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      Bacteria Etiological Agents Causing Lower Respiratory Tract Infections and Their Resistance Patterns

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          Abstract

          Background:

          Lower respiratory tract infections (LTRIs) are among the most common infectious diseases with potential life-threatening complications.

          Methods:

          The study consisted of 426 patients with suspected LTRIs from mid and far western region of Nepal between September 2011 and July 2014. The specimens were collected and processed according to the standard microbiological methods at the Central Laboratory of Microbiology of Nepalgunj Medical College, Nepal.

          Results:

          Among the isolated Gram-positive organisms, Streptococcus pneumonia (n = 30, 51.7%) was the most predominant pathogen, followed by  Staphylococcus aureus (n = 28, 48.3%). Among the isolated Gram-negative organisms, Pseudomonas aeruginosa (n = 71, 35.32%) was the most predominant pathogen, followed by Haemophilus influenzae (n = 68, 33.83%), Klebsiella pneumonia (n = 36, 17.19%), and Escherichia coli (n = 26, 12.94%). The pattern of resistance varied regarding the bacteria species, and there were multi-resistant isolates. Also, a significant difference ( P < 0.05) was observed between males and females for each type of bacterial species. Among 259 isolates, 86 (33.20%) were from children aged 1-10 years, which were statistically significant ( P < 0.05) compared to the other age groups.

          Conclusions:

          P. aeruginosa and H. influenzae (Gram-negative) and S. pnemoniae (Gram-positive) were the most common bacterial isolates recovered from LTRIs. Age group of 1-10 years old was at a higher risk. Many isolates showed appreciable levels of antibiotic resistance due to antibiotic abuse. There is a need to increase surveillance and develop better strategies to curb the increasing prevalence of LRTI in this region of Nepal.

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          Most cited references39

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          Performance standard for antimicrobial susceptibility testing.

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            Community-acquired pneumonia.

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              Persistent colonization by Haemophilus influenzae in chronic obstructive pulmonary disease.

              Nontypeable Haemophilus influenzae colonizes the respiratory tract of adults with chronic obstructive pulmonary disease (COPD) and causes intermittent exacerbations. Isolates of H. influenzae collected monthly in a prospective study were subjected to molecular typing. During a 7-year study spanning 345 patient-months of observation, 122 episodes of negative cultures lasting 1 month or more, and that were preceded and followed by isolation of an apparently identical strain of H. influenzae, were found. Seventeen such episodes of negative cultures, lasting 6 months or more and spanning 203 patient-months, were studied in detail to test the hypothesis that these periods of negative cultures represented continuous colonization by the same strain of H. influenzae. Molecular typing by three independent methods established that the strains preceding and following the episodes of negative cultures were indeed identical. Strain-specific H. influenzae DNA was detected in some of the sputum samples that had yielded negative cultures. These results indicate that some patients with COPD are persistently colonized with H. influenzae and that sputum cultures underestimate the frequency of colonization of the respiratory tract by H. influenzae in COPD. This observation has a significant impact on understanding bacterial colonization in COPD.
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                Author and article information

                Journal
                Iran Biomed J
                Iran. Biomed. J
                IBJ
                Iranian Biomedical Journal
                Pasteur Institute of Iran (Tehran, Iran )
                1028-852X
                2008-823X
                October 2015
                : 19
                : 4
                : 240-246
                Affiliations
                [1 ] Dept. of Microbiology, Nepalgunj Medical College, Nepal;
                [2 ] Dept. of Biochemistry, Nepalgunj Medical College, Nepal;
                [3 ] Dept. of Microbiology, Santosh Medical College, India
                Author notes
                [* ]Corresponding Author; Mobile: (+97-798) 4835 4981; E-mail: salman186631@gmail.com
                Article
                10.7508/ibj.2015.04.008
                4649860
                26220641
                0e6851e3-8ea1-48a0-b5a0-cb738db1e671

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 August 2014
                : 19 November 2014
                : 1 December 2014
                Categories
                Original Article

                bacterial infections,antimicrobial drug resistance,respiratory system,nepal

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