الفهرس 
PneumoniaOnly 14 pages are availabe for public view
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Abstract
The objective of this study was to evaluate the incidence and pattern of bacterial infection, and the rate of antibiotic resistance among patients admitted to the respiratory intensive care unit at Abbaseya Chest Hospital during the period from October 2006 to October 2007.
This study included 3 groups of patients:
1. Patients suffered from CARI
2. Patients developed HARI
3. Patients with VAP.
This study included 102 patients, of whom there was 42 patients who suffered from community acquired respiratory infection (CARI); of whom (27 were mechanically ventilated & only 8 of them developed ventilator-associated pneumonia). 48 patients developed hospital acquired respiratory infection (HARI); of whom 12 patients acquired ventilator-associated pneumonia. The remaining 12 patients were mechanically ventilated and acquired ventilator associated pneumonia as primary infection.
Patients in this study were subjected to:
1- Full clinical history taking,
2- Clinical examination,
3- Chest radiograph,
4- Arterial blood gases and oximeter,
5- Routine laboratory testing,
6- Microbiological examination of tracheo-bronchial secretions; either sputum from non-mechanically ventilated patients, endotracheal aspirates or brochoalveolar lavage (BAL) from intubated patients.
The mortality rate among patients, suffered from community acquired respiratory infection, was (35.7%). The most common type of infection among these patients was community-acquired pneumonia and the most frequent pathogen isolated from these patients, was Klebsiella pneumoniae.
Meanwhile, the mortality rate among patients who developed hospital-acquired respiratory infection (HARI) was 41.6%. The most frequent organisms from these patients were Pseudomonas aeruginosa and MRSA.
This study included 73 patients (71.5%) who needed invasive mechanical ventilation, (43.8%) patients acquired ventilator-associated pneumonia (VAP). The mortality rate among this group of patients was 78.1% and the most frequently isolated organism was Klebsiella pneumoniae.
In this study, chronic conditions as COPD, diabetes and heart diseases were the most frequent risk factor predisposing to lower respiratory tract infections.
Concerning the different isolated organisms in this study, MRSA represented 50% of all these staph.
All CA-staph isolates were highly susceptible to penicillins, cephalosprins and carbapenems meanwhile, the susceptibility rate decline in case of noscomial-staph
It’s to be noted that, all the isolated MRSA strains had a high resistance rate to all beta-lactam antibiotics. But at the same time, there was emergence of vacomycin resistance, of 9% & 20%, with all staph isolates and MRSA respectively.
Community-acquired and nosocomial MRSA showed high susceptible rates to levofloxacin, however in case of ciprofloxacin showed high resistance rate.
Klebsiella showed high susceptibility rate to carbapenems, and it was susceptible to ciprofloxacin but to lesser extent. While there was high resistance rate to cephalosporins.
Pseudomonas isolates had the highest susceptibility rates to carbapenems, and it was susceptible to amikacin but less than carbapenems. The nosocomial Pseudomonas had the highest resistance rates to both Ceftazidime and Aztreonam.
All the streptococcal strains had high susceptibility rates to fluoroquinolones, and azithromycin susceptibility rates is higher in community than nosocomial