Microbiology Department

The microbiology laboratory is one of the vital laboratories in Theodor Bilharz Research Institute. It is concerned in diagnoses of the most important infectious microbes and selection of the appropriate antimicrobial treatment for all patients attending the institute outpatient clinics in addition to inpatients. The lab clinic receives various clinical samples for the performance of culture and sensitivity tests for microbes. The lab also performs serological tests for diagnosis of hepatic viral diseases. The lab combines conventional and automated methods that allow rapid and accurate interventions to treat sepsis at early stage through culture followed by automated identification and sensitivity to isolated bacteria or fungi. In addition to reliable automated detection of important biomarkers of sepsis. It is also concerned in determining resistant infectious bacteria to various antibiotics and their resistance genes and conducting innovative scientific research addressing the global problem by using the most recent diagnostic techniques in molecular biology.

Microbiology department envisages a future where applied microbiology diagnostics and research policies contribute significantly in the community to overcome the emerging infectious diseases challenges including the uprising antimicrobial resistance crisis.

Service :The primary role of a microbiology laboratory is to identify causative agents of various infectious diseases and help and facilitate the justified use of antibiotics. This should be done in a cost-effective and timely manner that enable good and effective patient care.

Teaching :To teach appropriate use of diagnostic laboratory tests and resource utilization in the care of patients through upgrading of technical performance and scientific background of junior staff.

Research :To develop and to evaluate procedures and protocols that support, enhance and extend the ability of Microbiology lab to carry out effectively their primary service in diagnosis and combating antimicrobial resistance.

Prof.: Doaa Gamal Desouki
E.mail: doaagamal@gmail.com

Former Heads of Department

• • Prof. Effat Mahmoud El-Sherbini (1990 – 1993 and 2000 – 2003)
  • Late Prof. Soad Mokhtar (1993 – 2000)
  • Prof. Aisha Abu Aita (2003 – 2009)
  • Prof. Inas Emam El-Defrawy (2009-2015)
  • Prof. Hala El Sayed Badawi (2015-2017)
  • Prof. Manal Saad Diab (2017-2018)
  • Prof. Nevine Fam (2018-2020)

Staff Members

• • Prof. Maisa Mohamed Omar
  • Prof. Samah Saad El-Dine
  • Prof. Laila AboulFadl
  • Prof. Hoda Helmi
  • Prof. Manal El-Said El-Sayed
  • Assistant Prof. Dalia Adel Abdel-Latif
  • Lecturer Nahed Yehia Ismail
  • Lecturer Amira Talal El Far
  • Lecturer Heba Mostafa Dahroug
  • Lecturer Ahmed Mostafa El Shenawy
  • Associate researcher Ghada Ali
  • Associate researcher Rania El Gharbawy
  • Associate researcher Manar Khaled Rizk
  • Associate researcher Noha Youssry
  • Associate researcher Noha Refaat
  • Associate researcher Reham Magdy Wasfy
  • Associate researcher Manar Effat
  • Specialist Rania Mahdy El Gabry
  • Specialist Basma Tarek

Current research work focuses on four main categories;

1. Detection of multi-drug resistant (MDR) bacteria: Hot topics include researches on carbapenem resistant Enterobacteriaceae and Acinetobacter baumannii isolates as well as resistance among Helicobacter pylori(H. pylori).
2. Effect of novel or old reviving therapeutic agents against MDR pathogens: Research work of fosfomycin, doripenem, tigecycline and ceftolozane/ tazobactam against ESBL-producing Enterobacteriaceae have been recently carried out. Running hot topics of colistin susceptibility in carbapenem resistant Enterobacteriaceae as well as carbapenem resistant Acinetobacter baumannii are in progress.
3. Rapid diagnosis of septicemia and other life-threatening infections: Comparing various sepsis biomarkers (CRP- presepsin- procalcitonin) with blood culture results as well as with clinical methodology of APACHE score for septicemia is a hot running topic.
4. Methods of detection of endemic and various emerging pathogens:Helicobacter pylori, Chlamydia, Mycoplasma, Candida spp as well as nano bacteria have been in our concern in our research work.

