Bacterial etiology of sputum from tuberculosis suspected patients and antibiogram of the isolates
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RESEARCH NOTE
Bacterial etiology of sputum from tuberculosis suspected patients and antibiogram of the isolates Ramesh Sharma Regmi1, Sujan Khadka1,2,4, Sanjeep Sapkota1,3,4, Sanjib Adhikari1* , Khuma Kumari Dhakal1, Bishnu Dhakal1, Bandana Lamsal1 and Sarad Chandra Kafle1
Abstract Objective: The current study aims to explore the bacteriology of sputum of tuberculosis (TB) suspected patients. A cross-sectional study was carried out in the sputum samples of 150 TB suspected patients visiting District Public Health Office, Bharatpur, Nepal. The samples were subjected to cultural, microscopic and biochemical analyses for the identification of the isolates. In addition, antibiotic susceptibility tests were carried out with a special focus on ESBL and MBL production following Clinical and Laboratory Standard Institute guidelines. Results: Bacterial growth was recovered in 47% (71/150) of the TB suspected patients of which 12.66% (19/150) had pulmonary TB infection. Streptococcus spp. (9%) and Pseudomonas aeruginosa (9%) were the most frequently isolated bacteria. Enterobacteriaceae accounted for 35% of the total isolates. Occurrence of bacterial pathogens was more in males (69%) than in females (31%).The incidence of bacterial pathogen was seen associated with gender of the patients and with the TB infection (p 0.05). Tetracycline was effective against Streptococcus spp. whereas gentamicin was effective against Bacillus species. Imipenem and co-trimoxazole were effective drugs for Gram-negative isolates. Among 83 isolates, 35 were multi-drug resistant, 9 were ESBL producers and 4 were MBL producers. Keywords: Tuberculosis, Respiratory tract infection, MDR, Sputum Introduction Respiratory Tract Infections (RTIs) are the most frequently reported among human infections, out of which Lower Respiratory Tract Infections (LRTIs) account for almost 90% [1]. Upper Respiratory Tract Infections (URTIs) are commonly caused by viruses than bacteria and fungi but LRTIs are more commonly caused by bacteria and less by fungi and viruses. These diseases directly result in about 7 million deaths annually [2]. The HIV pandemic has even worsened morbidity and *Correspondence: [email protected] 1 Department of Microbiology, Birendra Multiple Campus, Tribhuvan University, Bharatpur, Chitwan 44200, Nepal Full list of author information is available at the end of the article
mortality due to LRTIs which causes about 70% of illnesses in AIDS patients [3]. To differentiate Tuberculosis (TB) from other LRTIs such as bacterial pneumonia is an important clinical challenge in developing countries, and failure to differentiate TB from other LRTIs may result in poorer health outcomes which may lead in high mortality rate [4]. Tuberculosis is the most feared health issue in developing countries like Nepal. Emergence of bacterial coinfections along with the development of antimicrobial resistance complicates the TB-treatment process [5]. Several studies carried out world-wide report that the potent pathogens of RT
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