الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
VAP is the most frequent ICU-acquired infection among patients receiving mechanical ventilation. The incidence varies from 9 to 20%. Although the attributable mortality rate for VAP is still debated, it has been shown that these infections prolong both the duration of ventilation and the duration of ICU stay.
Approximately 50% of all antibiotics prescribed in an ICU are administered for respiratory tract infections. BAL has proven to be a useful diagnostic tool for the diagnosis of VAP. Quantitative cultures of the retrieved samples appear to provide a good diagnostic yield. The ideal time of culture and sensitivity test is within two hours.
However, in most centers, microbiologic processing is not available around the clock (for example, at night or during weekends), and the appropriate storage of specimens may be of crucial importance to prevent loss of diagnostic accuracy of microbiologic culture. Multiple trials were done to test the impact of BAL samples storage for longer durations on accuracy of microbiological diagnosis and treatment decisions.
The aim of the present work is to:
• Compare the standard 2 hours BAL processing before culture with longer delay time (24 and 48 hours) regarding accuracy of microbiological diagnosis in VAP patients.
• Correlate 10 days morbidity and 28 days sepsis related mortality wherever the delay period is must.
This study was conducted on 100 subjects >18 years in age who were admitted to the ICUs of AMUH and were subjected to invasive mechanical ventilation for more than two days and developed during their ICU stay the CDC criteria of clinically defined VAP that was later fulfilled CDC the criteria of lab confirmed VAP.