الفهرس 
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Abstract
Multidrug-resistant Enterobacteriaceae have been frequently reported from different parts of the world with the emergence of treatment problems. Antibiotics given empirically without proper antibiotic susceptibility testing are one of the major causes for the development of MDR.
Multidrug-resistant Enterobacteriaceae infections are often caused by extended-spectrum b-lactamases (ESBLs) and carbapenemase-producing strains and represent an increasing global threat.
Due to the high morbidity and mortality rates of MDR Enterobacteriacae infections, combination therapy, as opposed to monotherapy, are suggested. A synergistic effect may be developed when antibiotics are used in combination. Through this synergistic effect, treatment efficacy can be improved and resistance can be prevented.
The results of the present study showed that 74% of the Enterobacteriacae isolates were MDR since they were resistant to ≥ 3 antimicrobial classes that are thought to be active against it. Also, 36.5% out of the MDR isolates were considered XDR being resistant to all antibiotic groups except for one or two agents.
E. coli was found to be the most commonly identified MDR organism of the Enterobacteriacae family (50%) whereas K. pneumoniae constituted 47% and E. cloacae constituted the remaining 3%. The MDR isolates were recovered from blood (44%), urine (26%), wound (12%), sputum (9%), ascitic fluid (6%) and from CSF (3%) samples.
Out of the MDR Enterobacteriaceae that were recovered from different samples, 34 isolate were selected and were further subjected to determination of the MIC for each antibiotic individually using the broth microdilution test and the E-test. Moreover, the effect of selected antimicrobial combinations that were thought to be active against the MDR isolates was determined using the checkerboard titration method and the E-test method.