A STUDY ON AETIOLOGICAL AGENTS OF LRTI WITH SPECIAL EMPHASIS ON DRUG SENSITIVITY PATTERN OF ISOLATED BACTERIA AND INCIDENCE OF PNEUMOCYSTIS CARINII PNEUMONIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2016, Vol 5, Issue 1
Abstract
Lower Respiratory Tract Infections (LRTIs) are important causes of morbidity and mortality for all age groups both in the hospital as well as in the community. Though international guidelines are available for treating bacterial LRTI they have not been validated very much in the Indian scenario. Scarce local information is available regarding aetiological agents of LRTI and their antibiotic sensitivity pattern. Pneumocystis carinii (Jiroveci) is a common pathogen in LRTI in immuno-compromised patients. It is rarely documented in our country. MATERIALS AND METHODSTwo hundred adults suffering from LRTI of less than 2 weeks duration from both inpatient and outpatient departments in a Tertiary Care Hospital at Kolkata were included in the study after taking valid informed consent. Study period was one year (2014-15). Sputum samples were collected as per criteria of Murray et al. 1975. After performing routine culture, diagnosis was made based on colony character and biochemical reactions. Antimicrobial sensitivity testing was then done according to CLSI guidelines. RESULTSThis study reveals that, LRTI was common in all age groups, in both Human Immunodeficiency Virus Non-Reactive (HIVNR) and Human Immunodeficiency Virus Reactive (HIVR) groups. In both the groups, 75% showed growth of single organism in sputum. But in the HIVR group, a considerable number showed growth of multiple organisms. Both the groups (HIVNR and HIVR) showed predominance of Gram positive bacteria. Antibiotic sensitivity was unremarkable, but one E.coli isolate was an Extended Spectrum Beta-Lactamase producer (ESBL). Pneumocystis Carinii (PC) was found in Giemsa stained smear of induced sputum in one HIVR case, who developed Pneumo-mediastinum and surgical emphysema, but recovered due to early initiation of treatment, suggesting that Pneumocystis Carinii (Jiroveci) pneumonia was not uncommon in HIVR patients and early diagnosis and treatment can save the life of the patient.CONCLUSION In our study LRTI was found to be equally common in both HIV-R and HIV-NR patients. Gram positive bacteria were the predominant pathogens in both groups. But double and multiple infection was found in the HIV-R cohort. Antibiotic sensitivity pattern was unremarkable. One E.coli isolate was an ESBL producer. Pneumocystis Jiroveci detection was done in induced sputum.
Authors and Affiliations
Manab Ghosh, Bibhuti Saha, Indrani Bhattacharyya, Mandira Chakraborty, Debabrata Roy, Md. Samidu Hoque
Keywords
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- EP ID EP118049
- DOI 10.14260/jemds/2016/3
- Views 89
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