Our achievements are unfolding in the form of research projects whether already finalized or underway:

Studies of beta lactamases in Gram-negative bacteria:

• Detection and molecular characterization of various β-lactamases responsible for antimicrobial resistance in multidrug-resistant Gram-negative Egyptian bacterial clinical isolates. Reports of various types of beta-lactamases including extended spectrum beta-lactamases (ESBLs) and carbapenemases have arisen from our Microbiology lab. Reports for the emergence of the intercontinental ST131 coli as well as NDM producing Enterobacteriaceae (NDM-1 and NDM-5) have been released from our research laboratory work.
• Extended spectrum beta-lactamases (ESBLs), metallo-beta lactamases (MBLs) and plasmid mediated AmpC beta lactamase (pAmp-C), detected in our bacterial clinical isolates, both from hospital and community settings, justifies the need for screening Enterobacteriaceae for the production of those enzymes by the simple and accurate diagnostic phenotypic methods utilized in this study.
• A comparative epidemiologic study on the prevalence of faecal carriage of ESBL-producing Enterobacteriaceae in patients with liver disease in Egypt and in France revealed that the prevalence of ESBL in faecal carriers was very high in Egyptian patients (77.5%) compared to 6.5% from French patients within the same study period (May – June 2009). More than 50% of Egyptian patients did not have a history of previous hospitalization, suggesting a very high prevalence of ESBL in the community in Egypt.
• Ongoing projects are directed towards resistance to carbapenem, the most potent beta lactam antibiotic, in Enterobacteriaceae (CPE) and in Acinetobacter baumannii(A. baumannii) in clinical infections as well as in carrier stages. Studies for the detection of these superbugs as well as evaluation of the current available treatment options are in our priorities.
• A significant rate of carbapenemase producing Enterobacteriaceae in was recorded among clinical and colonized patients in TBRI hospital thus providing limited therapeutic options and suggests fast spread in the community.
• NDM-like gene was the main carbapenemase-producing gene found among clinical CPE isolates, whereas OXA-48-like was the predominant gene in colonized ones.
• Going more through more details in CPE isolates, we found IncR plasmids carrying bla_NDM-1 and rmtF circulating among our isolates, thus raising concerns regarding this type of replicon and their role in the transmission of these resistance determinants.

Assessment of frequency of pylori virulent factors isolated from different dyspeptic patients:

• pylori infection is highly endemic in Egypt; among dyspeptic patients 53.1% were confirmed to be infected with H. pylori. H. pylori-induced functional dyspepsia is different type from functional dyspepsia. Whereas H. pylori gastric carcinoma is not a common complication may be due to the absence of the East Asian carcinogenic type of cagA in Egypt.
• The overall vacA, iceA1 and cagA virulence genes were revealed (61.6%, 38.8%, 26.6% respectively). Six different genotypic types were recognized; iceA1, vacA/ cagA, vacA/iceA1, vacA/cagA/iceA1 by PCR-based molecular testing. Mutant genes conferring antimicrobial resistance were observed in 25% for metronidazole (rdxA gene), in 18.3%for amoxicillin (pbp1A gene), in 6.7% for clarithromycin (23S rRNA gene) and in1.7% for tetracycline (16S rRNA).

Biofilms and device associated infections: bacteriological and morphological study:

• Associated infections were detected in 55% of patients with indwelling medical devices, culture being positive for 65% of all medical devices.
• Minimal inhibitory concentrations of different antibiotics against cells within biofilms were 10-fold higher than that against planktonic ones.

Emerging viral hepatitis agents in patients with chronic liver diseases and hepatocellular carcinoma:

• Occult HBV infection may increase the severity of chronic HCV infection, accelerate the evolution to cirrhosis and promote the development of HCC. The newly developed quantitative electro-spin-resonance-EIA technique represents a great evolution as alternative to molecular techniques for screening and diagnosis of occult HBV infection.
• Infection with hepatotropic viruses; TTV, GBV-C and SEN-V does not contribute to the severity of liver disease in patients infected with hepatitis C virus nor in causation of HCC.
• Lower HCV RNA levels in HGV coinfected patients raise the speculation of a possible beneficial role for HGV in HCV patients.

Role of viral infections in bladder carcinogenesis:The significant association of CMV, HSV-2 and HPV-16, -18, and -52 with bladder cancer in Egyptian bilharzial patients strongly supports the hypothesis of a viral synergistic action in bladder carcinogenesis.

