Ventilator-associated pneumonia (VAP) is a major health problem for people intubated in intensive care units (ICUs), leading to increased mortality rates, hospital stay, and treatment costs. In the present study, the core pathogens causing VAP in Beni-Suef University's Hospital, Egypt, was investigated over a study period of 2 years (2017–2019). Of a total of 213 patients subjected to mechanical ventilation, 60 have developed VAP during their stay in the ICU. The mortality rate reached 41.7% among VAP patients. Sixty bacteria were isolated from an endotracheal aspirate of hospitalized patients. The different isolates were cultured followed by running biochemical tests, sensitivity assays, and automated VITEK®2 System analysis. Unexpectedly, all the isolates were Gram-negative bacteria. Klebsiella pneumoniae were the main pathogen encountered (27/60 isolates) followed by Acientobacter baumannnii (7/60) and other microorganisms belonging to the genera Moraxella, Escherichia, and Pseudomonas (11/60). Antibiotic sensitivity testing was performed via the VITEK®2 System using up to 16 different antibiotics representing 8 different antibiotic classes and subclasses (aminoglycosides, carbapenems, fluoroquinolones, penicillin/β-lactamase inhibitor, extended-spectrum cephalosporins, aminopenicillins, aminopenicillins/β-lactamase inhibitor, folic acid synthesis inhibitor). Majority of the isolates (28/60) showed a remarkable extensive drug resistance (XDR) pattern, while 15 isolates were multi-drug resistant (MDR) and only 6 were pan-drug resistant (PDR) with regard to antibiotics under evaluation. The association of VAP with multi-drug-resistant bacteria is alarming, and rapid management is crucial. Identification of core pathogens is essential for identifying the most appropriate technique for infection control.

中文翻译：

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贝尼苏夫大学医院重症监护室呼吸机相关性肺炎 (VAP) 的微生物病因

呼吸机相关性肺炎 (VAP) 是重症监护室 (ICU) 插管患者的主要健康问题，导致死亡率、住院时间和治疗成本增加。在本研究中，埃及贝尼苏夫大学医院导致 VAP 的核心病原体在 2 年（2017-2019 年）的研究期间进行了调查。在总共 213 名接受机械通气的患者中，60 名在 ICU 期间发生了 VAP。VAP患者的死亡率达到41.7%。从住院患者的气管内抽吸物中分离出 60 种细菌。培养不同的分离物，然后进行生化测试、敏感性分析和自动 VITEK®2 系统分析。出乎意料的是，所有分离物都是革兰氏阴性菌。肺炎克雷伯菌是遇到的主要病原体（27/60 分离株），其次是鲍曼古杆菌（7/60）和其他属于莫拉菌属、埃希氏菌属和假单胞菌属的微生物（11/60）。通过 VITEK®2 系统使用多达 16 种不同的抗生素进行抗生素敏感性测试，代表 8 个不同的抗生素类别和亚类（氨基糖苷类、碳青霉烯类、氟喹诺酮类、青霉素/β-内酰胺酶抑制剂、超广谱头孢菌素、氨基青霉素、氨基青霉素/β-内酰胺酶抑制剂，叶酸合成抑制剂）。大多数分离株 (28/60) 表现出显着的广泛耐药 (XDR) 模式，而 15 株是多重耐药 (MDR)，只有 6 株对正在评估的抗生素具有泛耐药 (PDR)。VAP 与多重耐药细菌的关联令人担忧，快速管理至关重要。识别核心病原体对于确定最合适的感染控制技术至关重要。