Recent trend of bacterial aetiology of lower respiratory tract infection in a tertiary care centre of Nepal

Abstract

INTRODUCTION:Lower respiratory tract infections (LRTIs) are among the most common infectious diseases of humans. This study focused on determining the recent trend of bacterial aetiology of LRTIs among the patients attending Tribhuvan University Teaching Hospital (TUTH) in Kathmandu. MATERIALS AND METHODS:This was a prospective study conducted over a period of six months in the bacteriology laboratory of TUTH. A total of 1120 specimens representing lower respiratory tract were received from patients with suspected LRTIs. The specimens were collected and processed according to standard methodology. RESULTS:Respiratory pathogens were recovered from 44.4% cases (n=497). Gram-negative bacteria were recovered in 84.1% (n=488). Bacteria were more commonly recovered from endotracheal secretion (41/61, 67.2%) than in sputum (454/1039, 43.7%) and bronchial washing (2/20, 10%). Ninety-one percent (n=454) growth was monomicrobial while the rest accounted for mixed growth. Among the organisms isolated, Haemophilus influenzae (112, 21%) was the most predominant pathogen followed by Klebsiella pneumoniae (102, 19.1%), Pseudomonads (91, 17.1%), Acinetobacter baumannii calcoaceticus complex (60, 10.9%), Streptococcus pneumoniae (46, 8.6%), Escherichia coli (37, 6.9%).CONCLUSIONS: H. influenzae and S. pneumoniae were the most common Gram-negative and Grampositive bacterial isolates recovered, respectively from LRTIs urging for monitoring and surveillance of these pathogens.

Lower respiratory tract infections among HIV positive and control group in Nepal

“…Similar organisms were also observed in present study [14]. In HIV negative hospital attending patients, the prevalence of bacterial LRTIs had been reported to be 44.4 %-50.4 % [9,13]. The lower yield of pathogens in this study as compared to other studies might be attributable to various factors.…”

“…In Nepal, concerns on LRTIs are increasing among the HIV infected cases because they are being revealed as the important opportunistic infections among these cohorts. LRTIs are common not only among the HIV sero-positive cases but also the commonest domiciliary and nosocomial infections among the general population [9]. The risk of development of invasive pneumococcal diseases is higher among the HIV positive cases than the HIV sero-negative population [6].…”

“…The etiology of bacterial LRTIs among HIV Patients was reported to be Streptococcus pneumoniae, Hemophilus influenzae, Pseudomonas aeruginosa, Staphylococcus aureus, Klebseilla pneumoniae and Acinetobacter species. Bacteria such as Legionella pneumophila Mycoplasma pneumoniae and Chlamydia pneumoniae have also been incriminated in HIV associated pneumonia [7,9,10]. Fungi such as Candida albicans, Cryptococcus neorformans, Histoplasma capsulatum, Coccidioides immitis, Aspergillus spp., Blastomyses dermatitidis, Penicillium marneffei, Sporothrix schenckii can cause pulmonary infections in persons infected with HIV [2,5].…”

Study of Gram Negative Bacterial Isolates From Lower Respiratory Tract Infections (LRTI) and Their Antibiogram Pattern in A Tertiary Care Hospital in South India

“…In our study among the 109 sputum samples processed bacterial etiology was isolated in 71 (61.54%) samples. This is similar to the findings of Mishra et al (4) and Ramana et al (5) in which the isolation rates were 44% and 39.4% respectively. Similar higher prevalence rates of about 57.4% was shown in a study done by Thomas et al (7) tract infections than female sex.…”

Aetiology and Antimicrobial Susceptibility Patterns of Lower Respiratory Tract Infections (LRTI) in a Rural Tertiary Care Teaching Hospital in Karimnagar, South India

“…There was a predominance of Gram negative bacterial cause (70.9%) among the LRTI's as observed by a recent study from Nepal by SK Mishra et al who reported 84.1% occurrence. The same study reported Haemophilus influenzae (21%) as the most common Gram negative bacterium isolated and Streptococcus pneumoniae as a predominant Gram positive bacterial (8.6%) cause in contrast to the present study [18]. A recent study by Yuhua Zhou et al from China which included both molecular methods and automated culture methods to study the LRT microbiota from sputum samples, revealed that Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus and Streptococcus spp were predominant bacterial species associated with LRTI's al [19].…”