A new approach for detection of antibodies to Human papilloma virus: Development of rapid, simple and accurate detection EIA kit for early non-invasive diagnosis of the two prevalent cancer bladder Human papilloma-viruses in Egypt (HPV 16, 18). Purified HPV-16 and 18 VLPs, produced by recombinant Baculo-virus, are used as antigens for detection of IgG antibodies in human sera.

Microbiology service is achieved through several running techniques :

• Gram/ Ziehl-Neelsen and fluorescent staining
• Urine microscopic examination
• Urine culture and sensitivity
• Sputum culture and sensitivity
• Throat swab culture and sensitivity
• Pus / discharge culture and sensitivity
• Blood culture and sensitivity
• Ascitic/ pleural fluids culture and sensitivity
• Yeast culture and sensitivity by VITEK 2 compact system.
• Anaerobic and Microaerophilic cultures on request.
• Widal and Brucella agglutination tests
• Qualitative detection of CRP by latex agglutination.
• Quantitative detection of CRP by protein analyzer.
• Hepatitis markers (HBsAg, HCV Ab) by ELISA and VIDAS system.
• Measuring of procalcitonin (PCT) sepsis biomarker by VIDAS sysrem
• Rapid detection of Helicobacter pylori antigen in stool.

The department consists of 4 research laboratories and one outpatient clinic laboratory equipped with basic facilities for microbiological tests:

BacteriologyLab for Culture, Identification and AntimicrobialSusceptibilityTesting (AST)

• Routine bacterial cultures on different culture media.
• Kirby-Bauer disk diffusion method for routine AST for isolated bacterial species.
• Identification and detection of minimal inhibitory concentration (MIC) of antibiotics for Gram-positive and Gram-negative bacteria and yeasts by automated vitek 2 compact system.
• Culture for blood and other body fluids by automated Bact/Alert 3D or BACTEC 9050 systems.

 Serology Lab

• Automated Enzyme Linked Fluorescent Assay (ELFA) technology using benchtop VIDAS immunoanalyzer.
• Serological diagnosis of Hepatitis markers by ELISA system.
• Detection of pylori antigen in stool.
• Latex agglutination for detection of Typhoid disease and Brucellosis.
• Detection of Procalcitonin by VIDAS immunoanalyzer.
• Detection of CRP qualitative by latex agglutination tests and quantitative by automated protein analyzer

Molecular Lab

• DNA extraction by boiling methods as well as by commercialized kits.
• Detection of genes of antimicrobial resistance; ESBLs, Carbapenemases and mecA gene of MRSA by conventional PCR; singlex or multiplex.
• Typing of different infectious pathogens through Pulsed Field Gel Electrophoresis (PFGE) by Bio-Rad CHEF mapper system.

Training in the field of routine microbiological procedures are available periodically in the form of:

• Annual training program for local and foreign laboratory personnel working on the cutting edge of diagnosis of infectious diseases.
• Two weeks rotation program through the outpatient microbiology lab for undergraduate medical students and faculty of science candidates.
• Annual teaching of microbiology course for TBRI nursing school students.

The lab policy is designed to meet the needs of patients in the hospital and outpatient setting.So in- and out-patient services comprise routine identification and antimicrobial susceptibility testing of nosocomial and community-acquired clinical bacterial isolates to diagnose several infections :

• Urinary tract infections.
• Diarrheal diseases.
• Blood stream infections.
• Fever of unknown origin.
• Infections associated with medical devices and procedures.
• Post surgical infections and sepsis.
• Infections related to compromised immunity in hepatic and chronic renal patients.
• Pneumonias
• Tuberculosis
• Viral infections.
• Fungal infections.

External Projects

1- Science and Technology development fund: Detection of carabapenemases activity using mass spectrometry and therapeutic challenges. PI: Associate Prof. Doaa Gamal Desouki (2017-2018)

2- Egyptian-French scientific cooperation program “IMHOTEP”: Detection and molecular characterization of novel β-lactamases responsible for antimicrobial resistance in multidrug resistant Gram negative bacterial isolates from Egypt. PI: Prof. NevineSobhy Fam(2008-2010)

Internal Projects (Financed by TBRI) in the last 10 years

1- Assessing Risk Factors and Outcomes for Dissemination of Carbapenem-Resistant Enterobacteriaceae Isolates among Patients in TBRI Hospital.PI: Inas El-Defrawy (2019)

2- Emergence of Multidrug resistant Candida auris: A misidentified Fungus in Clinical Settings. PI: Prof.HodaHelmy (2019)

3- Detection of Main Resistance Mechanisms in Carbapenem Resistant Pseudomonas aeruginosa Clinical Isolates. PI: Assist. Prof. Dalia Salem (2019).

