Co-infections and antimicrobial resistance profile of Mycobacterium tuberculosis and Streptococcus pneumoniae among patients with pulmonary infections attending tertiary health facilities in Makurdi, Nigeria

Abstract

BACKGROUND: Pulmonary infections (Pls) cause mortality in elderly patients that have comorbidities. These infections are life-threatening in the younger population, especially in infants and children. Co-infection with Mycobacterium tuberculosis and Streptococcus pneumoniae occurring concurrently may lead to undiagnosed Streptococcus pneumoniae leading to inadequate treatment. Aim: The study investigates the co-infection and antimicrobial resistance profile of Mycobacterium tuberculosis and Streptococcus pneumoniae in Makurdi, Nigeria. Materials and methods: A total of 273 sputum samples were collected from patients with pulmonary infection attending chest clinics in tertiary health institutions in Makurdi and analysed. Genexpert was used for Mycobacterium tuberculosis while Streptococcus pneumoniae isolates were identified using Gram-staining reaction, optochin and bile solubility tests. The susceptibility test for Streptococcus pneumoniae was performed using Kirby-Bauer method. Results: Out of the 273 sputum samples, the percentage occurrence of mono-infections with Mycobacterium tuberculosis was 14(5.13%) while that with rifampicin resistance was 1(0.37%). The occurrence of mono-infection with Streptococcus pneumoniae was 11(4.03%). The resistance profile showed trimethoprim/sulphamethoxazole (septrin) with the highest resistance 6(54.55%) and vancomycin 5(45.45%) while amoxicillin/clavulanic acid and ceftriaxone had zero resistance (0.0%). There was the occurrence of co-infections in 3(1.10%) out of the 273 patients sampled. There was no significant association (p > 0.05) between Mycobacterium tuberculosis, Streptococcus pneumoniae, their co-infections and the variables analyzed. Conclusion: The occurrence rate of Streptococcus pneumoniae and Mycobacterium tuberculosis co-infections is low among suspected pulmonary infection cases with an occurrence rate of 1.10%. Early detection and proper management of co-infections are recommended.