الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Healthcare associated infections (HCAIs), in particular, are the major risks associated with critically ill patients of ICU, due to the reduced host immunity, frequent use of invasive medical devices, administration of multiple drugs, cross transmission of pathogens among patients and staffs, and inadequate infection control procedures (Parajuli et al., 2017). Prevalence of HCAIs is roughly about 10–30% in developing countries and 5–10% in developed countries (Divatia et al., 2020). Antimicrobial resistance (AMR) is a major cause for global concern due to its potential impact on global population health, costs to healthcare systems reduction of treatment options and treatment failure (Naylor et al., 2018) and is particularly dangerous in healthcare settings, where antimicrobials are heavily used, exerting an important selective pressure on microbes (Comar et al., 2019). In developing countries, many factors including overuse of antibiotics, limited clinical diagnostic and laboratory capacity, and poor infection control, hygiene, and sanitation have contributed to the emergence and spread of AMR. Healthcare facilities are high risk environments for the development and spread of drug resistance and frequently have the highest burden of multidrug resistant, extensive drug resistant (XDR) and even pandrug resistant pathogens (Raza& Chaudhary, 2019).