4- Molecular detection of disinfectant and antiseptic resistance genes among clinical Staphylococcus aureus isolates. PI: Prof. HalaBadawi (2018)

5- Diagnostic Value of Sepsis Biomarkers in Intensive Care Unit Patients.PI: Prof. Manal SaadDiab (2017).

6- Detection of carbapenemase producing Enterobacteriaceae (CPE) in infected patients and colonized carriers. PI: Inas El-Defrawy (2016)

7- In vitro activity of antibiotic combinations against carbapenem non-susceptible isolates of Acinetobacter baumannii and the effects of their antibiotic resistance Genes. PI:  NevineSobhy Fam (2016)

8- Rapid phenotypic and molecular detection of extended spectrum Beta –Lactamase (ESBL) producing Enterobacteriaceae. PI: Assist. Prof. Dalia Salem (2016)

9- Assessment of antimicrobial resistance in Helicobacter pylori related infection.PI: Prof. Manal SaadDiab (2011)

Publications in the last ten years

Samir, S., El-Far, A., Okasha, H., Mahdy, R., Samir, F., Nasr, S.( 2022). Isolation and characterisation of lyrics bacteriophages from sewage at an Egyptian tertiary care hospital against methicillin resistant Staphylococcus aureus clinical isolates. Saudi. J.Biol. Sci 3097-3106. https://doi.org/10.1016/j.sjbs.2022.03.01

El-Defrawy, I., Gamal, D., El-Gharbawy, R. et al. (2022). Detection of intestinal colonization by carbapenem-resistant Enterobacteriaceae (CRE) among patients admitted to a tertiary care hospital in Egypt. Egypt J Med Hum Genet 23, 83. https://doi.org/10.1186/s43042-022-00295-9.

El-Far A, Samir S, El-Gebaly E, Omar M, Dahroug H, El-Shenawy A, Soliman NS, Gamal D (2021). High rates of aminoglycoside methyltransferases Associated with Metallo-Beta-Lactamases in Multidrug-Resistant and Extensively Drug-Resistant Pseudomonas aeruginosa Clinical Isolates from a Tertiary Care Hospital in Egypt. Infect and Drug Resist 2021:14 4849–4858. DOI:  https://doi.org/10.2147/IDR.S335582

El-Far A, Samir S, El-Gebaly E, Taha NY, Fahmy EM, Diab TM, El-Shenawy A. (2021). Assessment of eugenol inhibitory effect on biofilm gene expression in methicillin resistant Staphylococcus aureus clinical isolates in Egypt. Infection, Genetics and Evolution.89: 104722.

El-Shabrawy R M, GawishA A, AbdelazizElgabryR M, Nasr F M, Diab M, Gamal D (2021). Presepsin, procalcitonin and C-reactive protein as diagnostic biomarkers of sepsis in intensive care unit patients. Microbes and Infectious Diseases. 2(1): 119-129.

Gamal D, Egea P, Elías C, Fernández-Martínez M, Causse M, Pérez-Nadales E, Salem D, Fam N, Diab M, AbuAitta A, El-Defrawy I, Martínez-Martínez L(2020).High risk clones and novel sequence type ST4497 of Klebsiella pneumoniae clinical isolates producing different alleles of NDM-type and other carbapenemases from a single tertiary-care centre in Egypt. International Journal of Antimicrobial Agents. doi:10.1016/j.ijantimicag.2020.106164.

Fam N S, Gamal D, Mohamed S H, Wasfy R M, Soliman M S, El-Kholy A A, Higgins P (2020).Molecular Characterization of Carbapenem/Colistin Resistant Acinetobacter baumannii Clinical Isolates from Egypt by Whole Genome Sequencing. Infect Drug Resist. 2020;13:4487-4493.https://doi.org/10.2147/IDR.S288865.

