Rukyaa Johannes, Mushi Martha F, Silago Vitus, Damiano Prisca, Keenan Katherine, Sabiiti Wilber, Holden Matthew T G, Seni Jeremiah, Mshana Stephen E
Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P. O. Box 1464, Mwanza, Tanzania.
Division of Infection and Global Health, School of Medicine, University of St. Andrews, St. Andrews, KY16 9AL, UK.
Pneumonia (Nathan). 2024 Sep 5;16(1):16. doi: 10.1186/s41479-024-00137-9.
Bacterial pneumonia is among the leading causes of morbidity and mortality worldwide. The extensive misuse and overuse of antibiotics observed during the Corona Virus Disease 2019 (COVID-19) pandemic may have changed the patterns of pathogens causing bacterial pneumonia and their antibiotic susceptibility profiles. This study was designed to establish the prevalence of culture-confirmed bacterial pneumonia and describe their antimicrobial susceptibility profile in adult patients who presented with signs and symptoms of lower respiratory tract infections (LRTIs) during the COVID-19 pandemic.
This hospital-based cross-sectional study was conducted from July 2021 to July 2022 at a zonal referral hospital and two district hospitals in Mwanza, Tanzania. Demographic and clinical data were collected using a standardized questionnaire. Sputum samples were processed by conventional culture followed by the identification of isolates and antibiotic susceptibility testing. Descriptive data analysis was performed using STATA version 15.0.
A total of 286 patients with a median age of 40 (IQR 29-60) years were enrolled in the study. More than half of the patients enrolled were females (52.4%, n = 150). The overall prevalence of bacterial pneumonia was 34.3% (n = 98). The majority of the bacterial pathogens isolated were Gram-negative bacteria (GNB) (61.2%, 60/98), with a predominance of Klebsiella spp., 38.8% (38/98), followed by Streptococcus pyogenes (21.4%, 21/98). Multi drug resistant (MDR) bacteria were detected in 72/98 (73.5%) of the isolates. The proportions of GNB-resistant strains were 60.0% (36/60) for ciprofloxacin, 60% (36/60) for amoxicillin, 60% (36/60) for amoxicillin, 68.3% (41/60) for trimethoprim-sulfamethoxazole and 58.3% (35/60) for ceftriaxone.
One-third of the patients with signs and symptoms of LRTIs had laboratory-confirmed bacterial pneumonia with a predominance of Gram negative MDR bacteria. This calls for continuous antimicrobial resistance (AMR) surveillance and antimicrobial stewardship programs in the study setting and other settings in developing countries as important strategies for tackling AMR.
细菌性肺炎是全球发病和死亡的主要原因之一。在2019年冠状病毒病（COVID-19）大流行期间观察到的抗生素广泛滥用和过度使用，可能改变了引起细菌性肺炎的病原体模式及其抗生素敏感性谱。本研究旨在确定成人患者中培养确诊的细菌性肺炎的患病率，并描述其在COVID-19大流行期间出现下呼吸道感染（LRTIs）体征和症状的患者中的抗菌药物敏感性谱。
本基于医院的横断面研究于2021年7月至2022年7月在坦桑尼亚姆万扎的一家地区转诊医院和两家区级医院进行。使用标准化问卷收集人口统计学和临床数据。痰标本通过常规培养进行处理，随后进行分离株鉴定和抗生素敏感性测试。使用STATA 15.0进行描述性数据分析。
共有286例患者纳入研究，中位年龄为40岁（四分位间距29 - 60岁）。纳入研究的患者中超过一半为女性（52.4%，n = 150）。细菌性肺炎的总体患病率为34.3%（n = 98）。分离出的大多数细菌病原体为革兰氏阴性菌（GNB）（61.2%，60/98），以克雷伯菌属为主，占38.8%（38/98），其次是化脓性链球菌（21.4%，21/98）。在72/98（73.5%）的分离株中检测到多重耐药（MDR）细菌。GNB耐药菌株对环丙沙星的比例为60.0%（36/60），对阿莫西林为60%（36/60），对阿莫西林为60%（36/60），对甲氧苄啶 - 磺胺甲恶唑为68.3%（41/60），对头孢曲松为58.3%（35/60）。
三分之一有LRTIs体征和症状的患者经实验室确诊为细菌性肺炎，以革兰氏阴性MDR细菌为主导。这就要求在研究环境以及发展中国家的其他环境中持续开展抗菌药物耐药性（AMR）监测和抗菌药物管理计划，作为应对AMR的重要策略。
