Абстрактный

Prevalence of bacterial pathogens, their antimicrobial susceptibility patterns and associated factors among patients suspected of bacterial pneumonia attending dessie referral hospital, northeast Ethiopia

Tewodros Dessie*, Mohabaw Jemal, Minwuyelet Maru, Moges Tiruneh

Background: Pneumonia is the most common cause of morbidity and mortality in developing countries, mostly caused by different species of bacterial pathogens. Hence, patient management needs awareness of the pathogens and Antimicrobial Susceptibility Testing (AST). This study was aimed to assess the type of bacterial isolates and their antimicrobial susceptibility patterns among pneumonia suspected patients at Dessie Referral Hospital, Amhara region, Dessie, Northeast Ethiopia. Materials and Methods: A hospital-based cross-sectional study design was employed among pneumonia suspected patients from February to April 2020. Socio-demographic characteristics and associated risk factors were collected using pretested questionnaire and clinical data was extracted by reviewing medical records. Sputum specimens were collected and inoculated into chocolate agar, blood agar, Manitol salt agar and MacConkey agar which then incubated at 35 OC or 37 OC for 24-48 hours. Bacterial species were identified based on Gram stain, colony characteristics and biochemical techniques. Antimicrobial susceptibility testing was done using Kirby–Bauer disc diffusion technique. The data was entered in to Epi-Info version 7.1.5 and analyzed with SPSS software version 20.PValue< 0.05 at 95% CI was considered as statistically significant. Results: A total of 406 sputum specimens were collected and cultured among which157 (38.7%) were positive for different bacterial pathogens. The predominant pathogens were Klebsiella pneumoniae with 28.0% (n=44), Streptococcus pneumoniae with 24.8% (n=39), Staphylococcus aureus with 18.5% (n=29) and Pseudomonas aeruginosa with 14.0% (n=22). Majority of the isolates exhibited resistance to Ampicillin with 81.5% (n=53) followed by penicillin with 75.9% (n=22) and amoxicillin-clavulanate with 61.2% (n=43). Multivariable logistic regression showed significant association of culture positivity with older age(AOR = 2.43, CI: 1.12-5.28, p-value = 0.025), cigarette smoking (AOR=4.67, CI: 2.39-9.20, pvalue< 0.001) and alcohol use (AOR=5.58, CI: 3.14-9.92, p-value<0.001). Resistance to Ampicillin and penicillin was associated with repeated prescription and use. Conclusions: This study found high prevalence of bacterial pneumonia in the study area and high rate of bacterial resistance was observed in Ampicillin, penicillin and amoxicillin –clavunalate. Repeated prescriptions and use of antimicrobials were significantly independent factors of bacterial resistance. Therefore, expanding routine bacterial culture and identification with antimicrobial susceptibility testing and strengthening regular surveillance systems are essential for appropriate patient care.