Fam N S, Mohamed S H, Gamal D, Wasfy R M, Soliman M S, El-Kholy A A(2020). Reliability of Phenotypic Methods for Detection of Colistin Resistance among Carbapenem-resistant Acinetobacter baumannii Clinical Isolates from Egypt. Germs. 28;10(4):303-309. doi: 10.18683/germs.2020.1222. PMID: 33489945; PMCID: PMC7811857.

Gamal D, Salem D, Fernández-Martínez M, Abdelkhalek A, and El-Defrawy I (2019). Colonization with OXA-23 and NDM Positive Clonally Related Carbapenem Resistant Acinetobacter baumannii in ICU Patients from Egypt. International Journal of Pharmaceutical Research.11 (3):331-337.

Fam N, Gamal D, Salem D, Dahroug H, Wasfy R, Morcos M (2019). Clonal Diversity and High Prevalence of Oxa-23 among Carbapenem Resistant Acinetobacter baumannii Isolates in Egypt. Journal of Bioscience and Applied Research. 5(1): 110 -124.

Fam N, Dahroug H, El Far A, El Said M, Gamal D (2019). Efficacy of colistin combination with tigecycline or doripenem against carbapenem resistance Acinetobacter baumannii in relation to bla_OXA-23 and bla_NDM carbapenem resistance genes. Kasmera Journal.47(2): 2-14.

 El Said M, Dahroug H, El Shenawy A, El Far A (2019). Detection of inducible clindamycin resistance phenotypic and erm genes among clinical isolates of Staphylococci. Kasmera Journal. 47(2): 2-16.

Diab M, Salem D, Elshenawy A, El Far A, Abdelghany A, RedaAwad A, El Defrawy I, Shemis M (2019). Detection of high level aminoglycoside resistance genes among clinical isolates of Enterococcus species. Egyptian journal of medical human genetics. 28 (2019).

Ahmed N, Rizk D E, El Said M, Barwa R M F, Adel Elsokary M, Hassan R H I (2019). Molecular Identification and Virulence Factors Determination in Candida Species Isolated from Egyptian Patients. American Journal of Microbiological Research. 7(4):108-117.

Diab M, El-Shenawy A, El-Ghannam M, Salem D, Abdelnasser M, Shaheen M, Abdel-Hady M, El-Sherbini E, Saber M (2018). Detection of antimicrobial resistance genes of Helicobacter pylori strains to clarithromycin, metronidazole, amoxicillin and tetracycline among Egyptian patients. The Egyptian Journal of Medical Human Genetics. 19: 417–423. www.sciencedirect.com

Diab M, El-Shenawy A, Shemis M, El-Ghannam M, El Said M, Abdelnasser M, Abdel-Hady M, El-Sherbini E and Saber M (2018).Helicobacter pylori infection in Egyptian patients with dyspepsia: diagnostic, demographic, endoscopic and clinical characteristics. Int. J. Adv. Res. 6(6): 226-234.www.journalijar.com

Diab M, Shemis M, Gamal D, El-Shenawy A, El-Ghannam M, El-Sherbini E, Saber M (2018). Helicobacter pylori Western cagA genotype in Egyptian patients with upper gastrointestinal disease. The Egyptian Journal of Medical Human Genetics, 19: 297-300. www.sciencedirect.com

Mohamed S H, Salem D, Azmy M, Fam N S (2018). Antibacterial and antibiofilm activity of cinnamaldehyde against carbapenem-resistant Acinetobacter baumannii in Egypt: In vitro study. Journal of Applied Pharmaceutical Science. 8(11):151-156, www.japsonline.com

Zaiton M, Saad EL Din S, Abd EL- Hamid N, Salem D, EL Sheikh S (2018). Rapid Detection of Extended Spectrum β –Lactamases (ESBL) and their CTX-M Genetic Characterization. International Journal of Advanced Research (IJAR). 6 (7): 60-68.

