Abstract:
Introduction: Lower respiratory tract infections (LRTIs) are major cause of morbidity and
mortality throughout the world. Moreover, in recent years, there has been dramatic rise in
prevalence of multidrug-resistant bacteria among respiratory pathogens in both hospital and
community setting. Updated knowledge on etiology and antibiotic susceptibility pattern of lower
respiratory tract infections is essential for optimal management of patients.
Objective: The objective of this study was to determine bacterial isolates and their antibiotic
resistance pattern among adult hospitalized patients with lower respiratory tract infections at
Jimma University Medical Center, Southwest Ethiopia, 2019
Materials and Methods: A cross sectional study was conducted from April to October 2019.
Demographic and related clinical data were collected from 189 study participants using a
structured questionnaire. Respiratory sample from adults suspected with lower respiratory tract
infection was collected and processed to identify potentially pathogenic bacteria using the
conventional culture according to standard bacteriological techniques. Antibiotic susceptibility
testing was performed by using Kirby Bauer disk diffusion method. Data was analyzed using SPSS
version 23. Chi-square and odds ratios were calculated and P values <0.05 was considered as
statistically significant.
Results: Out of the 189 suspected study participants with lower respiratory infections, 102(54.0%)
of participants were a culture positive. The predominant bacterial isolates were Klebsiella species,
Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter species, Escherichia coli and
Streptococcus pneumonia. Overall, 92(82.1%) of the isolates were multidrug resistance (MDR);
71.9% of gram-negative isolates were ESBL positive. Having two or more exacerbations in
previous one year [AOR 6.59 (95%CI: 1.06-38.73)] was found independent associated risk factor
for positive sputum culture from acute exacerbation of chronic obstructive pulmonary (AECOPD)
patients & being age ≥65 years [AOR 4.21 (95%CI: 1.12-14.64) and chronic respiratory disease
[AOR 3.68 (95%CI: 1.29-10.50)] from community acquired pneumonia(CAP) were found
independent associated risk factor for positive sputum culture.
CONCLUSIONS: High prevalence of multidrug resistance in bacterial isolates of lower
respiratory tract infections are clear characteristics of this study. 71.9% of Gram-negative isolates
were ESBL (Extended spectrum of betalactamase) positive. Management of bacterial LRTI better
to guide by culture isolation and antimicrobial susceptibility testing to decrease morbidity and
mortality. Empiric antibiotic therapy should consider the prevalence of antibiotic resistant
pathogens in our community and certain risk factors that may increase the occurrence of MDR
bacterial pathogens
