to examine all aspects relevant to the insertion of hemodialysis catheters in the dialysis unit at Alexandria Main University Hospital,Alexandria, Egypt, in order to identify practices that could be contributing to high complication rates. Methods We used the CDC's Guidelines for the Prevention of Intravascular Catheter-Related Infections to define the criteria relevant to hemodialysis catheter insertion procedures. These criteria were made into a form to be used as the primary auditing tool. The form was then used to record catheterization procedures in the dialysis unit from March 2024 to July 2024. Eighty patients scheduled for hemodialysis catheter insertion were randomlyselected, 40 in the initial cycle of the audit, and 40 in the re-audit cycle. Percentage adherence to each criterion was then calculated for each audit cycle and compared. Results Overall, adherence to the criteria assessed showed significant improvements, with mean compliance increasing from 69% in the initial cycle to 90% in the second cycle. In addition, the rate of mechanical complications recorded decreased. Conclusion Our study emphasized the effectiveness of using closed-loop clinical audits to ensure continuous improvement of care delivered during hemodialysis catheter insertion procedures.

Predictive Factors for Morbidity and Mortality in Patients with Blunt Pancreatic Trauma in a Tertiary Hospital in Egypt

Predictive Factors for Morbidity and Mortality in Patients with Blunt Pancreatic Trauma in a Tertiary Hospital in Egypt

TERT C228T Mutation in Circulating Tumor DNA as a Clinical Marker in Hepatocellular Carcinoma Patients Attending a Tertiary Hospital in Egypt: A Case-Control Study

TERT C228T Mutation in Circulating Tumor DNA as a Clinical Marker in Hepatocellular Carcinoma Patients Attending a Tertiary Hospital in Egypt: A Case-Control Study

Our experience in management of traumatic duodenal injuries in two tertiary hospitals in Egypt.

Our experience in management of traumatic duodenal injuries in two tertiary hospitals in Egypt.

Distribution and Antimicrobial Resistance of Complicated Intraabdominal Infection Pathogens in Two Tertiary Hospitals in Egypt.

Background: Management of complicated intraabdominal infections (cIAIs) requires containment of the source and appropriate initial antimicrobial therapy. Identifying the local data is important to guide the empirical selection of antimicrobial therapy. In this study, we aimed to describe the pathogen distribution and antimicrobial resistance of cIAI. Methods: In two major tertiary care hospitals in Egypt, we enrolled patients who met the case definition of cIAI from October 2022 to September 2023. Blood cultures were performed using the BACTAlert system (BioMerieux, Marcy l'Etoile, France). A culture of aspirated fluid, resected material, or debridement of the infection site was performed. Identification of pathogens and antimicrobial susceptibility testing were conducted by the VITEK-2 system (BioMerieux, Marcy l'Etoile, France). Gram-negative resistance genes were identified by PCR and confirmed by whole bacterial genome sequencing using the Nextera XT DNA Library Preparation Kit and sequencing with the MiSeq Reagent Kit 600 v3 (Illumina, USA) on the Illumina MiSeq. Results: We enrolled 423 patients, 275 (65.01%) males. The median age was 61.35 (range 25-72 years). We studied 452 recovered bacterial isolates. Gram-negative bacteria were the vast majority, dominated by E. coli, followed by Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Proteus mirabilis (33.6%, 30.5%, 13.7%, 13%, and 5.4%, respectively). High rates of resistance were detected to third- and fourth-generation cephalosporins and fluoroquinolones. No resistance was detected to colistin. Resistance to amikacin and tigecycline was low among all isolates. Resistance to meropenem and ceftazidime/avibactam was moderate. ESBL genes were common in E. coli and K. pneumoniae. CTX-M15 gene was the most frequent. Among Enterobacterales, blaOXA-48 and blaNDM were the most prevalent carbapenemase genes. Pseudomonas aeruginosa isolates harbored a wide variety of carbapenemase genes (OXA, NDM, VIM, SIM, GIM, SPM, IMP, AIM), dominated by metallo-beta-lactamases. In 20.6% of isolates, we identified two or more resistance genes. Conclusion: High resistance rates were detected to third- and fourth-generation cephalosporins and fluoroquinolones. Amikacin and tigecyclines were the most active antimicrobials. Our data call for urgent implementation of antimicrobial stewardship programs and reinforcement of infection control.

