Retrospective audit of LRTI from sputum samples with respect to Acinetobacter spp., Pseudomonas spp. and Klebsiella spp. From tertiary care Hospital of Nepal
Journal Title: International Journal of Medical and Health Sciences - Year 2013, Vol 2, Issue 3
Abstract
Introduction: Lower Respiratory Tract Infection (LRTI) is one of the leading causes of morbidity and mortality in both developed and developing countries including Nepal. Materials and Methods: Between July 2007 and July 2011, total 774 sputum samples from suspected LRTI patients were collected aseptically. The organisms were identified and antibiotic susceptibility test by standard bacteriological technique following American Society for microbiology guideline. Results: Out of 774 sputum samples, 174 (22.48%) showed significant microbial growth. Among them, 164 (21.18%) had established bacterial etiology and 9 (1.16%) had established fungal etiology. Among culture positive cases, 8(4.59%) had polymicrobial growth. No specimen showed fungal and bacterial growth together. The average incidence of Gram negative bacteria was about 4.5 fold more than Gram positive bacteria. Major pathogens isolated were Acinetobacter spp., Pseudomonas aeruginosa, Klebsiella pneumoniae, Streptococcus pneumoniae, Staphylococcus aureus respectively. Multidrug Drug resistant (MDR) isolates were found to be 104 (62.80%). MDR was found highest (33, 89.19%) in Acinetobacter spp. K. pneumoniae was isolated in almost equal number in all age group while A. baumannii and P. aeruginosa were most common among older age group above 60. There is no significant difference in the frequency of isolation of LRTI causing organisms seasonally. Conclusion:The study found the low prevalence of lower respiratory tract infection but high prevalence of MDR organisms. Since no organisms were sensitive to all antibiotics, antibiotic should be prescribed based on antibiotic sensitivity test result and there should be definite antimicrobial prescribing policy in order to prevent the emergence of MDR organisms.
Authors and Affiliations
Buddha Bahadur Basnet, Rajan Kumar Dahal, Nabin karmacharya, Basista Prasad Rijal
Keywords
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