PREVALENCE AND ANTIBIOGRAM OF ISOLATES FROM LOWER RESPIRATORY TRACT INFECTION IN UMUAHIA, ABIA STATE.

ABSTRACT

The prevalence and antibiogram of isolates from Lower Respiratory Tract Infections (LRTI) was investigated in Umuahia metropolis. A total of 35 patients presenting with LRTI defined by a new or increasing cough, productive sputum, chest pain, fever, anorexia, haemoptysis, headache and throat ache were enrolled with their consent. The sputum specimen was cultured on the appropriate bacteriological media. Bacterial isolates were identified by standard laboratory and biochemical methods. Lower respiratory tract infection was found to be prevalent in 16 (46.0%) cases. Males 8 (53.3%) were found to be infected while females 7 (46.67%). Lower respiratory tract infection was found to be most prevalent in age group 41 – 60 years 7 (46.67%). Escherichia coli, was identified as the most frequently bacterial isolate 7(44.0%) and Streptococcus pneumoniae 4(43.75%) followed by Klebsiella pneumoniae 2(12.5%), Proteus spp 2(12.5%) and Moraxella catarrhalis 1(6.25%). Using Agar disk diffusion method with McFarland turbidity standard, the overall antibiotic sensitivity test of the isolates showed ciprofloxacin, gentamicin and streptomycin as the most potent antibiotic against Gram–positive and Gram–negative isolates. High resistance was recorded for septrin, cephalexin, amoxycillin-clavulanic acid - 100% in each case. This study recorded a low percentage of sensitivity to the antibiotic agents tested.

TABLE OF CONTENTS

Title                                                                                                        i

Certification                                                                                          ii

Dedication                                                                                             iii

Acknowledgement                                                                                 iv

Table of content                                                                                   v-viii

List of table                                                                                        ix

Abstract                                                                                               x

CHAPTER ONE

1.0   INTRODUCTION                                                                                                        1         

1.1   Aim of the Study                                                                                                            3         

1.2 Objectives                                                                                                                         3         

CHAPTER TWO

2.0 LITERATURE REVIEW                                                                                              4         

2.1 Bronchitis                                                                                                                         4         

2.2 Types of Bronchitis                                                                                                          5         

2.2.1 Acute Bronchitis                                                                                                            5         

2.2.2 Epidemiology of Acute Bronchitis                                                                                6           

2.2.3 Etiology of Acute Bronchitis                                                                                         6

2.2.4 Signs and Symptoms of Acute Bronchitis                                                                     6

2.2.5 Physical Examination and Diagnosis of Acute Bronchitis                                            7

2.2.6 Prevention of acute Bronchitis                                                                                      8

2.2.7 Antibiotics for acute Bronchitis                                                                                    8

2.2.8 Smoking Cessation                                                                                                        9

2.3 Chronic Bronchitis                                                                                                           9

2.3.0 Etiology of Chronic Bronchitis                                                                                     10

2.3.1 Epidemiology of Chronic Bronchitis                                                                            10

2.3.2 Symptoms of Chronic Bronchitis                                                                                  13

2.3.3 Risk Factors                                                                                                                   13

2.3.4 Effect of Chronic Bronchitis on Outcomes                                                                   13

2.3.4.0 Lung Function Decline                                                                                               13       

2.3.4.1 Mortality                                                                                                                     14       

2.3.5 Diagnosis                                                                                                                       14

2.3.6 Treatment                                                                                                                      15

2.3.6.0 Smoking Cessation                                                                                                     15

2.3.6.1 Physical Measures                                                                                                      16

2.3.6.2 Expectorants and Mucolytics                                                                                     16

2.3.6.3 Glucocorticoids                                                                                                          17

2.3.6.4 Antibiotics                                                                                                                  17

2.3.7   Prevention and Control                                                                                                18

CHAPTER THREE

3.0 MATERIALS AND METHODS                                                                                   19

3.1 Sampling and Sample Collection                                                                                     19

3.2 Data Collection                                                                                                                 19       

3.3 Laboratory Procedures (Sample Processing)                                                                   19

3.3.1 Sample Handling                                                                                                           19

3.3.2 Microbiological Analysis of Samples                                                                           20       

3.3.3 Microscopy                                                                                                                    20

3.4 Procedures for Preparing Of Media for Culturing                                                           20

3.4.1 Procedure for Culturing With Blood Agar                                                                    20

3.4.2 Procedures for Culturing With Chocolate Agar                                                                        21

3.4.3 Procedures for Culturing With MacConkey Agar                                                         21

3.5 Gram Staining                                                                                                                  21       

3.6 Biochemical Test                                                                                                              22

3.6.1 Catalase                                                                                                                         22

3.6.2 Oxidase                                                                                                                          22

3.6.3 Fermentation of Carbohydrate                                                                                      23

3.6.4 Coagulase Test                                                                                                              23

3.6.5 Motility Test                                                                                                                  23

3.6.6 Indole Test                                                                                                                     24

3.6.7 Triple Sugar Iron (Tsia) Test                                                                                         24

3.6.8 Urease Test                                                                                                                    25

3.7 Antibiotic Susceptibility Testing                                                                                      25

3.8 Data Analysis                                                                                                                    26       

CHAPTER FOUR

4.0 RESULT                                                                                                                          27

