Abstract
The majority of bacteria responsible for Lower Respiratory Tract Infections (LRTIs) are multiresistant to antibiotics. The objectives of this study are to describe the antibiotic resistance of these bacteria in LRTIs and to describe the factors associated with these infections. It is a prospective study of 54 respiratory samples of patients with LRTIs for a period of six months from July 2019 to December 2019 in the laboratory of the University Hospital of Befelatanana Antananarivo. The microbiological results showed 12 (22%) isolates of nonfermenting gram-negative bacilli, 10 (19%) isolates of streptococci and 6 (11%) isolates of enterobacteria. Regarding the isolates of nonfermenting gram-negative bacilli, the antibiotic resistance, varies from 42% (amikacin) to 100% (cotrimoxazole). Concerning the isolates of streptococci, it varies from 0% (vancomycin) to 80% (penicillin G). And the antibiotic resistance of the isolates of enterobacteria varies from 0% (imipenem and amikacin) to 100% (amoxicillin). Concerning the associated factors, subjects aged 40 and over (58.6%) (p = 0.84; NS), men (71.4%) (p = 0.01) and subjects hospitalized in intensive care units (70.3%) (p = 0.004) are the most affected by LRTIs. In brief, the knowledge of antibiotic resistance of bacteria responsible for LRTIs allows better patient management.
Highlights
According to the Global Burden of Disease 2015 study, Chronic Obstructive Pulmonary Disease (COPD) and Lower Respiratory Tract Infections (LRTIs) represent the third and fourth most common causes of death, respectively, after ischemic heart disease and cerebrovascular disease (Global Burden of Disease, 2016)
While patients’ complaints such as fever, cough, sputum and dyspnoea lead to symptomatic treatment prescription by general practitioners (GPs) in addition to antibiotics, little is known about the real magnitude of nonantibiotic therapeutic prescriptions in LRTI (Rahericon et al, 2003)
To improve the management of patients with LRTIs, the aims of this study are to describe the antibiotic resistance of bacteria responsible for LRTIs and to describe the factors associated with these infections
Summary
According to the Global Burden of Disease 2015 study, Chronic Obstructive Pulmonary Disease (COPD) and Lower Respiratory Tract Infections (LRTIs) represent the third and fourth most common causes of death, respectively, after ischemic heart disease and cerebrovascular disease (Global Burden of Disease, 2016). The rates differ based on the age, with higher incidence observed in patients between 65 and 79 years of age (63.0/10,000 adults) and >80 years of age (164.3/10,000 adults) (CDC EPIC Study Team, 2015). They are usually treated by antibiotics, guidelines and recommendations suggest reducing the total volume of antibiotic prescription. Epidemiological studies are generally focused on supplementary investigations and on the prescriptions of antibiotics. To improve the management of patients with LRTIs, the aims of this study are to describe the antibiotic resistance of bacteria responsible for LRTIs and to describe the factors associated with these infections
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