PURPOSE:
To identify the causative bacteria, antibiotic sensitivity and antibiotic resistance of community acquired pneumonia (CAP) in Upper Egypt considering this an important issue to be investigated in our locality.
METHODS:
A multicentre prospective study was performed for two years in Assiut, El-Minia and Sohag universities. Sampling was done for all patients including, sputum and /or bronchoalveolar lavage (BAL) for gram stain and culture, and serum sample for serology. The validated sputum as well as BAL samples were cultured on three bacteriological media (Nutrient, Chocolate and MaConkey,s agar plates) . The colonies were processed for identification of micro-organisms by Automated Walkaway Microscan 96.Pneumoslide IgM kit (Vircell-slide) was used for detection of atypical pathogens through the use of serological indirect Fluorescent Antibody method.
RESULTS:
The predominant isolates in 360 patients with CAP (community acquired pneumonia) were streptococcus pneumoniae (36%), chlamydia pneumoniae (18%), mycoplasma pneumoniae (11%) and Klebsiella (10%). A higher sensitivity was recorded for Moxifloxacin, Levofloxacin, Macrolides, and Cefipime. A higher rate of resistance was recorded for amoxicillin-clavulinic acid, ampicillin-sulbactem, lincomycin, clinadamycin, tetracyclines, first or second generations cephalosporins and aminoglycosides.
CONCLUSIONS:
The most predominant bacteria for CAP in Upper Egypt are streptoccus pneumoniae and atypical organisms, Respiratory quinolones, cefipime and Macrolids had the highest sensitivity rate, while amoxicillin-clavulinic acid, ampicillin-sulbactem, lincomycin, clinadamycin, tetracyclines, first or second generations cephalosporins and aminoglycosides had the highest resistence rate.
CLINICAL IMPLICATIONS:
Respiratory quinolones, cefipime and Macrolids are the most efficient antibiotics in treatment of lower bacterial respiratory tract infections in our locality
Abbreviations: CAP (community acquired pneumonia)