The prevalence of antimicrobial resistant bacterial pathogens has become a major public health concern. Extended-spectrum ß lactamase(ESBL) production in the members of the family Enterobacteriaceae can confer resistance to extended spectrum cephalosporins as azetronam and penicillins. Horizontal gene transfer has already been proven as a significant mechanism for disseminating antimicrobial resistance in bacterial populations.
Resistance to ESCs is primarily mediated by Beta lactamases especially ESBLs and AmpC beta lactamases. Although avarity of ESBLs have been described,SHV,TEM, and CTX-M enzymes are the main three types of ESBLs among members of the family Enterobacteriaceae Antimicrobial drug resistance can also be facilitated by integrons in case of many other bacteria.
Integrons are genetic structures capable of capturing and excising gene cassettes, which usually encode antimicrobial drug resistance determinants. Although integrons are not self mobilizable, they are usually found in association with transposons and are often located on plasmids, facilitating their mobility .
The dissemination of antibiotic resistance genes among bacterial strains is an increasing problem in bacterial infections. Integron had become an important horizontal gene transfer system of resistance genes in clinical isolates. Incidence of class 1 integron was high in ESBL-producing Enterobacteriaceae .
Antibiotic resistance has been noted in Benha univeristy hospital .the third generation cephalosporins have been used in amajority of patients and resistance even to these antibiotics has been reported . The unrecognized wide spread presence of integron containing gram negative bacteria, both within hospitals and in the community poses a serious threat of the spread of antibiotic resistance.