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Abstract
Nosocomial pneumonia represents a major medical and economic problem , It represents the second most nosocomial infection, and it is the leading cause of death among patients with hospital acquired infection .Most nosocomial pneumonia is caused by Gram negative bacilli which represent 50 -- 75% of infections .Ps aeuroginosa is the most common particularly in intensive care settings Enteobacteriaceae are main pathogens which must be considered for all cases of NP including K. pneumoniae, E.coli, Proteus spp, Enterobacter spp and Serratia spp. The use of antibiotics in the hospital setting has been associated with an increased risk of nosocomial pneumonia and selection of resistant pathogens . Nosocomial infections by extended spectrum [3 -lactamases is a major health problem as it is an important cause of morbidity and mortality in hospitals and their prevalence among clinical isolates varies between countries and institutions .