الفهرس 
Acknowledgement
Klebsiella pneumoniaeOnly 14 pages are availabe for public view
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Abstract
Ventilator-associated pneumonia is a common nosocomial infection occurring in patients receiving mechanical ventilation especially in pediatric intensive care units (PICUs). Klebsiella pneumoniae is a multidrug resistant nosocomial pathogen that plays an important role in respiratory tract infection among critically ill patients.
This study included 51 pediatric patients had VAP admitted to the Pediatric Intensive Care Unit (PICU) at Assiut university children’s hospital through 12 months’ period in 2014-2015, using quantitative endotracheal aspirate (EA) culture as well as 100 environmental swabs taken from surfaces, walls, floor, tubes from ventilator circuits and side tables. K. pneumoniae were isolated by cultured onto blood and MacConkey`s agar plates then incubated aerobically at 35 °C for 24-48 hrs. This study was carried out on 23 K. pneumoniae strains isolated from pediatric patients (19 (37.25%) infected with VAP) as well as, 4 (4%) strains from environmental samples. K. pneumoniae isolates were confirmed and biotyped by the use of API®20E strips that identified two different analytical profile index.
All the clinical and environmental K. pneumoniae strains were sensitive to colistin and resistant to cefazolin. The resistant rates of the isolates were found as 82.6% for piperacillin, 91.3% for each amoxacillin- clavulanate, cefoperazone and ceftriaxone, 95.65% for each cefazolin, ceftazdime and meropenem, 86.95% for cefipeme, 52.17% for imipenem, 73.91% for both gentamicin and amikacin, 26.08% for levofloxacin and 78.29% for trimethoprim/sulphamethoxazole. Ten (10) resistotype were detected among total 23 K. pneumoniae isolates as a phenotypic marker based on their resistant pattern to seven (7) different antimicrobial classes. DNA was extracted from all isolates.