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PCR reactions for each strain were repeated at least three times. Sequencing of TEM and CTX-M genes The PCR products were purified with a QIA quick PCR purification kit (Qiagen, Hilden, Germany) and sequenced on an ABI Prism 377 automated sequencer (Perkin-Elmer, Norwalk, CT, USA). The primers for sequencing were the amplification primer. All sequences were confirmed by two independent determinations and analyzed by Basic Local Alignment Search Tool. Results Bacterial Strains In our samples, these strains were Isolated mainly from patients in urinary surgery ward 110 (38.1%) and ICU 63 (21.8%). The rest in turn were derived from Respiratory Medicine, 27 (9.3%), Neurosurgery 22 (7.6%), Thoracic Surgery and General Surgery 21 (7.3%), Non-specific serine/threonine protein kinase Oncology 11 (3.8%), Orthopedic Surgery 9 (3.1%), Cardiovascular Medicine 9 (3.1%), Gastroenterology 8 ATR activation (2.8%), Endocrinology 7 (2.4%), Neurology 2 (0.7%). A total of 197 ESBL-producing Isolates were detected phenotypically using the CLSI criteria for ESBL screening and disk confirmation test, the detection rate being 68.2% (197/289) (See Table ?Table1).1). We found that much more ESBL-producing Isolates exited in urinary surgery ward and ICU and the detection rate were higher than the other wards. The cohort of 197 patients had a mean age of 53.8, which ranges from 20 to 88 (See Table ?Table2).2). Of all Isolates, 109 (55.3%) patients were over 60. According to statistical results by age, we concluded that we should further enhance elderly patients�� management and treatment dynamics, completes the prevention and treatment work. The main sources of ESBL- producing E-coil were unire 96 (48.73%, of total ESBL-producing Isolates), wounds 27 (13.71%), sputa 26 (13.20%), genital secretion 16 (8.12%), hydrothorax and ascite 15 (7.61%), blood 12 (6.09%), bile 5 (2.54%) (See Table ?Table33). TABLE 1 Distribution of strains in different wards. TABLE 2 Frequency of ESBL Isolates by age. TABLE 3 Distribution of E. coli Isolates by type of specimen. Antimicrobial Susceptibility The Crizotinib mw ESBL-producing Isolates were often multidrug-resistant. ESBL producers have shown much higher rates of resistance than those non-ESBL to ciprofloxacin (ESBL versus non-ESBL, 74% versus 30%, P