Abstract
Lower respiratory tract infection is a common cause of morbidity and mortality worldwide. A cross-sectional study was carried out with an objective to study the antibiogram of Gram-negative isolates of patients with lower respiratory tract infection visiting Kathmandu Model Hospital. A total of 274 specimens including sputum, endotracheal aspirates, suction tips were cultured as per standard microbiological technique. Antibiotic susceptibility and detection of Extended-spectrum beta- lactamases (ESBLs) were performed following Clinical Laboratory Standard Institute (CLSI 2014) guidelines. Respiratory pathogens were recovered from 24.6% (n=65) cases. Klebsiella pneumoniae (40%) was the commonest isolates. The highest prevalence of multidrug-resistance (69.23%) was observed in Acinetobacter calcoaceticus baumannii complex. Extended-spectrum beta- lactamases were detected in Escherichia coli (n=4), Klebsiella pneumoniae (n=4) and Acinetobacter calcoaceticus baumannii complex (n=1). High prevalence of multidrug-resistance and extended- spectrum beta- lactamase producers were observed in respiratory isolates. For effective management of lower respiratory tract infections, an ultimate and detailed microbiological diagnosis and susceptibility testing is required.
Highlights
Lower respiratory tract infection (LRTI) is considered as one of the major public health problems and a leading cause of morbidity and mortality in many developing countries.[1,2,3] It is a global problem accounting for over 50 million deaths each year and occurs in both community and health care settings.[4]
This study was conducted with the aim of studying the Gramnegative etiological agents causing LRTI in patients of all age groups and their antibiogram with special interest to MDR in Kathmandu Model Hospital
Lower respiratory tract (LRT) representing specimens, viz., sputum, endotracheal (ET) secretion and bronchial washings received for culture and sensitivity which met the criteria as recommended by American Society for Microbiology (ASM) were included in the study.[7]
Summary
Lower respiratory tract infection (LRTI) is considered as one of the major public health problems and a leading cause of morbidity and mortality in many developing countries.[1,2,3] It is a global problem accounting for over 50 million deaths each year and occurs in both community and health care settings.[4] In developing countries, the situation is more complicated, and management is often difficult due to the problem associated with the identification of the etiological agents and the administration of an appropriate treatment in cases requiring antibiotic therapy.[5] Gram‐positive bacteria such as, Staphylococcus aureus, Streptococcus pneumoniae and Gram‐negative bacteria such as Haemophilus influenzae, Pseudomonas spp, Acinetobacter spp., Klebsiella spp. have been recovered from LRTIs.[6] This study was conducted with the aim of studying the Gramnegative etiological agents causing LRTI in patients of all age groups and their antibiogram with special interest to MDR in Kathmandu Model Hospital. A crosssectional study was carried out with an objective to study the antibiogram of Gram-negative isolates of patients with lower respiratory tract infection visiting Kathmandu Model Hospital
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