الفهرس 
Introduction and the aim of workOnly 14 pages are availabe for public view
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Abstract
It is important to assess the quality of sputum samples before culture on microscopic rather than macroscopic appearance. There was an overall agreement between direct Gram and sputum culture as regard percentage of total positive and negative results. There was no agreement between blood and sputum cultures as regard percentage of total positive and negative results. PCR technique has sensitivity and specificity of 100% and 98.7% in comparison to culture with strong agreement between the two techniques for diagnosis of M. pneumoniae PCR has the advantage of short detection time. Direct antigen detection of M. pneumoniae has low sensitivity of 50% and specificity of 96.3% with high percentage of false positive results (50%) in comparison to culture with overall agreement between direct antigen detection, culture and PCR for diagnosis of M. pneumoniae infection. L. pneumophila PCR has sensitivity and specificity of 100% and 98.8% in comparison to culture with strong agreement between the two techniques. PCR has the advantage of short detection time for Legionella infection. There is discrepancy between PCR, IgM and IgG results with overall agreement between C. pneumoniae IgM and PCR in diagnosis of C. pneumoniae infection. There was no difference between results obtained from sputum or BAL samples (9 cases). The commonest causative organisms of CAP was S. pneumoniae while that causing HAP was S. aureus. Atypical organisms represent adequate percentage of CAP cases. M. pneumoniae in 6.2%, L. pneumophila in 4.9% and C. pneumoniae in 2.5%. L. pneumophila serogroup 1 accounted for 60% of legionella isolates. Recommendations: 1Use of PCR for the timely diagnosis of M. pneumoniae and L. pneumophila. 2Evaluation of multiplex PCR in the diagnosis of M. pneumoniae, L. pneumophila and C. pneumoniae in single tube. 3Extended study to compare results of sputum, BAL and Throat swab samples regarding molecular techniques. 4Evaluation of another techniques in comparison to PCR for diagnosis of: Chlamydia: including culture and direct antigen detection. Mycoplasma: including serology and another direct antigen detection techniques e.g. MIF. Legionella: including urinary direct antigen detection. 5 Evaluation of PCR technique in diagnosis of another pathogens causing pneumonia.