Department of Biochemistry, Microbiology and Biotechnology, Kenyatta University, P.O Box 43844-00100, Nairobi, Kenya.
BMC Microbiol. 2023 Jun 29;23(1):172. doi: 10.1186/s12866-023-02905-x.
Respiratory tract infections cause significant morbidity and mortality globally and are the most common infectious diseases in humans. This study aims at assessing the presence of bacterial respiratory infections, number of people infected and antimicrobial susceptibility profile among antibiotic naïve outpatients presenting with respiratory tract infections in Meru Teaching and Referral Hospital.
The study was conducted in Meru Teaching and Referral Hospital, Meru County from April 2017 to August 2018. Upper respiratory infections were characterized by acute infection of nasal cavity, pharynx and larynx while lower respiratory infections were characterized by chest pains, prolonged cough, productive sputum, difficulty in breathing, fever and weight loss. A total of 384 sputum and throat samples were collected aseptically from patients who were clinically suspected to have respiratory infections and cultured in blood agar, MacConkey agar and chocolate agar. Bacterial isolates were identified by colonial morphology, Gram stain and confirmed by biochemical tests. Antimicrobial susceptibility profile was determined using agar disc diffusion method.
Respiratory bacterial pathogens were isolated in 45.6% of the samples. The prevalence of the bacteria species isolated were as follows Pseudomonas species (36.6%), Klebsiella species (20.6%), Staphylococcus aureus (16.6%), Streptococcus pyogenes (13.7%), Streptococcus pneumoniae (10.3%) and mixed isolates (2.3%). Amoxicillin and ampicillin recorded the highest resistance rate. Most of the isolates displayed high level of resistance to more than two antibiotics. Although multidrug resistance is reported in the study, gentamicin, amikacin and cefuroxime are recommended as the antibiotics of choice against bacterial isolates obtained.
Bacterial respiratory infections were prevalent in the study area and the isolates obtained showed resistance to commonly used antibiotics such as amoxicillin, ampicillin, ciprofloxacin piperacillin ciprofloxacin, ceftazidime, piperacillin-tazobactam and cephalexin. Therefore need for a continuous surveillance of antimicrobial resistance in management of respiratory infections in the study area.
呼吸道感染在全球范围内造成了很大的发病率和死亡率，是人类最常见的传染病。本研究旨在评估梅鲁教学和转诊医院无抗生素经验的呼吸道感染门诊患者中细菌呼吸道感染的存在、感染人数和抗生素药敏谱。
本研究于 2017 年 4 月至 2018 年 8 月在肯尼亚梅鲁县的梅鲁教学和转诊医院进行。上呼吸道感染的特征是鼻腔、咽部和喉部的急性感染，而下呼吸道感染的特征是胸痛、长时间咳嗽、有痰、呼吸困难、发热和体重减轻。从临床疑似呼吸道感染的患者中无菌采集 384 份痰和咽喉样本，并分别接种于血琼脂、麦康凯琼脂和巧克力琼脂中进行培养。通过菌落形态、革兰氏染色和生化试验对细菌分离株进行鉴定。采用琼脂纸片扩散法测定抗生素药敏谱。
在 45.6%的样本中分离出呼吸道细菌病原体。分离出的细菌种类如下：假单胞菌（36.6%）、克雷伯菌（20.6%）、金黄色葡萄球菌（16.6%）、化脓性链球菌（13.7%）、肺炎链球菌（10.3%）和混合分离株（2.3%）。阿莫西林和氨苄西林的耐药率最高。大多数分离株对两种以上抗生素表现出高水平耐药。虽然研究报告了多药耐药性，但推荐庆大霉素、阿米卡星和头孢呋辛作为治疗分离出的细菌的抗生素。
细菌呼吸道感染在研究地区流行，分离出的细菌对常用抗生素如阿莫西林、氨苄西林、环丙沙星、哌拉西林/环丙沙星、头孢他啶、哌拉西林/他唑巴坦和头孢氨苄表现出耐药性。因此，需要在研究地区持续监测抗生素耐药性，以管理呼吸道感染。
