Changing trends in aetiology and antibiotic resistance of symptomatic community acquired bacterial pneumonia in hospitalised adult patients -A South Indian study

Abstract

Background: Community Acquired Pneumonia (CAP) of bacterial origin in adults is a leading cause of mortality and morbidity in developing countries. Etiological diagnosis plays a significant role in hospitalised patients for better treatment strategies. The present study analyses the trends in bacterial pathogens causing adult CAP in hospitalised patients along with comparison of their annual drug resistant profiles between years 2016 and 2017. Methodology: A total of 113 suspected cases of CAP in hospitalised patients from 2016 and 135 cases from year 2017 were included in the study. Respiratory specimens like sputum, broncho alveolar lavage and tracheal aspirates were collected aseptically in sterile containers and inoculated on appropriate culture media. Bacterial pathogens were identified by conventional methods and antimicrobial sensitivity testing was performed by Kirby-Bauer’s disc diffusion method. Results: Incidence of bacterial pathogens in hospitalised patients with CAP had increased from 60% in 2016 to 68% in 2017. Staphylococcus aureus (35%) and Klebsiella pneumoniae (27%) were common causative agents in 2016 while Klebsiella pneumoniae (36%) followed by Staphylococcus aureus (27%) were major pathogens in 2017. An upsurge in resistance pattern among Gram positive and Gram negative pathogens from 2016 to 2017 was observed. A rise in Methicillin Resistant Staphylococcus aureus and Extended Spectrum beta lactamase producing Escherichia coli and Klebsiella pneumoniae is of major concern. Conclusions: Periodical monitoring of local Etiological agents together with a study on resistant patterns would help in better management protocols in CAP. Keywords: Community Acquired Pneumonia; Klebsiella pneumonia; Staphylococcus aureus.