Objective This prospective study aimed at detecting the microbial profile of a paediatric intensive care unit (PICU) in a tertiary care hospital in Alexandria, Egypt.

Methods The study was conducted over a 9-month period and included 130 patients admitted to the PICU during that period. All patients were subjected, on admission, to routine cultures (blood, urine, stool and throat). The patients were examined daily for detecting any possible nosocomial infections and cultures were taken accordingly. All medical devices were also cultured on their removal. Staff members of the unit were subjected to under-nail and throat swabs for cultures every 3 months during the study period. All inanimate objects, equipment and surfaces were also cultured every 3 months.

Results All patients showed positive cultures on admission whether blood, urine, stool or throat. Klebsiella, Escherichia coli, Pseudomonas and Candida albicans were the commonest isolated organisms from patients and devices. All the isolates showed marked resistance to the commonly used antibiotics but meropenem, imipenem and cefepime. Coagulase-negative staphylococci were freqently isolated from the under-nail and throat of staff members. Dephteroids were isolated infrequently from inanimate objects and surfaces of the PICU.

Conclusion Gram-negative rods (bacilli) constitute a great problem in the PICU in Alexandria, Egypt and they were introduced into the unit from precolonised patients. These rods showed a great resistance to many used antibiotics. These surveillance data need to be periodically repeated, so we will be familiar with the prevailing organisms and the sensitivity pattern, which will aid in delivering optimal care to patients.