Gram-negative bacilli are a major cause of secondary pneumonia in patients with pulmonary tuberculosis: evidence from a cross-sectional study in a tertiary hospital in Nigeria

Iliyasu, Garba; Mohammad, Aminu Bashir; Yakasai, Ahmad M.; Dayyab, Farouq Muhammad; Oduh, Joan; Habib, Abdulrazaq G.

doi:10.1093/trstmh/try044

Cited by 20 publications

(17 citation statements)

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“…Another study of patients with acute LRI in Cambodian provincial hospitals found that Gram negative bacteria were more likely to be cultured from patients whose chest radiographs had pulmonary sequelae of prior infections, including TB, compared to those whose chest radiographs were normal [13]. Nonetheless, as in other studies, [5, 6, 13] our results highlight that clinical and radiographic characteristics are insufficient to meaningfully distinguish between pulmonary TB, bacterial infection and TB/bacterial co-infection in TB endemic regions, given overlapping presentations.…”

Section: Discussionmentioning

confidence: 88%

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Tuberculosis and other bacterial co-infection in Cambodia: a single center retrospective cross-sectional study

et al. 2019

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BackgroundCambodia, a lower middle-income country of about 16 million individuals in southeast Asia, endures a high burden of both tuberculosis and other lower respiratory infections. Differentiating tuberculosis from other causes of respiratory infection has important clinical implications yet may be challenging to accomplish in the absence of diagnostic microbiology facilities. Furthermore, co-infection of tuberculosis with other bacterial lower respiratory infections may occur. The objective of this study was to determine the prevalence and etiologies of tuberculosis and other bacterial co-infection and to analyze the clinical and radiographic characteristics of patients presenting with respiratory infection to a provincial referral hospital in Cambodia.MethodsWe performed a retrospective, cross-sectional analysis of laboratory and clinical data, on patients presenting with respiratory symptoms to a chest clinic of a 260-bed provincial referral hospital in Cambodia. We analyzed mycobacterial and bacterial sputum test results, and demographics, medical history and chest radiography.ResultsAmong 137 patients whose treating clinicians ordered sputum testing for tuberculosis and other bacteria, the median age was 52 years, 54% were male, 3% had HIV infection, and 26% were current smokers. Nearly all had chronic respiratory symptoms (> 96%) and abnormal chest radiographs (87%). Sputum testing was positive for tuberculosis in 40 patients (30%) and for bacteria in 60 patients (44%); 13 had tuberculosis and bacterial co-infection (9% overall; 33% of tuberculosis patients). Clinical characteristics were generally similar across pulmonary infection types, although co-infection was identified in 43% of patients with one or more cavitary lesions on chest radiography. Among those with bacterial growth on sputum culture, Gram negative bacilli (Klebsiella and Pseudomonas spp.) were the most commonly isolated.ConclusionsAmong patients with symptoms of respiratory infections whose treating clinicians ordered sputum testing for tuberculosis and other bacteria, 9% of all patients and 33% of tuberculosis patients had tuberculosis and bacterial co-infection. Greater availability of microbiologic diagnostics for pulmonary tuberculosis and bacterial infection is critical to ensure appropriate diagnosis and management.

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Section: Discussionmentioning

confidence: 88%

“…Alarmingly, this trend may not be isolated to southeast Asia. Gram negative bacteria were isolated from nearly half of Nigerian TB patients receiving anti-TB therapy who presented with acute LRI [6].…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis and other bacterial co-infection in Cambodia: a single center retrospective cross-sectional study

et al. 2019

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“…Several studies carried out world-wide report that the potent pathogens of RTIs are Streptococcus pneumoniae , Haemophilus influenzae , Klebsiella pneumoniae , Pseudomonas aeruginosa , Escherichia coli , Staphylococcus aureus , Bacillus spp., Moraxella catarrhalis , Streptococcus pyogenes and some other enteric Gram-negative rods such as Salmonella choleraesuis , Citrobacter koseri [ 6 , 7 ]. Most of these bacteria are normal flora of the human respiratory tract.…”

