尼日利亚西北部社区获得性肺炎：流行病学、抗菌药物耐药性及转归

COMMUNITY ACQUIRED PNEUMOCOCCAL PNEUMONIA IN NORTHWESTERN NIGERIA: EPIDEMIOLOGY, ANTIMICROBIAL RESISTANCE AND OUTCOME.

作者信息

Iliyasu Garba, Mohammad Farouq Dayyab, Habib Abdulrazaq Garba

机构信息

Department of medicine, College of Health Sciences, Bayero University Kano. Kano, Nigeria.

Department of Medicine, Aminu Kano Teaching Hospital. Kano, Nigeria.

出版信息

Afr J Infect Dis. 2017 Nov 15;12(1):15-19. doi: 10.21010/ajid.v12i1.3. eCollection 2018.

DOI:10.21010/ajid.v12i1.3

PMID:29302645

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5733253/

Abstract

BACKGROUND

Pneumococcus is the leading cause of community acquired pneumonia (CAP) worldwide, and the leading cause of mortality. Pneumococcal pneumonia is poorly studied in Nigeria. We describe the epidemiology including associated co-morbidities and outcome of pneumococcal pneumonia in North-western Nigeria.

MATERIAL AND METHODS

We conducted a prospective, hospital based study on patients with community acquired pneumococcal pneumonia. Detailed clinical evaluation and relevant laboratory investigations were carried out. Susceptibility test to commonly used antibiotics was carried out on all confirmed pneumococcal isolates. In hospital mortality was recorded. Analysis was carried out using descriptive statistics with differences and relationships were determined using Chi square and Fisher's exact tests as appropriate, with p < 0.05 regarded as significant.

RESULTS

Of the one hundred and twenty-five (125) patients with pneumococcal pneumonia were studied. The mean age of the patients was 41.3years (± 16.84), and 69/125(55.2%) were males. Co-morbidities were observed in 63/125 (53.8%) of the patients. Resistance to commonly used antibiotics was observed. Overall in-hospital mortality was 9/117(7.8%). HIV (OR=2.081; 95%CI 1.651-3.237), age ≥65years (OR=5.947; 95%CI3.581-17.643), and CURB-65 score of ≥ 3 (OR=2.317; 95%CI1.734-4.719) were independent predictors of mortality.

CONCLUSION

Pneumococcal pneumonia is the commonest cause of CAP in North-western Nigeria with relatively high mortality. There is need to strengthened the vaccination policy targeting at risk adult population in Nigeria.

摘要

背景

肺炎球菌是全球社区获得性肺炎（CAP）的主要病因及主要致死原因。在尼日利亚，肺炎球菌性肺炎的研究较少。我们描述了尼日利亚西北部肺炎球菌性肺炎的流行病学情况，包括相关合并症及预后。

材料与方法

我们对社区获得性肺炎球菌性肺炎患者进行了一项基于医院的前瞻性研究。进行了详细的临床评估及相关实验室检查。对所有确诊的肺炎球菌分离株进行了常用抗生素的药敏试验。记录了住院死亡率。采用描述性统计进行分析，根据情况使用卡方检验和费舍尔精确检验确定差异及关系，p<0.05被视为具有统计学意义。

结果

共研究了125例肺炎球菌性肺炎患者。患者的平均年龄为41.3岁（±16.84），69/125（55.2%）为男性。63/125（53.8%）的患者存在合并症。观察到对常用抗生素的耐药情况。总体住院死亡率为9/117（7.8%）。HIV（比值比=2.081；95%置信区间1.651-3.237）、年龄≥65岁（比值比=5.947；95%置信区间3.581-17.643）以及CURB-65评分≥3（比值比=2.317；95%置信区间1.734-4.719）是死亡的独立预测因素。