El-Badry AA, Aufy S M, El-Wakil E S, Rizk E M, Mahmoud S S, Taha N Y (2018).  First identification of Naegleria species and Vahlkampfiaciguana in Nile water, Cairo Egypt: Seasonal morphology and phylogenetic analysis. Journal of microbiology, Immunology and Infection. http://www.japsonline.com

Badawi H, El-Said M, Samir S, Ismail A, Badawy A, Barakat A, and Saber M A (2018). Prevalence of Human Papillomavirus genotypes among Egyptian patients with cancer bladder. Journal of International Pharmaceutical Research. 45: 203-214.

Abd El Salam M, Gamal D, El Said M, Salem D, Abu Aitta A and El Gamal M S (2018). Prevalence of Plasmid-Mediated Quinolone Resistance in Multidrug-Resistant Gram Negative Bacilli in Egypt. Biomedical & Pharmacology Journal. 11(4):1927-1936.

Badawi H, Abass M, Hamam O, Diab M, El Said M, Ismail A, Badawy A, Mostafa G, Samir S, El-Dabaa E, Saber M (2018). Molecular and In-Situ Hybridization Detection of Human Papillomavirus Genotypes among Egyptian Patients with Bladder Cancer. International Journal of Pharmaceutical Research. 10(4):402-411.

Fam N, Gamal D, Azmy M, Wasfy R, Aboul-Fadl L, Badr M, El-Damarawy M (2017). Antimicrobial Efficacy of Doripenem Colistin Combination on Carbapenem-Resistant Acinetobacter baumannii Isolates by E-test Agar Dilution and Ultrastrastructural Methods. Egypt. J. Med. Microbiol. 26 (1): 1-7.

Aguirre-Quiñonero A, Cano M, Gamal D, Calvo J, Martínez-Martínez L (2017). Evaluation of the carbapenem inactivation method (CIM) for detecting carbapenemase activity in Enterobacteria”. Diagnostic Microbiology and Infectious Diseases; 88(3): 214-218.

El-Shenawy A, Diab M, Shemis M, El-Ghannam M, Salem D, Abdelnasser M, Shahin M, Abdel-Hady M, El-Sherbini E, Saber M (2017).  Detection of Helicobacter pylori vacA, cagA and iceA1 virulence genes associated with gastric diseases in Egyptian patients. The Egyptian Journal of Medical Human Genetics;18: 365-371.

Badawi H, El-Said M, Helmi A, Azmy M, Riad E, Beshr M and Helmi O (2016). Detection of Biological Nanoparticles and Their Association with Aluminium and Bariumin in Serum, Urine and Renal Stone in Egyption patients with Urolithiasis. Ciência e TécnicaVitivinícola31(2):254-223.

Diab M, Shemis M, El-Ghannam M, Gamal D, Azmy M, Salem D, Mansy S and Saber M (2016).  Helicobacter pylori VacA genotyping in relation to cagA status, ultra-structure of gastric mucosa and Clinical Outcomes in Egyptian Patients. AJMR.10(14): 465-472.

 Gamal D, Fernández-Martínez M, Salem D, El-Defrawy I, Álvarez Montes L, Ocampo-Sosa AA, Martínez-Martínez L (2016). Carbapenem–resistant Klebsiella pneumoniae isolates from Egypt containing bla_NDM-1 on IncR plasmids and its association with rmtF. Int. J. Infect. Dis. 43: 17-20.

Badawi H, El-Said M, Helmi A, Hassan M, Elansarey M, Hazem A, Azmy  M and Helmi O (2016). Role of Nanoparticles in Egyptian patients with Biliary Lithiasis and Their Association with Aluminium and Barium in Serum and Urine”.Ciência e TécnicaVitivinícola. 31(4): 31(4):162-177

Gamal D, Fernández-Martínez M, El-Defrawy I, Ocampo-Sosa AA and Martínez-Martínez L (2016). First identification of NDM -5 associated with OXA-181 in Escherichia coli from Egypt. Emerging microbes and infection journal. 5(4): e30; doi:10.1038/emi.2016.24.

Azmy M, Ghanem L, Kassem F, Gamal D, Abdelkhalek A, El-Kholy E, Abo ELEneen M (2016). Scanning Electron Microscopy Biofilm Grading and Ventilator Associated Pneumonia in Relation to Duration of Intubation. Egypt. J. Med. Microbiol. 25(3): 81-88.

