Background and study aim: Cirrhotic patients are more vulnerable to bacterial infection. Pneumonia is the fourth ‎most common infection, particularly in advanced disease. Antimicrobial resistance ‎‎(AMR) has great concern among cirrhotic. The aim of this study was to characterize the ‎AMR, distribution of bacteria isolated from chronic hepatic patients with pulmonary ‎infections, and evaluation the antimicrobial susceptibility of bacteria isolated from ‎sputum‎‎.‎
Patients and Methods: This cross-sectional observational study was carried on 98 cirrhotic patients with healthcare-associated pneumonia. Antimicrobial susceptibility testing was conducted using ‎the Kirby–Bauer disc diffusion process according to Clinical and Laboratory Standards ‎Institute (CLSI) guidelines for various therapeutically applicable antibiotics. Data ‎manipulation was done using Microsoft Excel® spreadsheet‎‎.‎
Results: The most common organisms isolated from sputum samples in the present study were E ‎coli (19.39%), Klebsiella spp (15.31%), Staph aureus (14.29%) and Pseudomonas ‎‎(9.18%) while no growth of organisms observed in 28.58%. The antimicrobial-‎susceptibility  for Enterobacteriaceae species isolated from sputum showed higher ‎sensitivity to Imipenem (88.2%), Piperacillin – tazobactam (73.5%), and Ampicillin ‎‎(70.59%) while Ceftriaxone , Ceftazidime and Cefotaxime showed  higher resistance ‎respectively (64.71%, 58.82% and  55.89%). The antimicrobial-susceptibility results for S.aureus species isolated from sputum ‎showed higher sensitivity to Vancomycin (100%) followed by Oxacillin ( 64.29%) ‎while Penicillin G showed complete resistance 100%, followed by Tetracycline 92.86% ‎‎,and Co- trimoxazole 85.71%‎‎‎‎‎‎.
Conclusion: Gram-negative bacteria were the cause of bacterial infections in significant proportion ‎of patients with increased sensitivity to B-lactam antibiotics and ampicillin. However ‎third and fourth generation cephalosporin had the higher resistance values‎.