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Background Hospital-acquired pneumonia (HAP) is the second most common nosocomial infection in intensive care units (ICUs). The present study aims to determine the prevalence of pathogenic bacteria, their biofilm formation, and molecular typing from patients with HAP in southwestern Iran. Methods Fifty-eight patients with HAP participated in this cross-sectional study. Sputum and endotracheal aspirate were collected from each patient for isolation and detection of bacteria. Biofilm formation was evaluated using Congo red agar or Microtiter plate assay. The antimicrobial susceptibility patterns of the isolates were investigated. The multiplex polymerase chain reaction (M-PCR) technique was used to determine the Staphylococcal Cassette Chromosome mec (SCC mec ) types of methicillin-resistant  Staphylococcus aureus  (MRSA) strains. All  S. aureus  isolates were typed using the  agr  typing method. A repetitive element sequence-based PCR (rep-PCR) typing method was used for typing of Gram-negative bacteria. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software version 15 and the chi-square test. Results Bacteria were isolated in 52 (89.7%) of patients.  Acinetobacter baumannii  ( A. baumannii ) was the most prevalent organism (37%), followed by  S. aureus ,  Pseudomonas aeruginosa  ( P. aeruginosa ), and  Escherichia coli  ( E. coli ). Using the PCR method, 56 bacteria were detected.  A. baumannii  was the most prevalent (35.7%) organism.  A. baumannii  and  P. aeruginosa  were biofilm-producing. All Gram-negative isolates were colistin-sensitive, and most of the  A. baumannii  isolates were multidrug-resistant (MDR). MRSA was identified in 12 (80%)  S. aureus  isolates, and 91.6% of MRSA were SCC mec  type III. The agr type III was the most predominant. The rep-PCR analysis showed seven different patterns in 20  A. baumannii , six patterns in 13  P. aeruginosa,  and four patterns in 6  E. coli . Conclusion A. baumannii  was more prevalent than  S. aureus  in ventilator-associated pneumonia (VAP), while  S. aureus  is a major pathogen in non-ventilator hospital-acquired pneumonia (NV-HAP), possibly due to the tendency of the former to aquatic environments. Based on the rep-PCR typing method, it was concluded that bacteria were transmitted from patients or healthcare workers among different wards. Colistin can be used as a treatment in Gram-negative MDR isolates.

bmc pulmonary medicine

Identification and detection of pathogenic bacteria from patients with hospital-acquired pneumonia in southwestern Iran; evaluation of biofilm production and molecular typing of bacterial isolates