Bacterial isolates and their antibiotic resistance pattern among Adult hospitalized patients with lower respiratory tract Infections at jimma university medical center, southwest Ethiopia

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