Objectives: Ventilator-associated pneumonia (VAP) is the second most prevalent nosocomial infectivity in ICU and most frequent among mechanically ventilated patients. VAP is divided in the two groups based upon mechanical ventilation duration, early and late onset VAP. The most common pathogens in Pakistan were Acinetobacter lwoffi (22%), Staphylococcus aureus (33%) and Pseudomonas aeruginosa (63%). Improper antibiotic therapy has increased the frequency of MDR strains of the pathogens, further aggravating threat posed by disease. The objectives of the study were to identify the organisms up to species level and to determine the Minimum Inhibitory Concentration (MIC) of the isolated organisms by using VITEK.Methods: It was a descriptive study in which 74 patients having ventilator associated pneumonia i.e., patients who developed pneumonia after 48 hours of stay in intensive care unit of hospital were included. Collected Tracheobronchial secretions were sent to the pathology laboratory as soon as for culture and sensitivity. After initial identification of isolates, final identification/ confirmation was done by Vitek 2-compact system.Results: Among 74 patients, 51.0% were males and 54.0% were 51-60 years old. Major cause of ICU admission was head trauma and stroke. Among 72 patients, klebsiella pneumonia was identified in 37.0% patients, pseudomonas aeruginosa in 28.0% patients, acinetobacter baumannii in 21.0% patients and Escherichia coli was identified in 14.0% patients. Klebsiella pneumoniae was 100% resistant to piperacillin. Pseudomonas aeruginosa were 80% resistant to Ampicillin/salbactem. Acinetobacter baumanii was 100% resistant to ampicillin/salbactem, piperacillin, cefuroxime axetil, cefixime, ceftriaxone cefepime, aztreonam, meropenem, levofloxacin, moxifloxacin, trimethoprim. Similarly, E. coli was 60.0% resistant to ampicillin/ salbactem, piperacillin, cefuroxime, cefuroxime axetil, cefixime, ceftriaxone, cefepime, aztreonam, meropenem, levofloxacin, moxifloxacin and chloramphenicol. Conclusion:A very high prevalence of multi drug resistance organisms are noted among ventilator associated pneumonia at a teaching hospital in Pakistan.

Objective: The objective of this study was to evaluate and screen the antibacterial activity of medicinal plant which were most cultivated in ancient time. Study Design: Experimental Study. Setting: Microbiology Section, Pathology Department, Sheikh Zayed Hospital/Medical College Rahim Yar Khan. Period: February 2019 to May 2019. Material & Methods: The fresh aqueous extract of garlic cloves (Allium sativum), onion bulb (Allium cepa) and neem (Azadirachta indica) leaves used against the clinically isolated Staphylococcus aureus(S.aureus), Escherichia coli (E.coli), Klebsiella, Acinetobacter and Pseudomonas species by using agar well diffusion method. Aqueous extract of used plant tested at different concentrations of 100%, 75%, 50%, 25%. Results: All these concentrations showed inhibitory effect towards Gram positive bacteria (S.aureus), while Gram negative bacteria more sensitive to higher concentration. In this analysis, on comparison we observed that fresh garlic juice extract was more efficient on all tested bacteria either Gram positive or Gram negative than other and give maximum zone of inhibition on S.aureus (40mm) due to their high chemistry. Gram negative bacteria mainly E. coli somehow resistant to onion and neem extract because they possess the ability to rapidly mutate their genetic makeup towards phytochemical compounds. Conclusion: The result of study also elicits that efficacy of fresh extract depends upon concentrations levels. The plant showed maximum zone of inhibition at 100% than at 25% because on higher level they contain higher bioactive compounds.