PURPOSE:
To identify the most common causative bacteria, antibiotic sensitivity and the rate of antibiotic resistance of non ventilator hospital acquired pneumonia in Upper Egypt.
METHODS:
A multicentre prospective study was performed for two years in Assiut, El-Minia and Sohag universities. Sampling was done for all patients including, sputum and /or bronchoalveolar lavage (BAL) for gram stain and culture, and serum sample for serology. The validated sputum as well as BAL samples were cultured on three bacteriological media (Nutrient, Chocolate and MaConkey’s agar plates) . The colonies were processed for identification of micro-organisms by Automated Walkaway Microscan 96. Pneumoslide IgM kit (Vircell-slide) was used for detection of atypical pathogens through the use of serological indirect Fluorescent Antibody method.
RESULTS:
The results revealed that in 206 patients with HAP (hospital acquired pneumonia) Klebsiella pneumoniae , MRSA were the commonest isolated pathogens followed by Pseudomonas Aerogonasa. Vancomycin, Ciprofloxacin, Levofloxacin, Moxifloxacin, Amikacin and Cefipime recorded the highest sensitivity against hospital acquired pneumonia. On contrast, A highest rate of resistance was recorded for amoxicillin-clavulinic acid, ampicillin-sulbactem, lincomycin, tetracyclines, first, second or third generations cephalosporins and erythromycin.
CONCLUSIONS:
The most predominant bacteria for HAP are gram negative bacteria and MRSA. Antibiotic targeted these organisms should be considered in management of HAP in our locality.
CLINICAL IMPLICATIONS:
Respiratory quinolones, cefipime, vancomycin and amikacin are the most efficient antibiotics in treatment of lower bacterial respiratory tract infections in our locality