الفهرس 
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Abstract
HAIs, especially those caused by antibiotic-resistant pathogens, represent an important source of morbidity and mortality for the patient hospitalized in an ICU. Important antibiotic-resistant nosocomial pathogens including MRSA, Gram-negative bacilli especially, Klebsiella and Enterobacter producing ESβL. The main infection was VAP followed by CAUTI and BSI and the most important causes of ICU infections caused by Ps. aeruginosa, S.aureus and Acinetobacter spp.
Acinetobacter spp. is widespread, environmental, opportunistic pathogens. A.baumannii- calcoaceticus complex being the most prevalent acinetobacters in human disease and the most commonly associated with HAI. It accounts for 75% of the Acinetobacter spp. isolated from clinical samples. The skin, throat, respiratory tract and the digestive tract are the major sites of Acinetobacter colonization in ICU patients.
The present study aimed to:
1-Isolation and identification of bacterial isolates from patients hospitalized in ICU according to infection sites.
2) Estimation of the rate of isolation of A. baumannii.
3)Determination of antimicrobial susceptibility patterns of the isolated organisms.
The Present study was conducted on 87 patients admitted to ICU. A total of 108 samples were collected including (mini-BAL, sputum, urine, wound blood, CSF). The samples were aseptically collected, labeled and then transported to the lab. All samples were cultured and subjected to microbiological procedures for isolation and identification of isolates. A.baumannii/calcoaceticus was further identified by the APi20NE system.
The results of this study showed that:
1- Out of the 108 studied samples, 95(88%) were positive while 13(12%) were negative.
2- The infection rate increased from 43% in the 1st week till 100% in 3 rd and more weeks of stay.
3- It is apparent that A.baumannii/ calcoaceticus showed the highest frequency of isolation in the overall samples (32.6%)
4-A.baumannii/ calcoaceticus was the predominant organism in RTIs, 62.5% in mini-BAL samples and 22.8% sputum, while E.coli were the most frequently isolates caused UTIs 25%.
5- P.aeruginosa was the most predominant isolate (39.2%) caused wound infection followed by A.baumannii (21.7%).
6- It is clear that the majority of isolates were MDR (77.9%) and (54.6%) were ESβL, the highest rates of MDR were A.baumannii/ calcoeticus (93.5%), followed by P.aeruginosa (73.3%), and E.coli (60%).
7- The majority of ESβL appeared with A.baumannii/ calcoeticus (80.6%), followed by P.aeruginosa (66.6%), E.coli (50%), P. mirabilis (40%), and K.pneumoniae (30%).
8- A.baumannii showed high resistance to antibiotics, and the lowest resistance was against Imipinem (41.9%), meropenem(45.2%),and gentamycin (48.3%).
9- There was no resistance of E. coli, k.pneumoniae and P.mirabillis against imipinem and meropenem.
from this study it could be concluded that:
1-A.baumannii / calcoaceticus complex showed the highest rate of isolation.
2-The more the duration of stay in ICU, the more infection rate.
3-The majority of isolates were MDR and ESβL
4-A.baumannii was the most predominant isolate caused respiratory tract infection.
5-The lowest percentage of A.baumannii resistance was against imipinem and meropenem.
6-There was no resistance of E.coli, k.pneumoniae and P.mirabillis against imipinem and meropenem