Characteristics of Rapid Response Team Calls in a Tertiary Hospital in Egypt

Abstract Background Rapid Response Teams (RRTs) help in the early recognition of deteriorating patients in hospital wards, and provide the needed management at the bedside by a qualified team. Aim of the Work To describe the characteristics of the RRT calls in a tertiary hospital in Egypt. Patients and Methods A prospective cohort study for a one-year duration from January 2021 till December, 2021was conducted, during this period a total of 2338 patients were reviewed, and 34 RRT calls were recorded. Results Our results showed that 10 calls (63%) of Rapid Response Team calls were in the daytime, and Nurses were the main activators with 27 activations (90%). Modified Early Warning scoring system (MEWS) and Pediatric Early Warning Score (PEWS) used were the main cause of RRT activation with a total of (66.7%), the majority of cases didn’t refer to the Intensive Care Unit (ICU), 19 patients stay in the ward (76%) and 22 cases (100%) were recovered. Conclusion More than half of RRT calls were in the daytime, and nurses were the main activators. Most rapid response team activations involve relatively few interventions, patient-activated RRT should consider as a patient right in the future, and further studies showed be conducted to evaluate the best effective methods for applying RRT among different health care facilities.

Epidemiology of Household Transmission of COVID-19 among Patients Attending Outpatient Clinics of Teaching Hospital in Cairo, Egypt

Abstract Background Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). People in closed settings with COVID-19 patients, such as household contacts, were more likely to become infected. Household studies can provide informative data for COVID-19 prevention and control. Aim to identify the epidemiological features of household transmission in a sample of patients attending the family medicine clinic of a tertiary hospital in Egypt, and to calculate the household COVID19 secondary clinical attack rate for the recruited patients. Materials and Methods An observational follow-up study was conducted among a sample of 180 primary probable COVID-19 cases attending a tertiary hospital in Cairo, Egypt and their 395 household contacts. The modified WHO case reporting form was used for follow-up of primary probable COVID-19 cases, and the modified WHO contact reporting form was used for their household contacts follow-up. Follow-up phone calls were conducted after 7, 10, and 14 days after attending to the hospital. Results The mean household Secondary clinical attack rate is 65.3 ± 29.9 (95 CI: 60.5% - 70.1%). There was a significant statistical association between reporting symptoms consistent with COVID-19 and sharing a room with the primary case, being not vaccinated, not using Personal protective equipment (PPE) as well as taking care of a primary case (p < 0.001). Conclusion and Recommendations Secondary clinical attack rate among the household contacts was high; more than the average reported rates globally. Vaccination and using PPE had important roles in lowering the risk of reporting symptoms consistent with COVID-19 among household contacts, yet the overall rate of using PPE was low and vaccination coverage was low compared to the rates reported globally. which necessitates more efforts to increase awareness of household transmission and how to safely care for a home-isolated COVID-19 case. The presence of co-morbidities increased the risk of hospitalization among symptomatic contacts This gives an alert to increase the awareness of cases with comorbidities about warning signs that necessitate early hospitalization for a better prognosis. about using PPE among household contacts with a COVID-19 case and also about the importance of vaccination against COVID- 19.

Effectiveness of Rapid Response Team implementation in a tertiary hospital in Egypt: an interventional study

BackgroundRapid response teams (RRTs) help in the early recognition of deteriorating patients in hospital wards and provide the needed management at the bedside by a qualified team. RRT implementation is...

Antimicrobial resistance patterns among critical priority pathogens in an intensive care unit at a tertiary hospital in Egypt: a descriptive analysis comparing pre- and COVID-19 eras.

