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Sputum bacteriology and antibiotic sensitivity patterns of community-acquired pneumonia in hospitalized adult patients in Nigeria: a 5-year multicentre retrospective study.
Scand J Infect Dis. 2014 Dec; 46(12):875-87.SJ

Abstract

BACKGROUND

A clear knowledge of the pathogens responsible for community-acquired pneumonia (CAP) in a given region and their antibiotic sensitivity patterns is necessary for optimal treatment. We determined the common bacterial pathogens causing CAP in Nigeria and further reviewed their antibiotic senstivity patterns with a view to providing recommendations to improve antibiotic management of CAP.

METHODS

Case notes of all adult patients who were 18 years or more admitted to four major tertiary hospitals in South East Nigeria with a diagnosis of CAP between 2008 and 2012 were retrospectively studied. To be eligible, patients were required to have sputum culture and sensitivity results available. Socio-demographic, clinical, pre-admission and in-hospital treatment data were also obtained.

RESULTS

Of 400 patients with a radiologically confirmed diagnosis of CAP, 232 fulfilled the study criteria; 122 (52.6%) were women and the mean age was 50.6 ± 18.8 years. Aetiological agents were identified from sputum in 189 (81.5%) patients. Streptococcus pneumoniae (n = 90, 47.6%) was the most frequent isolate followed by Klebsiella pneumoniae (n = 62, 32.8%), Staphylococcus aureus (n = 24, 12.7%) and Streptococcus pyogenes (n = 13, 6.9%). The pathogens were most sensitive to levofloxacin (77%), ceftazidime (75.5%) and ofloxacin (55.8%). The susceptibility of the isolates to antibiotics most frequently presecribed for empirical therapy was low (co-amoxiclav, 47.6%; ciprofloxacin, 45.9% and ceftriaxone, 47.6%) and this was associated with higher mortality and/or longer duration of hospital stay in survivors.

CONCLUSION

Strep. pneumoniae and K. pneumoniae were the most common causes of CAP. The pathogens were most sensitive to levofloxacin and ceftazidime. We suggest that these antibiotics should increasingly be considered as superior options for empirical treatment of CAP in Nigeria.

Authors+Show Affiliations

From the Department of Medicine, College of Medicine, University of Nigeria Enugu Campus , Nigeria.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25288384

Citation

Iroezindu, Michael O., et al. "Sputum Bacteriology and Antibiotic Sensitivity Patterns of Community-acquired Pneumonia in Hospitalized Adult Patients in Nigeria: a 5-year Multicentre Retrospective Study." Scandinavian Journal of Infectious Diseases, vol. 46, no. 12, 2014, pp. 875-87.
Iroezindu MO, Chima EI, Isiguzo GC, et al. Sputum bacteriology and antibiotic sensitivity patterns of community-acquired pneumonia in hospitalized adult patients in Nigeria: a 5-year multicentre retrospective study. Scand J Infect Dis. 2014;46(12):875-87.
Iroezindu, M. O., Chima, E. I., Isiguzo, G. C., Mbata, G. C., Onyedum, C. C., Onyedibe, K. I., & Okoli, L. E. (2014). Sputum bacteriology and antibiotic sensitivity patterns of community-acquired pneumonia in hospitalized adult patients in Nigeria: a 5-year multicentre retrospective study. Scandinavian Journal of Infectious Diseases, 46(12), 875-87. https://doi.org/10.3109/00365548.2014.954263
Iroezindu MO, et al. Sputum Bacteriology and Antibiotic Sensitivity Patterns of Community-acquired Pneumonia in Hospitalized Adult Patients in Nigeria: a 5-year Multicentre Retrospective Study. Scand J Infect Dis. 2014;46(12):875-87. PubMed PMID: 25288384.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sputum bacteriology and antibiotic sensitivity patterns of community-acquired pneumonia in hospitalized adult patients in Nigeria: a 5-year multicentre retrospective study. AU - Iroezindu,Michael O, AU - Chima,Emmanuel I, AU - Isiguzo,Godsent C, AU - Mbata,Godwin C, AU - Onyedum,Cajetan C, AU - Onyedibe,Kenneth I, AU - Okoli,Leo E, Y1 - 2014/10/07/ PY - 2014/10/8/entrez PY - 2014/10/8/pubmed PY - 2015/5/12/medline KW - Aetiology KW - antibiotic sensitivity KW - bacterial KW - community-acquired pneumonia KW - sputum SP - 875 EP - 87 JF - Scandinavian journal of infectious diseases JO - Scand J Infect Dis VL - 46 IS - 12 N2 - BACKGROUND: A clear knowledge of the pathogens responsible for community-acquired pneumonia (CAP) in a given region and their antibiotic sensitivity patterns is necessary for optimal treatment. We determined the common bacterial pathogens causing CAP in Nigeria and further reviewed their antibiotic senstivity patterns with a view to providing recommendations to improve antibiotic management of CAP. METHODS: Case notes of all adult patients who were 18 years or more admitted to four major tertiary hospitals in South East Nigeria with a diagnosis of CAP between 2008 and 2012 were retrospectively studied. To be eligible, patients were required to have sputum culture and sensitivity results available. Socio-demographic, clinical, pre-admission and in-hospital treatment data were also obtained. RESULTS: Of 400 patients with a radiologically confirmed diagnosis of CAP, 232 fulfilled the study criteria; 122 (52.6%) were women and the mean age was 50.6 ± 18.8 years. Aetiological agents were identified from sputum in 189 (81.5%) patients. Streptococcus pneumoniae (n = 90, 47.6%) was the most frequent isolate followed by Klebsiella pneumoniae (n = 62, 32.8%), Staphylococcus aureus (n = 24, 12.7%) and Streptococcus pyogenes (n = 13, 6.9%). The pathogens were most sensitive to levofloxacin (77%), ceftazidime (75.5%) and ofloxacin (55.8%). The susceptibility of the isolates to antibiotics most frequently presecribed for empirical therapy was low (co-amoxiclav, 47.6%; ciprofloxacin, 45.9% and ceftriaxone, 47.6%) and this was associated with higher mortality and/or longer duration of hospital stay in survivors. CONCLUSION: Strep. pneumoniae and K. pneumoniae were the most common causes of CAP. The pathogens were most sensitive to levofloxacin and ceftazidime. We suggest that these antibiotics should increasingly be considered as superior options for empirical treatment of CAP in Nigeria. SN - 1651-1980 UR - https://www.unboundmedicine.com/medline/citation/25288384/Sputum_bacteriology_and_antibiotic_sensitivity_patterns_of_community_acquired_pneumonia_in_hospitalized_adult_patients_in_Nigeria:_a_5_year_multicentre_retrospective_study_ L2 - https://www.tandfonline.com/doi/full/10.3109/00365548.2014.954263 DB - PRIME DP - Unbound Medicine ER -