Section: Introductionmentioning

confidence: 99%

Bacterial etiology of sputum from tuberculosis suspected patients and antibiogram of the isolates

et al. 2020

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Objective The current study aims to explore the bacteriology of sputum of tuberculosis (TB) suspected patients. A cross-sectional study was carried out in the sputum samples of 150 TB suspected patients visiting District Public Health Office, Bharatpur, Nepal. The samples were subjected to cultural, microscopic and biochemical analyses for the identification of the isolates. In addition, antibiotic susceptibility tests were carried out with a special focus on ESBL and MBL production following Clinical and Laboratory Standard Institute guidelines. Results Bacterial growth was recovered in 47% (71/150) of the TB suspected patients of which 12.66% (19/150) had pulmonary TB infection. Streptococcus spp. (9%) and Pseudomonas aeruginosa (9%) were the most frequently isolated bacteria. Enterobacteriaceae accounted for 35% of the total isolates. Occurrence of bacterial pathogens was more in males (69%) than in females (31%).The incidence of bacterial pathogen was seen associated with gender of the patients and with the TB infection (p < 0.05) but independent with age of the patients and HIV infection (p > 0.05). Tetracycline was effective against Streptococcus spp. whereas gentamicin was effective against Bacillus species. Imipenem and co-trimoxazole were effective drugs for Gram-negative isolates. Among 83 isolates, 35 were multi-drug resistant, 9 were ESBL producers and 4 were MBL producers.

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“…Several studies carried out world-wide report that the potent pathogens of RTIs are Streptococcus pneumoniae, Haemophilus in uenzae, Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, Bacillus spp., Moraxella catarrhalis, Streptococcus pyogenes and some other enteric Gram-negative rods such as Salmonella choleraesuis, Citrobacter koseri [6,7]. Most of these bacteria are normal ora of the human respiratory tract.…”

Section: Emergence Of Bacterial Coinfections Along With the Developmementioning

confidence: 99%

Bacterial Etiology of Sputum from Tuberculosis Suspected Patients and Antibiogram of the Isolates

Regmi

Khadka

Adhikari

et al. 2020

Preprint

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Objective: The current study aims to explore the bacteriology of sputum of tuberculosis (TB) suspected patients. A cross-sectional study was carried out in the sputum samples of 150 TB suspected patients visiting District Public Health Office, Bharatpur, Nepal. The samples were subjected to cultural, microscopic and biochemical analyses for the identification of the isolates. In addition, antibiotic susceptibility tests were carried out with a special focus on ESBL and MBL production following Clinical and Laboratory Standard Institute guidelines. Results: Bacterial growth was recovered in 47% (71/150) of the TB suspected patients of which 12.66% (19/150) had pulmonary TB infection. Streptococcus spp. (9%) and Pseudomonas aeruginosa (9%) were the most frequently isolated bacteria. Enterobacteriaceae accounted for 35% of the total isolates. Occurrence of bacterial pathogens was more in males (69%) than in females (31%).The incidence of bacterial pathogen was seen associated with gender of the patients and with the TB infection (p<0.05) but independent with age of the patients and HIV infection (p>0.05). Tetracycline was effective against Streptococcus spp. whereas gentamicin was effective against Bacillus species. Imipenem and co-trimoxazole were effective drugs for Gram-negative isolates. Among 83 isolates, 35 were multi-drug resistant, 9 were ESBL producers and 4 were MBL producers.

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Gram-negative bacilli are a major cause of secondary pneumonia in patients with pulmonary tuberculosis: evidence from a cross-sectional study in a tertiary hospital in Nigeria

Abstract: Gram-negative bacilli are a major cause of pneumonia in patients with PTB on treatment.

Cited by 20 publications

References 3 publications

Tuberculosis and other bacterial co-infection in Cambodia: a single center retrospective cross-sectional study

Tuberculosis and other bacterial co-infection in Cambodia: a single center retrospective cross-sectional study

Bacterial etiology of sputum from tuberculosis suspected patients and antibiogram of the isolates

Bacterial Etiology of Sputum from Tuberculosis Suspected Patients and Antibiogram of the Isolates

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