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Abstract
HAP remains as an important cause of morbidity & mortality despite advances in antimicrobial therapy, better supportive care modalities & use of wide preventive measures. It increases hospital stay & produces an excess cost. This forms a universal health problem that is propagated in developing countries such as Egypt.
This study aimed at identification of pathogens causing HAP and their resistance patterns among hospitalized patients who were admitted to Ministry of Electricity Hospital & National Chest & Allergy Center. Twenty patients were included in the study; seven patients were from Electricity Hospital & thirteen were from the Chest Center.
MRSA was the most frequent organism to cause HAP(35%), followed by Pseudomonas auregenosa (25%), then Staphylococcus aureus (15%) & Klebsiella pneumoniae (15%) & lastly Proteus & Haemophilus influenza, both (5%).Pseudomonas and Klebsiella had the highest mortality. Staph aureus had the best prognosis. Patients with P. aeruginosa isolates represented 25% of all patients, all were with pre-existing pulmonary diseases, all caught VAP & all of them died.
Patients who were 65 years old or more were more liable to death.
Patients with comorbidites showed a significant worse prognosis.
Those with early onset HAP had a significant improvement while those with late onset HAP showed no improvement at all.
All bacterial isolates were sensitive to Amikacin with different sensitivity rates. All bacterial isolates showed least sensitivity to Cefotaxime, Ceftazidime, Ampicillin-Sulbactam and Amoxycillin-Clavulanate. MRSA isolates showed 100% sensitivity to Vancomycin.
There was no significant relationship between pathogen-acquired and age group, pathogen-acquired and co-morbidity, sex and outcome nor between nature of preexisting pulmonary disease and outcome.