Sensitivity pattern of bacteria causing respiratory tract infections in a tertiary care centre
Keywords:Antimicrobial susceptibility, Bacteria, resistance, Respiratory tract infections
Background: Respiratory tract infections (RTIs) are one of the major public health problems and a leading cause of morbidity and mortality in many developing countries. A better understanding of pathogens that cause RTIs is important to select appropriate antimicrobials. In recent years, due to inappropriate use of antimicrobials there is spread of bacterial resistance. The present study was designed to analyze the etiological agents of RTIs and their susceptibility pattern to some commonly prescribed antibiotics.
Methods: The study was conducted in Narayana Medical College Hospital of Nellore in Andhra Pradesh in South India from January 2011 to November 2011. Patients who were clinically suspected of having RTIs were included in the study. Sputum or throat swab samples were collected aseptically from the patients and subjected to testing and antibiotic sensitivity.
Results: Out of 466 samples 54.9% were males and 45.1% were females. Most prevalent microbes were Klebsiella spp. (51.1%) and least prevalent microbe was enterococci (1.3%). Bacteria were highly sensitive to Meropenem, Imipenem, Piperacillin with Tazobactum and were resistant to Penicillin G, Ampicillin, Cotrimoxazole and Cefepime.
Conclusion: RTIs are one of the most common health problems in developing countries. Various drugs are being used in the treatment of RTIs, in the mean time resistance to many of them are emerging. An appropriate antibiotic has to be initiated only after culture sensitivity in RTIs.
Carroll KC. Laboratory diagnosis of lower respiratory tract infections: Controversy and conundrums. J Clin Microbiol 2002;40(9):3115-20.
Bipin Prajapati., Nitiben Talsania., Sonaliya, K. N. A study on prevalence of acute respiratory Tract infections (ARI) in under five children in Urban and rural communities of Ahmedabad District, Gujarat. Nat J Com Med 2011;2(2):255-259.
Jacobs, E., Dalhoff, A., and Korfmann, G. 2009. Susceptibility patterns of bacterial isolates from hospitalised patients with respiratory tract infections. Int. J. Antimicrob. Agents, 33: 52–57.
Sharma, R., Sharma, C. L., and Kapoor, B. 2005. Antibacterial resistance: Current problems and possible solutions. Indian Journal of Medical Sciences 59, 120-129.
World Health Organization. 2003. Disease Burden and Economics. Practical Approach to Lung Health (PAL). WHO.
Mizgerd JP. 2008. Acute lower respiratory tract infection. N. Engl. J. Med., 358: 716-727.
Gauchan P, Lekhak B, Sherchand JB. 2006. The Prevalence of lower respiratory tract infection in adults visiting Tribhuvan University Teaching Hospital. Journal of Institute of Medicine, 28(2):10-14.
Imani R, Rouchi H, Ganji F. 2007. Prevalence of antibiotic resistance among bacteria isolates of lower respiratory tract infection in COPD Shahrekord – Iran, 2005. Pak. J. Med. Sc., 23: 438-440.
Tenever FC, McGowan JE Jr (1996). Reasons for the emergence of antibiotic resistance, Am. J. Med. Sci., 311: 9-16.
Hryniewicz K, Szezypa K, Sulikowska A, Jankowski K, Bethejeewska K, Hryniewicz (2001). Antibiotic susceptibility of bacterial strains isolated from urinary tract infections in Poland, J. Antimicrob. Chemother., 47: 773-780.
Kurutepe S, Surucuoghu S, Sezgin C, Gazi H, Gulay M, Ozbakkaloglu B (2005). Increasing antimicrobial resistance in E. coli isolates from community-acquired urinary tract infections during 1998-2003 in Manisa, Turkey. Jpn. J. Infect. Dis., 58: 159-161.
Kumari HBV, Nagarathna S, Chandramuki A. 2007. Antimicrobial resistance pattern among aerobic gram-negative bacilli of lower respiratory tract illness in the community. Thorax. 56:109-114.
Zafar A, Hussain Z, Lomama E, Sibiie S, Irfan S, Khan E (2008). Antibiotic susceptibility of pathogens isolated from patients with community-acquired respiratory tract infections in Pakistan-the active study. J. Ayub Med. Coll. Abbottabad.,20(1): 7-9.
