الفهرس 
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Abstract
Colistin (polymyxin E) is presently regarded the medicine of choice for the treatment of infections caused by multi-drug-resistant Gram-negative bacteria (MDR-GNB) due to its advantageous qualities of fast bacterial death, a restricted range of activity, and moderate resistance development.
Our goal is to screen for the mcr-1 plasmid, which mediates colistin resistance in Gram negative infections.
This prospective experimental studies included 500 specimens in total. We investigated the detection of plasmid-mediated colistin resistance mcr-1 among Gram negative bacteria clinical isolates from different ICUS in Alexanderia hospitals; 500 Gram negative bacterial isolates (493 were mcr-1 negative and 7 were mcr-1 positive), isolated from 500 different cases were studied.
According to the present information, five of the seven mcr-1 positive isolates were
K. pneumonia followed by E. coli (one isolate), and P. aeruginosa (one isolate).
In terms of phenotypic colistin susceptibility, three of the five mcr-1 positive
K. pneumonia were colistin resistant, whereas the remaining two were colistin susceptible. Colistin resistance was found in the E.coli sample, while colistin susceptibility was found in the P. aeruginosa isolate.
6.2 Conclusions
The present study highlights the following:
1.This investigation validated the low frequency of mcr-1 genes in clinical isolates from several ICUs of Aexanderia hospitals.
2. Excessive or improper use of colistin antibiotics in veterinary medicine and agriculture may be the primary cause of the prevalence of mcr-1 mediated colistin resistance.
3. The presence of mcr-1 in Gram negative isolates does not always imply colistin resistance.
4. Colistin resistance can be caused by mechanisms other than mcr-1.
5. mcr-1 was predominantly identified in K.pneumonia isolates, with mcr-1 positive in 7 samples, 5 of which were K.pneumonia isolates.