Background. The intensified global challenge of antimicrobial resistance, set against the backdrop of the COVID-19 pandemic, is a cause for major concern. Within healthcare settings, intensive care units are recognized as focal points for Gram-negative infections. The study pursued to assess the prevalence and antimicrobial resistance patterns of critical priority pathogens (Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacteriaceae, comprising Klebsiella pneumoniae and Escherichia coli) during both pre- and COVID-19 periods.Gap Statement. The decision to explore this topic stemmed from the urgent need to understand how the exceptional healthcare crisis of COVID-19 affected AMR patterns.Methods. This was an observational retrospective analysis of 1056 clinical specimens obtained from 950 patients who were admitted to the Medical Intensive Care Unit at Kasr Al-Aini Hospital, Cairo University, Egypt.Results. In the period before COVID-19, 342 pathogenic isolates (135 K. pneumoniae, 83 P. aeruginosa, 76 A. baumannii and 48 E. coli) were obtained from samples collected from 450 patients. Conversely, during the COVID-19 period, 714 isolates (237 K. pneumoniae, 205 A. baumannii, 199 P. aeruginosa and 73 E. coli) were collected from the same number of patients. In the course of the pandemic, there is a slight increase in A. baumannii and P. aeruginosa infections, whereas E. coli and K. pneumoniae exhibit a distinct trend with a noticeable reduction in infection rates during COVID-19. During the COVID-19 period, a noticeable rise in resistance rates was observed for all antibiotics utilized. The results from Fisher's exact test indicated a substantial increase in resistance towards certain antibiotics. Specifically, a significant rise in resistance was observed for E. coli to ciprofloxacin (P = 0.00), gentamicin and P. aeruginosa (P = 0.02), levofloxacin and A. baumannii (P = 0.01), piperacillin-tazobactam and A. baumannii (P = 0.04), and piperacillin-tazobactam and P. aeruginosa (P = 0.01).Conclusion. Our results display how the pandemic impacted bacterial infections and antibiotic resistance, indicating a general increase in resistance rates. These findings are crucial for guiding healthcare practices, emphasizing the need for continued surveillance and potentially checking antibiotic usage schemes.

Dissemination of NDM-1 and OXA-48 Co-producing Carbapenem-resistant Enterobacterales at Two Tertiary Hospitals in Egypt

Dissemination of NDM-1 and OXA-48 Co-producing Carbapenem-resistant Enterobacterales at Two Tertiary Hospitals in Egypt

Co-Infection with respiratory viruses among critically-ill SARS-CoV2 patients in a tertiary hospital in Egypt: Incidence and effect on patients outcome

Co-Infection with respiratory viruses among critically-ill SARS-CoV2 patients in a tertiary hospital in Egypt: Incidence and effect on patients outcome

Lessons from Maternal Mortality in Cases of Emergency Peripartum Hysterectomy at Tertiary Hospital in Egypt (Retrospective Study)

Lessons from Maternal Mortality in Cases of Emergency Peripartum Hysterectomy at Tertiary Hospital in Egypt (Retrospective Study)

Risk factors, antimicrobial susceptibility, and outcome of methicillin-resistant Staphylococcus aureus bacteremia in critically ill children with sepsis in a tertiary hospital in Egypt

Background Staphylococcus aureus bacteremia (SAB) and methicillin-resistant Staphylococcus aureus (MRSA) infection are associated with unfavorable outcomes. Aim To reveal the risk factors, sensitivity to antibiotics, and outcome of MRSA bacteremia in infants and children with sepsis. Settings and design A prospective observational cross-sectional study was performed in Mansoura University Children’s Hospital from March 2023 to January 2024. Patients and methods The study involved infants and children diagnosed with sepsis and confirmed SAB on blood culture. Demographic data and blood culture with antibiotics sensitivity were recorded. Risk factors for MRSA bacteremia, antibiotic susceptibility, and mortality are the study outcomes. Statistical analysis used Multivariate analysis was done to assess the predictors of MRSA infection. Results A total of 319 patients were admitted with sepsis. SAB was isolated from 133 patients, 99 (74.4%) with methicillin-sensitive Staphylococcus aureus and 34 (25.6%) with MRSA. Risk factors for the development of MRSA infection are the presence of hospital-acquired infection (adjusted odds ratio=6.95), prolonged mechanical ventilation, presence of shock, and decreased body weight. Mortality was higher in the MRSA group (20.6 vs. 6.1%, P=0.014) with prolonged median duration of pediatric intensive care unit admission (19.5 vs. 14 days; P=0.040). Linezolid and teicoplanin were the most efficient antibiotics used in MRSA with 100% sensitivity in-vitro cultures, whereas resistance to erythromycin (90.9%) was documented. Conclusion MRSA poses a significant threat in pediatric sepsis. The presence of hospital-acquired infection and prolonged mechanical ventilation are the chief predictors of MRSA infection. Linezolid and teicoplanin are the most sensitive antibiotics used in MRSA management.