Riley, C., and Riley, S. 2003. Influenza and pneumococcal disease in the community. Nursing Standard 18(4):45-51.
Rudan, I., Boschi-Pinto, C., Biloglav, Z., Mulholland, K. and Campbell, H. 2008. Epidemiology and etiology of childhood pneumonia. Bulletin of the World Health. Org 86: 408-416.
El-Astal Z (2004). Bacterial pathogens and their antimicrobial susceptibility in Gaza Strip, Palestine. Pakistan. J. Med., 20(4):365-370.
Kolawale AS, Kolawale OM, Kandaki-Olukemi YT, Babatunde SK,Durowade KA, Kolawale CF (2009). Prevalence of urinary tract infections among patients attending Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria. Int. J. Med. Sci., 1(5): 163-167.
Cheesborough M (2006). District Laboratory Practice in Tropical Countries Vol. II, Microbiology second edition Cambridge University Press., pp. 158-195.
Sharma, K., 2008. Manual of Microbiology: Tools and Techniques, [2nd Ed.] Ann Books Gopaljee Enterprises, Dehi, India. pp. 163-165; 181-7.
Clinical Laboratory Standard Institute (2006). Zone diameter Interpretive Standards and corresponding minimal inhibitory concentration (MIC) interpretive break point. Supplement M44-S1. Clinical and Laboratory Standard Institute, Wayne, PA.
Bauer AW, Kirby WM, Sharris JC, Jurck M (1966). Antibiotic susceptibility testing by a standard single disk method, Am. J. Clin. Pathol., 45: 493-496.
Akingbade OA, Ogiogwa JI, Okerentugba PO, Innocent-Adiele HC, Onoh CC, Nwanze JC, Okonko IO. Prevalence and Antibiotic Susceptibility Pattern of Bacterial Agents Involved In Lower Respiratory Tract Infections in Abeokuta, Ogun State, Nigeria. Report and Opinion 2012; 4(5):25-30]. http://www.sciencepub.net/report.
Jafari J, Ranjbar R, Haghi-Ashtiani MT, Abedini M, Izadi M.2009. Prevalence and Antimicrobial susceptibility of Tracheal Bacterial strains isolated from Paediatric patients. Pakistan Journal of Biological Sciences, 12(5):455-458.
K. Kousalya, S. Thirumurugu, D. C. Arumainayagam, R. Manavalan, J. Vasantha, and C. Uma Maheswara Reddy. Antimicrobial resistance of bacterial agents of the upper respiratory tract in South Indian population. J Adv Pharm Technol Res. 2010 Apr;1(2):207-15.
Zeba B (2005). Overview of β-lactamase incidence on bacterial drug resistance, Afr. J. Biotechnol., 4(13): 1559-1562.
Onanuga A, Oyi AR, Olayinka BO, Onaolapo JA (2005). Prevalence of community- associated multi-resistant Staphylococcus aureus among healthy women in Abuja, Nigeria. Afr. J. Biotechnol., 4: 942-945.
Nwanze P, Nwaru LM, Oranusi S, Dimkpa U, Okwu MU,Babatunde BB, Anke TA, Jatto W, Asagwara CE (2007). Urinary tract infection in Okada village: Prevalence and antimicrobial susceptibility pattern. Sci. Res. Essays., 2(4): 112-116.
Song JH, Lee NY, Ichiyama S, Yoshida R, Hirakata Y, Fu W (1999). Spread of drug resistant Streptococcus pneumonia in Asian Countries: Asian Network for Surveillance of Resistant Pathogens (ANSORP) study. Clin. Infect. Dis., 28:1206-1211.
Schito GC, Debbia EA, Marchese A. The evolving threat of antibiotic resistance in Europe: new data from the Alexaner Profect. J Antimicrob Chemother 2000;46:TL.3-9.
Morrissey I, Robbins M, Viljoen L, Brown DFJ. Antimicrobial susceptibility of community –acquired respiratory tract pathogens in the UK during 2002-2003 determined locally and centrally by BSAC methods. J Antimicrobial Chemother 2005;55:200-8.