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Abstract Introduction:Pneumonia remains the main cause of death in childrenin the world despite advances in antimicrobial therapies, microbiological diagnostic tests and prevention measures. Objective:This cross-sectional study aimed todeterminethe most common organisms causing community acquired pneumonia (CAP) versus hospital acquired pneumonia (HAP) and determine the prevalence,risk factors for Multidrug resistant organisms in pediatric intensive care units of Cairo University Children Hospital, Egypt. Subjects and methods:The study was performed on allpatients admitted with bacterial CAP or acquired HAP after admission with positive sputum cultureat our PICUsbetween March 2017 and August 2017. 200 patientswere studied; 150 patients with HAP and 50 patients with CAP.Complete blood count, C-reactive protein, sputum cultures and chest X ray were reported and compared between bothgroups. Results:There is high incidence of infection with MDROs pneumonia. There is a high incidence of VAP in our PICUs (43.5%).The risk factors of MDR pneumonia were identified as previous hospitalization (P value 0.008), VAP (P value <0.001), chronic dialysis (P value 0.040) which more in HAP patients and 100% of our patients received antibiotics before developing MDROs. Conclusions:Klebsiella MDR was the commonest organism.There is antibiotic misuse in our community and PICUs |