الفهرس 
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Abstract
Klebsiella pneumoniae is commonly associated with a wide range of hospital acquired infections including bacteremia, respiratory tract, and urinary tract infections. K.pneumoniae strains resistant to third generation cephalosporins and monobactams by producing extended spectrum lactamases (ESBLs) were described in the 1980s, and have now spread worldwide. Out of 4173 clinical samples collected from 2208 nosocomially infected patients at MUHs, 1955 yielded positive culture results and K. pneumoniae was identified in 275 cases. Antibiotic susceptibility testing yielded 168 resistant isolates. Screening for ESBLs was performed using double disk synergy and confirmed by inhibitor potentiated disk diffusion method and determining MICs of different lactams alone or in the presence of clavulanic acid. The addition of clavulanic acid reduced the MICs of some drugs by more than 30fold. The production of ESBLs was confirmed in 82 isolates representing 29.8% and 48.8% of the total and resistant K.pneumoniae, respectively. The ESBLproducing K.pneumoniae showed different degrees of resistance to various antibiotics, in addition to resistance to lactams. They were resistant to other antibiotics as follow : ciprofloxacine 43.9% of isolates; gentamicine, 64.15%; and amikacine, 10.9%. On the other hand, all of the examined isolates were sensitive to imipenum. ESBLproducing K.pneumoniae was isolated mostly from the department of pediatrics and surgery.Wound, blood, and urine specimens were the common sources of ESBLproducing K.pneumoniae. Plasmid profiling of ESBL producing isolates showed the presence of 8 different profiles (Ato H). The profile A predominated in all departments and all specimens, while the profile D was mostly deviceassociated.