الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Summary
• This prospective study conducted on 100 patients admitted to the Hepatogastrointestinal intermediate care unit. All the patients were subjected to laboratory investigation including rectal swabs at the day of admission to the ICU then after 5 days and imaging.
• The patients mean age was 58.3±11.3 years and ranged from 20 to 84 years with 52% males and 48% females. The percentage of patients with liver cirrhosis etiology was 86%, while 14% of other etiologies. The study showed that 55%of the cirrhotic patients were Child C.
• Our study revealed that E.Coli was the most common organism isolated after 1 and 5 days of ICU admission (56%, 56% respectively) followed by Klebsiella oxytoca (26%, 24%, respectively). However, Enterobacter accounted for (11%,12%, respectively), Klebsiella pneumonae (7%, 7%, respectively) and Pseudomonas aerognosa appeared only in the second rectal swab (1%).
• E.coli was sensitive to meropenem(89.3%) and resistant to ciprofloxacin (75%).
• Klebsiella oxytoca was sensitive to meropenem(69.2%) and resistant to ciprofloxacin(65.4%).
• Enterobacter was sensitive to pipracillin-tazobactam (100%) and resistant to ciprofloxacin (54.5%).
• Klebsiella pneumonia was sensitive to pipracillin-tazobactam (71.4%) and resistant to ceftriaxone (85.7%).
• Pseudomonas aerogenosa appeared only in the second rectal swab, was sensitive to meropenem, ciprofloxacin, pipracillin-tazobactam and gentamicin (100%) and resistant to ceftriaxone, cefoxitine and ceftazidime (100%).
• The main cause of admission showed no association with the type of isolated organisms.
• The organism has no relation with the fate of the patients.
• Most of the patients who died in the ICU had high bilirubin level (6.73±4.60 mg/dl)(P-value=0.001), high level of serum urea (120.33±26.02 mg/dl) (P-value=0.014) and serum creatinine (2.54±2.20 mg/dl)(P-value<0.001).
• The patients with no animal contact had high incidence of Klebsiella pneumonea. While patients with animal contact had high incidence of Enterobacter.
• Patients with liver cirrhosis with Child-Pough C associated with high incidence of E.coli appearance in their both rectal swabs.
• Non – cirrhotic patients had no significant relation to the type of the isolated organisms.