Resistance patterns of bacterial pathogens causing lower respiratory tract infections: Aleppo-Syria

Abstract

Background: Globally, lower respiratory tract infections (LRTIs) are one of the lead causes of death. Bacterial and susceptibility profiles are not constant over time and geographically, and different patient factors can be correlated with those infections. Objective: This study aimed to scan the bacterial spectrum causing LRTIs, their susceptibility profile and patient related risk factors. Material and methods: Two hundred sixty-eight specimens from LRTIs suspected patients attending University Hospital were collected. Specimens included bronchial washings, transtracheal aspiration samples and sputum. After appropriate culture and identification tests, susceptibility test was done using minimum inhibitory concentration method. Data were collected from patients for further analysis. Results: of total specimens, 150 showed positive culture results (Acinetobacter baumannii, Pseudomonas aeruginosa, Citrobacter koseri, Escherichia coli, Klebsiella pneumonia, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Streptococcus pneumonia and Candida spp.). The antibiogram showed high resistance among all bacterial isolates against most antibiotics. Good susceptibility rates were shown to colistin in Gram-negative group and piperacillin\tazobactam in Gram-positive group. Trimethoprim\sulfamethoxazole showed good susceptibility results in both groups. Many factors showed correlation with LRTIs such as age (P=0.004), smoking (P=0.049), residency (P=0.043), hypertension (P=0.012), lung chronic disease (P=0.007) and cancer (P=0.048). Conclusion: The leading cause of LRTIs in our study were A. baumannii and P. aeruginosa which both are very troublesome pathogens and multidrug resistant frequency was alarming. Random empirical antibiotic using can highly lead to increased resistance. Further care must be taken after patients with risk factors, and adjustments should be done to those modifiable factors.