Patient Satisfaction with a Tertiary Hospital in Egypt using a HCAHPS-Derived Survey.

Study DesignRetrograde cross-sectional study.ObjectiveTo assess patient satisfaction and outcomes in polytraumatized patients in EL-Demerdash hospital.BackgroundThis is the first study that assessed patient satisfaction with a tertiary hospital in Egypt. Ain Shams University Surgery Hospital, which is one of the largest hospitals in Egypt and serves millions of patients each year, was the site of the study.MethodsA version of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was used to query 361 patients from November 2015 until July 2018 Survey questions were divided into the following categories: communication with doctors, responsiveness of hospital staff, cleanliness of the hospital environment, quietness of the hospital environment, pain management, communication about medicines, discharge information, overall rating of the hospital, and willingness to recommend the hospital.ResultsA total of 361 patients were interviewed. The results showed both positive and negative levels of satisfaction. The positive results included no delay in admission, friendly staff including nurses and doctors, better patient outcomes regarding pain management and adverse side effects, and the overall rating of the hospital was good, which reflected patient satisfaction. The negative findings were lack of proper communication between the medical staff and patients. Patients indicated they did not get a satisfactory explanation of their prescribed drug doses and drug adverse effects. In addition, they did not get enough instruction on what to do after being released from the hospital.ConclusionThe medical staff at Ain Shams University Surgery Hospital should focus more on the patient’s own preferences and communicate better with patients. We recommended that the hospital organize regular communication skills courses for medical students, physicians, and nurses. Patients should understand the discharge report and indications and side effects of the medications before leaving the hospital.

Assessment of Food Services Pre-requisite Program in a Tertiary Hospital in Egypt

Abstract Background Hospital food service systems are one of the most complicated processes where safety in this sector is considered high priority issue due to high susceptibility of hospital population. Objectives Our objectives were to identify the pre-requisite program components and the degree of compliance with these components in Ain Shams University Specialized Hospital. Methods A team was formed, identification of the prerequisite program components was carried out and a check list for determining the compliance with the identified components was used. Results From our study it was found that there is a severe lack in the prerequisite program items. Only 25% of the items were achieved, and the implementation of the prerequisite items ratio was 59.4% with severe lack of temperature control in the different stages of the food flow. Conclusions The present study showed that the necessary founding element of any food safety program, comprising the policies, operating procedures and similar organizing documents which was deficient in the studied hospital. Similarly, implementation of the basic required sanitation aspects in food handling was almost half applied. Reconsideration of basic underlying system for food services is mandated in our hospital.

Incidence, risk factors and management of post cesarean section surgical site infection (SSI) in a tertiary hospital in Egypt: a five year retrospective study

BackgroundSurgical site infection (SSI) is one of the commonest complications following cesarean section (CS) with a reported incidence of 3–20%. SSI causes massive burdens on both the mother and the health care system. Moreover, it is associated with high maternal morbidity and mortality rate of up to 3%.This study aims to determine the incidence, risk factors and management of SSI following CS in a tertiary hospital.MethodsThis was an observational case control retrospective study which was conducted at Minia maternity university hospital, Egypt during the period from January 2013 to December 2017 (Five years). A total of 15,502 CSs were performed during the studied period, of these, 828 cases developed SSI following CS (SSI group). The control group included 1500 women underwent cesarean section without developing SSI. The medical records of both groups were reviewed regarding the sociodemographic and the clinical characteristics.ResultsThe incidence of SSI post-cesarean section was 5.34%. Significant risk factors for SSI were; chorioamnionitis (adjusted odds ratio (AOR) 4.51; 95% CI =3.12–6.18), premature rupture of membranes (PROM) (AOR 3.99; 95% CI =3.11–4.74), blood loss of > 1000 ml (AOR 2.21; 95% CI =1.62–3.09), emergency CS (AOR 2.16; 95% CI =1.61–2.51), duration of CS of > 1 h (AOR 2.12; 95% CI =1.67–2.79), no antenatal care (ANC) visits (AOR 2.05; 95% CI =1.66–2.37), duration of labor of ≥24 h (AOR 1.45; 95% CI =1.06–2.01), diabetes mellitus (DM) (AOR 1.37; 95% CI =1.02–2.1 3), obesity (AOR 1.34; 95% CI =0.95–1.84), high parity (AOR 1.27; 95% CI = 1.03–1.88), hypertension (AOR 1.19; 95% CI = 0.92–2.11) and gestational age of < 37 wks (AOR 1.12; 95% CI = 0.94–1.66). The mortality rate due to SSI was 1.33%.ConclusionsThe obtained incidence of SSI post CS in our study is relatively lower than other previous studies from developing countries. The development of SSI is associated with many factors rather than one factor. Management of SSI is maninly medical but surgical approach may be needed in some cases.RegistrationLocal ethical committee (Registration number: MOBGYN0040).

