Abstract
BackgroundCommunity acquired pneumonia (CAP) in adults is still a common and serious illness in the sub-Saharan Africa. Identification of the pathogens is crucial in the management of CAP. This study was done to determine the common bacterial pathogens, treatment outcomes and associated factors for microbiological confirmed CAP among adults attending the Bugando Medical Centre and Sekou Toure hospital in the city of Mwanza, Tanzania.MethodsThis was a hospital based cross sectional study involving patients with community acquired pneumonia attending Bugando Medical Centre and Sekou Toure regional Hospital. Demographic and other data were collected using standardized data collection tool. Sputum culture was done followed by identification of the isolates and antibiotics susceptibility testing.ResultsA total of 353 patients were enrolled in the study. Out of 353 sputum samples, 265(75%) were of good quality. Of 353 non-repetitive sputum cultures, 72/353 (20.4, 95% CI: 16.2–24.6) were positive for the bacterial pathogens with five patients having more than one pathogen. Good quality sputa had significantly higher yield of pathogenic bacteria than poor quality sputa (26.1% vs.3.4%, P = 0.001). The majority 64 (83.1%) of the isolates were gram negative bacteria. Common bacteria isolated were Klebsiella pneumoniae 23/77(29.9%), Streptococcus pyogenes 10/77 (13.0%), Pseudomonas aeruginosa 9/77 (11.7%) and Escherichia coli 7/77 (9.1%). Of 23 K. pneumoniae isolates, 20/23 (87.0%) were resistant to ceftriaxone. Resistance to ceftriaxone was found to be associated with prolongation of CAP symptoms (p = 0.009).ConclusionGram negative bacteria resistant to ampicillin, amoxicillin/clavulanic acid and ceftriaxone were most frequently isolated bacteria among adults’ patients with CAP attending BMC and Sekou Toure hospital. Routine sputum culture should be performed to guide appropriate treatment of CAP among adults in developing countries.
Highlights
Community acquired pneumonia (CAP) in adults is still a common and serious illness in the sub-Saharan Africa
Community-acquired pneumonia (CAP) according to British Thoracic Society is defined as an acute symptomatic infection of the pulmonary parenchyma which develops outside the hospital or nursing home as evidenced by a new infiltrate demonstrated on chest radiograph or auscultatory findings consistent with
Microbiological studies of sputum can yield the correct diagnosis of CAP in the majority of cases [8]. Different guidelines including those from Infectious Disease Society of America (IDSA) recommend 2 pre-treatment blood cultures as well as gram staining and culture of the sputum in the diagnosis of CAP [8]
Summary
Community acquired pneumonia (CAP) in adults is still a common and serious illness in the sub-Saharan Africa. Diagnosis of CAP depends on different diagnostics methods; including chest radiography which is required to demonstrate new infiltrates, sputum and blood culture which can confirm the microbiological pathogens [8]. Microbiological studies of sputum (microscopic examination of sputum specimens and sputum culture) can yield the correct diagnosis of CAP in the majority of cases [8]. Different guidelines including those from Infectious Disease Society of America (IDSA) recommend 2 pre-treatment blood cultures as well as gram staining and culture of the sputum in the diagnosis of CAP [8]. Despite CAP being the commonest reason for hospital visits, there are limited information regarding the etiological causes of CAP in these countries [11]
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