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      Bacteriology of community acquired pneumonia in adult patients at Felege Hiwot Referral Hospital, Northwest Ethiopia: a cross-sectional study

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          Abstract

          Background

          Community acquired pneumonia (CAP) is reported as a common cause of lower respiratory tract infection worldwide. Bacterial pathogens and antimicrobial resistance (AMR) associated with this infection varied between geographical regions. Knowledge of the pathogens in a given area and their up-to-date AMR profile is essential for optimal management of patients. This study was aimed at assessing the type of bacterial isolates and their AMR among CAP adult patients at the Felege Hiwot Referral Hospital (FHRH), Northwest Ethiopia.

          Methods

          This cross-sectional study was conducted during 1 April to 30 July 2018. Demographic related data were collected from the study participants using a structured questionnaire. Sputum samples were collected and processed to identify pathogens using the conventional culture and biochemical tests as per the standard procedures. The Kirby Bauer disk diffusion method was implemented for the AMR testing. Descriptive and multivariable analysis was conducted using SPSS version 23.

          Results

          Among 414 presumptively diagnosed study participants for CAP, bacterial pathogens were identified from 167 (40.3%) participants. Among these, multidrug resistance (MDR) accounted for 127(76%) of the isolates. The predominant isolates were Streptococcus pneumoniae at 60(35.9%) and Klebsella pneumoniae at 30(18%). Overcrowded living conditions [AOR 1.579 (95%CI: 1.015–2.456)] and alcohol use [AOR 4.043 (95% CI, 2.537–6.443)] were found statistically associated with culture positive sputum.

          Conclusions

          The study showed high prevalence of mono- and multi -drug resistant isolates in the study area. Therefore, regular surveillance of the type of isolates and their AMR patterns should be considered. Interventions for reducing community acquired pneumonia should be integrated with lifestyle factors related to household and alcohol use.

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          Etiology of Community-Acquired Pneumonia: Increased Microbiological Yield with New Diagnostic Methods

          Niclas Johansson, Mats Kalin, Annika Tiveljung-Lindell … (2010)
          Abstract Background The microbial etiology of community-acquired pneumonia (CAP) is still not well characterized. During the past few years, polymerase chain reaction (PCR)-based methods have been developed for many pathogens causing respiratory tract infections. The aim of this study was to determine the etiology of CAP among adults—especially the occurrence of mixed infections among patients with CAP—by implementing a new diagnostic PCR platform combined with conventional methods. Methods Adults admitted to Karolinska University Hospital were studied prospectively during a 12-month period. Microbiological testing methods included culture from blood, sputum, and nasopharyngeal secretion samples; sputum samples analyzed by real-time quantitative PCR for Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis; nasopharyngeal specimens analyzed by use of PCR; serological testing for Mycoplasma pneumoniae, Chlamydophila pneumoniae, and viruses common in the respiratory tract; and urine antigen assays for detection of pneumococcal and Legionella pneumophila antigens. Results A microbial etiology could be identified for 67% of the patients (n = 124). For patients with complete sampling, a microbiological agent was identified for 89% of the cases. The most frequently detected pathogens were S. pneumoniae (70 patients [38]) and respiratory virus (53 patients [29]). Two or more pathogens were present in 43 (35%) of 124 cases with a determined etiology. Conclusions By supplementing traditional diagnostic methods with new PCR-based methods, a high microbial yield was achieved. This was especially evident for patients with complete sampling. Mixed infections were frequent (most commonly S. pneumoniae together with a respiratory virus).
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            Community-acquired pneumonia

            Elena Prina, Otavio Ranzani, Antoni Torres … (2015)
            Summary Community-acquired pneumonia causes great mortality and morbidity and high costs worldwide. Empirical selection of antibiotic treatment is the cornerstone of management of patients with pneumonia. To reduce the misuse of antibiotics, antibiotic resistance, and side-effects, an empirical, effective, and individualised antibiotic treatment is needed. Follow-up after the start of antibiotic treatment is also important, and management should include early shifts to oral antibiotics, stewardship according to the microbiological results, and short-duration antibiotic treatment that accounts for the clinical stability criteria. New approaches for fast clinical (lung ultrasound) and microbiological (molecular biology) diagnoses are promising. Community-acquired pneumonia is associated with early and late mortality and increased rates of cardiovascular events. Studies are needed that focus on the long-term management of pneumonia.
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              New evidence of risk factors for community-acquired pneumonia: a population-based study.