INTERNAL VAGINAL DOUCHING INCREASES THE RATE OF VAGINAL INFECTION IN INTRAUTERINE CONTRACEPTIVE DEVICE USERS: A CROSS SECTIONAL STUDY

To compare the frequency, type, and severity of vulvovaginitis in women who are performing vaginal douching (VD) or not while using an intrauterine contraceptive device (IUCD). This study was a cross-sectional study conducted on 604 consecutive IUCD users presented to an outpatient clinic in a tertiary hospital in Egypt. They should have been using the cupper IUCD for at least 6 months before recruitment. Women were stratified into two groups according to if they were performing internal VD or not. Group I (302 women) performing internal VD and Group II(302 women)not practicing this habit (NVD). The primary outcome of the study was to compare the frequency of vaginal infections in IUCD users who perform VD compared to women who were abstaining from this habit. Secondary outcomes included the type and severity of infection in both groups. Women who were using IUCD and performing internal VD had a past history of more frequent episodes of vaginal infection compared with NVD IUCD users {260 (88.1%) versus 151(43.4%); respectively} (P<0.001). Current vaginal infection was significantly higher in VD (275; 91.05%) compared to NVD (115; 38.1%) (P<0.001). Bacterial vaginosis was the most common clinical detected type of infection (287; 47.5%) followed by candida vulvovaginitis (278; 46.03%). Moreover, both types of infection were significantly more common in VD versus NVD groups (p<0.001). Internal VD while using IUCD is associated with a higher risk of vulvovaginal infections. In these women bacterial vaginosis is more common than candida vulvovaginitis.

Emergence of Hypervirulent Carbapenem-Resistant Klebsiella pneumoniae Coharboring a blaNDM-1-Carrying Virulent Plasmid and a blaKPC-2-Carrying Plasmid in an Egyptian Hospital.

ABSTRACTThe emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates in Egyptian hospitals has been reported. However, the genetic basis and analysis of the plasmids associated with carbapenem-resistant hypervirulent K. pneumoniae (CR-HvKP) in Egypt have not been presented. Therefore, we attempted to decipher the plasmid sequences that are responsible for transferring the determinants of carbapenem resistance, particularly blaNDM-1 and blaKPC-2. Out of 34 K. pneumoniae isolates collected from two tertiary hospitals in Egypt, 31 were CRKP. Whole-genome sequencing revealed that our isolates were related to 13 different sequence types (STs). The most prevalent ST was ST101, followed by ST383 and ST11. Among the CRKP isolates, one isolate named EBSI036 has been reassessed by Nanopore sequencing. Genetic environment analysis showed that EBSI036 carried 20 antibiotic resistance genes and was identified as a CR-HvKP strain: it harbored four plasmids, namely, pEBSI036-1-NDM-VIR, pEBSI036-2-KPC, pEBSI036-3, and pEBSI036-4. The two carbapenemase genes blaNDM-1 and blaKPC-2 were located on plasmids pEBSI036-1-NDM-VIR and pEBSI036-2-KPC, respectively. The IncFIB:IncHI1B hybrid plasmid pEBSI036-1-NDM-VIR also carried some virulence factors, including the regulator of the mucoid phenotype (rmpA), the regulator of mucoid phenotype 2 (rmpA2), and aerobactin (iucABCD and iutA). Thus, we set out in this study to analyze in depth the genetic basis of the pEBSI036-1-NDM-VIR and pEBSI036-2-KPC plasmids. We report a high-risk clone ST11 KL47 serotype of a CR-HvKP strain isolated from the blood of a 60-year-old hospitalized female patient from the intensive care unit (ICU) in a tertiary care hospital in Egypt, which showed the cohabitation of a novel hybrid plasmid coharboring the blaNDM-1 and virulence genes and a blaKPC-2-carrying plasmid.IMPORTANCE CRKP has been registered in the critical priority tier by the World Health Organization and has become a significant menace to public health. The emergence of CR-HvKP is of great concern in terms of both disease and treatment. In-depth analysis of the carbapenemase-encoding and virulence plasmids may provide insight into ongoing recombination and evolution of virulence and multidrug resistance in K. pneumoniae. Thus, this study serves to alert contagious disease clinicians to the presence of hypervirulence in CRKP isolates in Egyptian hospitals.

