الفهرس 
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Abstract
Ventilator-associated pneumonia is a problem in critically III patients, and it is associated with high morbidity and mortality (KO lief, I 9 9 9). The precise diagnosis of VAP is difficult. Accurate data on etiologic agents and the epidemiology of VAP are limited by the lack of a gold standard for diagnosis pencer,1996).The selection of antimicrobial agents for initial empiric treatment of VAP appears to be an important determinant of the outcome (Kollef,1999).The aim of this study is comparison of the yield of BAL samples (culture and direct smear by Gram’ stain) versus blood culture and ,comparison of the ordinary versus automated This study comprised 32 mechanically ventilated patients (21 males and I I females) who developed VAR They were subjected to thorough history taking, clinical examination and laboratory investigations. BAL was examined directly by Gram’ stain and cultured aerobically and anaerobically on ordinary culture media and BACTEC 9050. blood samples were cultured aerobically and anaerobically using BACTEC 9050.cultures for purpose of rapid * This stwdy revealed the Aollowing: 1. Statistically significant increase in the WBCs, as well as significant decrease in the RBCs and hemoglobin percentage after the development of VAR. and accurate diagnosis of VAR