              Francisco J. Roig, Paola Torres, M Agustí … (2008)
              The aim of the present study was to identify risk factors for community-acquired pneumonia (CAP), with special emphasis on modifiable risk factors and those applicable to the general population. A population-based, case-control study was conducted, with a target population of 859,033 inhabitants aged >14 yrs. A total of 1,336 patients with confirmed CAP were matched to control subjects by age, sex and primary centre over 1 yr. In the univariate analysis, outstanding risk factors were passive smoking in never-smokers aged >65 yrs, heavy alcohol intake, contact with pets, households with >10 people, contact with children, interventions on the upper airways and poor dental health. Risky treatments included amiodarone, N-acetylcysteine and oral steroids. Influenza and pneumococcal vaccine, and visiting the dentist were protective factors. Multivariable analysis confirmed cigarette smoking, usual contact with children, sudden changes of temperature at work, inhalation therapy (particularly containing steroids and using plastic pear-spacers), oxygen therapy, asthma and chronic bronchitis as independent risk factors. Interventions for reducing community-acquired pneumonia should integrate health habits and lifestyle factors related to household, work and community, together with individual clinical conditions, comorbidities and oral or inhaled regular treatments. Prevention would include vaccination, dental hygiene and avoidance of upper respiratory colonisation.
              Article 0 comments Cited 107 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Dinbere Temesgen: dinberetemesgen@gmail.com
                Fetlewok Bereded: fetleworkyeab@gmail.com
                Awoke Derbie:
                ORCID: http://orcid.org/0000-0002-6949-3494
                +251913059887 , awe.love2000@gmail.com
                Fantahun Biadglegne: fantahun.degeneh@gmail.com
                Journal
                Journal ID (nlm-ta): Antimicrob Resist Infect Control
                Journal ID (iso-abbrev): Antimicrob Resist Infect Control
                Title: Antimicrobial Resistance and Infection Control
                Publisher: BioMed Central (London )
                ISSN (Electronic): 2047-2994
                Publication date (Electronic): 14 June 2019
                Publication date PMC-release: 14 June 2019
                Publication date Collection: 2019
                Volume: 8
                Electronic Location Identifier: 101
                Affiliations
                [1 ]Amhara Public Health Institute (APHI), Bahir Dar, Ethiopia
                [2 ]ISNI 0000 0004 0439 5951, GRID grid.442845.b, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, , Bahir Dar University, ; P.O.BOX: 1383, Bahir Dar, Ethiopia
                [3 ]ISNI 0000 0001 1250 5688, GRID grid.7123.7, Center for Innovative Drug development and Therapeutics Trials for Africa (CDT-Africa), , Addis Ababa University, ; Addis Ababa, Ethiopia
                Author information
                http://orcid.org/0000-0002-6949-3494
                Article
                Publisher ID: 560
                DOI: 10.1186/s13756-019-0560-0
                PMC ID: 6570935
                PubMed ID: 31223478
                SO-VID: 73c1afe2-b068-4049-99be-66fe0b1650ef
                Copyright © © The Author(s). 2019
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 17 December 2018
                Date accepted : 10 June 2019
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © The Author(s) 2019

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: community acquired pneumonia,multi drug resistance,felege hiwot referral hospital,northwest ethiopia
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: community acquired pneumonia, multi drug resistance, felege hiwot referral hospital, northwest ethiopia

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