Spectrum of childhood interstitial and diffuse lung diseases at a tertiary hospital in Egypt.

BackgroundChildhood interstitial and diffuse lung diseases (chILD) encompass a broad spectrum of rare pulmonary disorders. In most developing Middle Eastern countries, chILD is still underdiagnosed. Our objective was to describe and investigate patients diagnosed with chILD in a tertiary university hospital in Egypt.MethodsWe analysed data of consecutive subjects (aged <18 years) referred for further evaluation at the Children's Hospital, Ain Shams University (Cairo, Egypt). Diagnosis of chILD was made in accordance with the ChILD-EU criteria. The following information was obtained: demographic data, clinical characteristics, chest computed tomography findings, laboratory studies, spirometry, bronchoalveolar lavage and histopathology findings.Results22 subjects were enrolled over 24 months. Median age at diagnosis was 7 years (range 3.5–14 years). The most common manifestations were dyspnoea (100%), cough (90.9%), clubbing (95.5%) and tachypnoea (90.9%). Systematic evaluation led to the following diagnoses: hypersensitivity pneumonitis (n=3), idiopathic interstitial pneumonias (n=4), chILD related to chronic granulomatous disease (n=3), chILD related to small airways disease (n=3), post-infectious chILD (n=2), Langerhans cell histiocytosis (n=2), idiopathic pulmonary haemosiderosis (n=2), granulomatous lymphocytic interstitial lung disease (n=1), systemic sclerosis (n=1) and familial interstitial lung disease (n=1). Among the subjects who completed the diagnostic evaluation (n=19), treatment was changed in 13 (68.4%) subjects.ConclusionSystematic evaluation and multidisciplinary peer review of chILD patients at our tertiary hospital led to changes in management in 68% of the patients. This study highlights the need for an Egyptian chILD network with genetic testing, as well as the value of collaborating with international groups in improving healthcare for children with chILD.

Colistin susceptibility among multidrug resistant Gram-negative bacilli isolated from Tertiary hospital in Egypt

Colistin is considered as the last resort for treatment of bacterial infections caused by carbapenem-resistant Gram-negative bacilli (GNB). Colistin resistance can increase due to the spread of plasmid-borne mcr-1 gene. This study aimed to determine colistin susceptibility and to detect the presence of mcr-1 gene in the clinical isolates of GNB recovered from different clinical samples collected from Ain Shams University Hospital, Cairo, Egypt. About thirty-five GNB isolates were recovered from the different clinical samples that were collected during the period from February-April, 2019. These isolates were subjected to antibiotic susceptibility testing using disc diffusion assay, and Colistin susceptibility through the E-test. In addition, conventional Polymerase chain reaction (PCR) was carried out for detection of mcr-1 gene among the colistin GNB resistant isolates. Most of the GNB isolates (60 %) were recovered from blood samples. Klebsiella pneumoniae (K. pneumoniae) was the most common isolated bacterium; that was represented by 24 isolates (68%). Out of the 35 GNB, only five isolates (14.3 %) were resistant to colistin by E-test, with MIC >256 𝜇g/ ml. The mcr-1 gene was detected only in one Pseudomonas aeruginosa (P. aeruginosa) isolate. This study concluded the low frequency of mcr-1 gene among the current GNB isolates. However, a large scale study is recommended to detect colistin resistance among GNB.