الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Burkholderia cepacia, actually a cluster of closely relatedgenomic species, is a group of nonfermenting Gram-negative bacilli, emerging as an important nosocomial pathogen. Epidemic spread of BCC strains amongst CF patients has been widely documented; in addition, there have been several reports of nosocomial outbreaks amongst non-CF patients. Treatment options for BCCinfections remain limited due to its high intrinsic antimicrobial resistance, the predominance of MDR strains and thus the lack of effective therapeutic antibiotics.
The efficiency of infection control measures are determined by the accuracy with which “B. cepacia” is diagnosed. However, the identification of this organism is not straightforward and poor laboratory proficiency in identification of this organism still prevails. Although several guidelines intended to enhance accurate identification of these bacterial species have been proposed, but the degree to which these are followed varies greatly among clinical microbiology laboratories. The policy that should be strictly adopted in routine clinical laboratories for the identification of putative BCCisolates should generally include the use of an efficient selective medium, conventional biochemical analysis and a special commercial system for the confirmation of its identify.
The present study aimed to:
1-To isolate and identify BCC from different samples collected from patients admitted to ICUs and burn units.
2-To isolate and identify BCC from different environmental samples collected from ICUs and burn units.
3-To estimate and compare the rate of BCC isolates from clinical and environmental samples, in the ICUs and burn units.
4- To determine antimicrobial susceptibility patterns the BCC isolates.
5- To detect rec A gene among BCC.
The present study was conducted on 115 patients admitted to burn units and ICUs.A total of 400 samples were collected including 150 clinical samples (mini-BAL, urine, wound, blood, tissue and CSF) and 250 other than clinical samples were collected frommedical and paramedical staff, in addition to medical equipment and environmental items in ICUs & burn units used by patients or healthcare personnel. 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. BCCwas further identified by the BSCA and PCR.
The results of this study showed that:
1- Out of 150 clinical cultured samples, 128 showed isolates and 22 no growth, while all of other than clinical samples (250) showed isolates.
2-B.cepacia showed the second highest rate of isolation in burn units (30.0%) isolated from burn (86.8%).
3-B.cepacia showed the highest rate of isolation in the second (30.9%) and third degree (33.3%) of burn.
4-B.cepacia showed the highest rate of isolation in bathtubs (36.4%) from the pediatric department of burn units and the lowest rate of isolation (11.1%) from curtains of male department.
5- B.cepacia showed the highest rate of isolation from hands of patients in burn units (32.1%).
6-The majority of isolates were MDR (77.9%) and (55%) were ESBL.
7-It is apparent that when the duration of stay in hospital increased, the infection rate increased ranging from (65.4%) in the 1st week till (92.7%) in 4rd week and more weeks of stay.
8-The lowest percentage of BCC resistance was against colistine.
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-BCC and P.aeruginosawere the most predominant isolates caused burn infection.
2-The more the duration of stay in burn units and ICUs, the higher infection rate.
3-The majority of isolates were MDR and ESβL.
4-Colistine might be the best choice for BCC and imipinem and meropenem were the best choice for E.coli, k.pneumoniae and P.mirabillis.