EL-Far A , Azza B, Saad El-Din S, Omar M, Ibrahim ZA, EL-Ghannam M,   EL-Dabaa E (2016).Laboratary Diagnosis of C. difficle Infection. Egypt. J. Med. Microbiol.   25(3).

 EL-Far A , Azza B, Saad El-Din S, Omar M, Ibrahim ZA, EL-Ghannam M,   EL-Dabaa E (2016). Detection of Clostridium Difficile from Faecal Specimens of Hospitalized Patients in Theodor Bilharz Research Institute. Egypt. J. Med. Microbiol. 25 (3).

Elsayed NY, Awad AMR, Omar MM and Desouki DG (2015). Rapid Simultaneous detection of AmpC and ESBLs among Enterobacteriaceae using MastD68C detection set and possible therapeutic options. Egypt. J. Med. Microbiol.24 (3): 1-12.

Radwan A, El-Defrawy I, El Sherbini E, Stefani A, Ghinolfi D, Desimone P, Filipponi F, Botros S (2014). Essential framework and strategic actions to establish North African medical research institute; Theodor Bilharz Research Institute (TBRI); as competence centers in liver research L management. JETEAS.5 (7):35-43.

Sayed HA, El-Desouki H, El-Qareh N, Abdelwadoud M, El-Sherbini E, El-Defrawy I, Fam N, Siyam M, El-Khayat H, Lawrance O, Radwan A, Sabry Y, Stefani A, Desimone P, Ghinolfi D, Filipponi F, Botros S (2014). Analysis of national liver disease state of the art in North African Country (Egypt): Identifying gaps and priority needs to reshape liver disease problem and promote Euro Mediterranean co-operation. JETEAS. 5 (5) 159-163.

Fam NS, Defasque S, Bert B, Leflon-Guibout V, El-Ray A, El Ghannam M, Attia ME, Omar M, Desouki DG, Valla D, Nicolas-Chanoine MH (2014).Faecal carriage of extended spectrum β-Lactamases (ESBL) –producing enterobacteria in liver disease patients from two hospitals in Egypt and France: a comparative epidemiological study, J. Epidemiol. Infect.(7): 1-9.

Badawi H, Abu Aitta A, Omar M, Ismail A, Mohamed H, El Said M, Gamal D Saber M (2014). Novel Simple Diagnostic Methods Compared to Advanced Ones for the Diagnosis of Chlamydia trachomatis, Ureaplasmaurealyticumand Mycoplasmas hominis in patients with Complicated Urinary Tract Infections. AJMR 8(8):830-838.

Badawi H, El Damarawy M, Atteya A, Bastawesy R, El Said M, Helmy A, HelmyO, Ismail E (2014). Detection of biological nano-Particles in Egyptian patients with coronary artery disease. Life Sci. J.11(2): 258-268

Abu Aitta A, El Said M, Gamal D, El-Kholy A, Omar M, Kamel M, Mohamed H. (2013).Biotyping and molecular characterization of Klebsiella pneumoniae producing extended-spectrum beta-lactamase in Cairo, Egypt: a multicentre study.Res. J.1-11;5(9)

Fam N, Gamal D, El Said M, El-Defrawy I, EL- Dabaa E, EL Attar S, Sorour A, Ahmed S and Klena J (2013). Prevalence of plasmid- mediated amp C genes in clinicalisolates of Enterobacteriaceae from Cairo, Egypt. BMRJ3(4):525- 537.

Fam N, Gamal D, El-Said M, Aboul –Fadl L, EL- Dabaa E, EL Attar S, Sorour A, Fouad S, and Klena J. (2013). Detection of plasmid mediated Amp C beta- lactamas in clinically significant bacterial isolates in a research institute hospital in Egypt. Life Sci. J. 10(2):2294-2304

Abu Aitta A, El- Said M, El – Dabaa E, Abd El-Slam M, Mahdy H (2013). Detection of plasmid-mediated 16S rRNA methylase conferring high-level resistance to aminoglycosides in Gram negative bacilli from Egypt. Life Sci. J.9(4):2472- 2479

Diab M, Fam N, El- Said M, El-Dabaa E, El- Defrawy I and Saber M (2013). Occurrence of VIM-2 metallo-β- lactamases in imipenem resistant and susceptible Pseudomonas aeruginosa clinical isolates from Egypt.  AJMR 7(35):4465-72.