Microbiological Profile, Sensitivity and Drug Resistance of Germs Responsible for Lower Respiratory Tract Infections in Yaounde, Cameroon

Abstract

Background: Lower respiratory tract infections (LRTIs) remains a serious public health problem in worldwide despite advances of medicine. The objectives of this study were to present the profile of germs responsible for LRTIs in Yaounde between 2010 to 2019, analyse the association between these germs with the gender and age groups of the study participants and present sensitivity and resistance profiles to the drugs used in this research during the same period. Methods: This retrospective and observational study was carried out from January 04, 2010 to December 24, 2019 in Yaounde, capital of the Center region, at Centre Pasteur of Cameroon. The laboratory analyses focused on the macroscopic study, the isolation and identification of bacterial and fungal species and the realization of an antimicrobial susceptibility testing by the method of diffusion. The automated method using the Vitek 2-compact automaton has also been used in the context of the search for profiles of sensitivity and resistance to antibiotics and antifungals. Results: A total of 1795 samples were analyzed during the study period with a prevalence of LRTIs of 47.8% (858 positive samples). Men were more represented with 449 (48.0%) samples compared to 377 (48.3%) samples for women. This difference in sample distribution by sex was significant (p = 0.01224). The age of the infected participants ranged from 7-90 years for a mean age of 51.2 years ± 15.4 SD. The age distribution in groups showed that LRTIs are common among adults aged 41-60 years with 372 (49.4%) samples. The difference in distribution was significant across age groups (pPseudomonas aeruginosa (7.24%), Klebsiella pneumoniae (6.13%), Haemophilus influenzae (4.40%), Candida albicans (4.07%), Streptococcus pneumoniae (2.01%), Streptococcus sp. (1.78%), Serratia marcescens (1.56%), Acinetobacter baumannii (1.50%), Enterobacter cloacae (1.28%), Pseudomonas fluorescens (1.23%), Straphylococcus aureus (1.23%), Haemophilus sp. (1.00%), Pseudomonas sp. (0.95%), Candida sp. (0.95%), Escherichia coli (0.89%), Stenotrophomonas maltophilia (0.84%), Chryseomonas sp. (0.78%), Pseudomonas putida (0.78%), Streptococcus oralis (0.78%), Burkholderia cepacia (0.72%), Proteus mirabilis (0.67%), Chryseomonas luteola (0.61%), Haemophilus parainfluenzae (0.61%), Acinetobacter calcoace (0.50%), Trichosporon spp. (0.39%). A statistically significant associations of age groups (pKlebsiella pneumoniae and 75.4% for Pseudomonas aeruginosa). For inhibitors of protein synthesis, higher sensitivities were observed for the same germs (92.7% and 83.8% respectively to amikacin, 83.5% to chloramphenicol for Haemophilus influenzae). For folic acid synthesis inhibitors, the highest resistance was also found for Haemophilus influenzae (87.3%) and Klebsiella pneumoniae (71.8%) to cotrimoxazole. The isolated fungi were mostly susceptible to the antifungal agents tested. Conclusion: In the light of this work, it is necessary to extend the surveillance of antibiotic resistance strains throughout the country in order to define therapeutic strategies adapted to the local epidemiological data.