Multiplex real-time PCR results showed that up to 67.5% of the cases were found the bacterial pathogens in which S pneumoniae and H influenzae were at the high rates (23.6% and 15.5%), followed by K pneumoniae (5.5%), A baumannii (6.3%), E coli (4.4%) and P aeruginosa (3.0%), The others were also detected with the lower rates.