Bacteriology of community-acquired pneumonia, antimicrobial susceptibility pattern and associated risk factors among HIV patients, Northeast Ethiopia: cross-sectional study

Abstract

Objective: Pneumonia is an opportunistic infection and it is a major cause of mortality and morbidity among human immunodeficiency virus/acquired immune deficiency syndrome-positive patients. Previous studies have shown the dominant pathogens bacterial isolates were K. pneumoniae 27.0%, S. aureus 20.8%, S. pneumoniae 18.8% and E. coli 8.3%. This study aimed to determine bacteriology of community-acquired pneumonia, antimicrobial susceptibility pattern and associated risk factors among human immunodeficiency virus patients in the Northeast Ethiopia: cross-sectional study. Methods: A health facility-based cross-sectional study was conducted from January to April 2021 at six health facilities in Dessie Town. A total of 378 community-acquired pneumonia patients suspected to be human immunodeficiency virus-positive were recruited using a consecutive sampling technique. Sociodemographic and clinical data were collected using a structured questionnaire. A two-milliliter sputum specimen was collected aseptically from each study participant. Samples were cultivated on blood agar, chocolate agar and MacConkey agar to isolate bacterial pathogens. To identify bacteria pathogens Gram stain, colony morphology and biochemical tests were performed. The Kirby-Bauer Disc Diffusion method was used to perform the antimicrobial susceptibility test. Descriptive statistics, logistic regression analysis was carried out using Statistical package for social science version 25 software. p-value < 0.05 with a corresponding 95% confidence interval (CI) was considered for statistical significance. Result: The overall prevalence of bacterial pneumonia was 175 (46.3%). Gram-negative bacteria accounted for 119 (68%) and the predominant isolates identified were Streptococcus pneumoniae 49 (28%) followed by Klebsiella pneumoniae 46 (26.3%), Pseudomonas aeruginosa 34 (19.4%). There were 148 (84.6%) multidrug-resistant bacteria overall. Statistically significant factors included viral load, cigarette smoking, cluster of differentiation 4 count, alcohol use, World Health Organization clinical stages III and IV and low white blood cell count. Conclusion: The study found that both multidrug resistance and bacterial pneumonia were high. Thus, bacterial culture and antimicrobial susceptibility tests should be routinely performed in health facilities in order to prevent and control the spread of bacterial infection and concurrent drug resistance.

Bacteriological Profile and Multidrug Resistance Patterns of Isolates from Sputum of Adults with Community Acquired Pneumonia in Diobu, Port Harcourt, Nigeria: A Retrospective Study

“…This study has successfully contributed to published data on bacteriological profile and antimicrobial resistance patterns in aetiological agents of community acquired pneumonia in Port Harcourt, Nigeria, by identifying nine bacterial species that are associated with CAP and their antimicrobial resistance patterns. The prevalence of bacterial pathogens identified in this study, at 43.8% aligns closely with results obtained elsewhere in Philippines, 40% [18] and Ethiopia, 46.3% [19] but lower that the results obtained in another study in Ethiopia, 50% [3] Zambia 59% [20] and Iran 64.8% [10]. It is however higher than the 33% [21] and 34.9% [22] in Switzerland and Brazil respectively.…”

Etiology of bacterial pneumonia and multi-drug resistance pattern among pneumonia suspected patients in Ethiopia: a systematic review and meta-analysis

“…The sample size of the studies included the least from Jimma 133 [ 31 ] to the highest from Addis Ababa 549 [ 23 ]. The reported prevalence of bacterial pneumonia ranged from 6.19% to in Addis Ababa [ 23 ] to 46.3% in Dessie [ 28 ], while the prevalence of MDR bacterial pneumonia ranged from 32.7% in Hawassa [ 26 ] to 84.6% in Dessie [ 28 ] (Table 1 ).…”

Prevalence of phenotypic multi-drug resistant Klebsiella species recovered from different human specimens in Ethiopia: A systematic review and meta-analysis

“…Article from 6 regions (Amhara, SNNPR, Sidama, Harari, Tigray, Somali) and one federal city Addis Ababa) met the criteria. A total of 40 articles that were published from 2018-2022 identified for the study, including 19 articles from Amhara region [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38], 7 articles from Addis Ababa [39][40][41][42][43][44][45], 5 articles from SNNPR [46][47][48][49][50], 3 articles from Sidama [51][52][53], 3 articles from Harari [54][55][56], 2 articles from Tigray [57,58]…”

“…Concerning articles based on specimen type, most of the articles (21 articles) reported MDR Klebsiella from urine [21-23, 25, 27, 30, 33, 38-41, 43, 44, 48-50, 53, 56, 58, 59]. It is followed by seven (7) articles from blood [20,35,37,42,46,47,51], 4 articles from sputum [24,34,52,57], 3 articles from eye swabs [26,28,45], 2 articles from body fluid [31,55], 1 article for each of this specimen stool [32]: vaginal discharge [36] and ear discharge [29]. All the susceptibility testing was conducted with the disk diffusion method.…”