            CHAPTER FIVE

5.0 DISCUSSION, CONCLUSION AND RECOMMENDATIONS                                    34

5.1 Discussion                                                                                                                         34

5.2 Conclusion                                                                                                                        37

5.3 Recommendation                                                                                                             37

     References

      Appendix

LIST OF TABLES

TABLE                              TITLE                                PAGE

1:           Number of sputum analyzed from the sample areas                                                28    

2:           Age and sex distribution of respondents                                                                  29

3:           Prevalence of Bronchitis among study respondents                                                 30

4:          Morphology and characteristics of the bacterial isolates                                          31

5:          Gram stain and biochemical characteristic of the bacterial isolates                                    32

6:          Antibiotic susceptibility of the bacterial isolates obtained                                       33

 CHAPTER ONE

1.0   I NTRODUCTION

 Bronchitis is an inflammation of the bronchi, the large airway inside the lung (Gwaltney , 2005). Bronchitis is different from bronchiolitis, which is an inflammation of the small airways that lack mucus secreting glands and cartilage, and also from bronchiectasis, which is the permanent dilation and destruction of bronchi involving chronic cough (Breslow, 2002). Sometimes the definition of bronchitis is extended to include inflammation of air passages between the nose and lungs, including the trachea (windpipe) and the bronchi (Longe, 2006). Similarly, trachiobronchitis refers to the inflammation of the trachea and bronchi (Breslow , 2002) causing bronchial glands (Goblet cells) of the airway passages or bronchial tubes to increase the production of mucus with a resultant thick and yellow or gray colored mucus being coughed up. Bronchitis may be either acute or chronic. Acute bronchitis begins as a respiratory tract infection that manifest as the common cold. Usually, winter and early spring is the peak time for occurrences (Tackett, 2012). It occurs most commonly in children younger than 2 years. However, children aged 9-15 years are also highly susceptible. Therefore, bronchitis is one of the top 5 reasons for childhood physician visits in most countries. Acute bronchitis affects approximately only 5% of adults annually (Macfarlane, 1993). In the United States of America, acute bronchitis is the ninth most common illness among outpatients (Wilson, 2001). Patients typically suffer from rhinorrhea, cough, low grade fever, tachypnea, chest wall retractions, nasal flaring, cyanosis, expiratory wheezing, hypoxemia, sore throat, back and muscle pain (Tackett, 2012) In neonates, apnea may be the only sign of the disease (Orga, 2004). Cough in these children is usually accompanied by an initial watery nasal discharge. After several days, the nasal discharge becomes thicker and colored or opaque. It then becomes clear again and has a mucoid watery consistency before it spontaneously resolves within 7-10 days. Purulent nasal discharge is common with viral respiratory pathogens and by itself, does not imply a bacterial etiology to the infection. Initially, the cough is dry and may sound harsh or raspy which subsequently loosens and becomes productive. Children younger than 5 years rarely expectorate. In this age group, sputum is usually seen in vomitus (ie. posttussive emesis). Patients frequently note a rattling sound in the chest. Hemoptysis, a burning discomfort in the chest and dyspnea may be present. If there is no serious secondary bacterial infection the patient recovers within days. Chronic Bronchitis Chronic bronchitis affects people of all ages but is more prevalent in people over 45 years of age. As opposed to acute bronchitis chronic bronchitis results from inhalation of respiratory tract irritants, the most common being cigarette smoke, air pollution, chemical fumes, fungal spores, dust, and other environmental irritants. Chronic bronchitis develops slowly over time Bronchitis. There are two types of chronic bronchitis due to cigarette smoking. 1. Simple chronic bronchitis and 2. chronic obstructive bronchitis. Patients with simple chronic bronchitis lack airflow obstruction on pulmonary function test or spirometry, while those with chronic obstructive bronchitis exhibit reduced airflow rates. Some patients with simple chronic bronchitis progress to the chronic obstructive form of bronchitis and most of these also have emphysema (Breslow, 2002). Brunton (2004) noted that adult patients with chronic bronchitis have a history of persistent cough that produces yellow, white or greenish sputum on most days for at least 3 months of the year for more than 2 consecutive years. Wheezing and reports of breathlessness are also common. Pulmonary function testing in these adult patients reveals irreversible reduction in maximum airflow velocity. Repeated irritation of the bronchial tubes by continued exposure to environmental pollutants and cigarette smoke are the major causes for chronic bronchitis. Acute bronchitis is the fifth most common reason why adults see their GP; 5% of the adult population seeks medical advice for bronchitis each year. On average, each attack results in 2 to 3 days off work. Viruses cause 85% to 95% of cases of acute bronchitis in healthy adults. The most common viruses are rhinovirus, adenovirus, influenza A and B, and parainfluenza virus; bacteria are usually commensals. Bacteria can cause bronchitis in people with underlying health problems. Mycoplasma pneumoniae, Klebsiella pneumonia, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Bordetella pertussisare most commonly involved.

1.1   AIM OF THE STUDY

To evaluate the diversity and prevalence of bacterial isolates from lower respiratory tract infection and their antibiogram.

1.2 OBJECTIVES

·       To isolate and identify pathogens in sputum samples from LRTI

·       To determine the antibiotic susceptibility pattern of the bacterial isolates.

Buyers has the right to create dispute within seven (7) days of purchase for 100% refund request when you experience issue with the file received. 

Dispute can only be created when you receive a corrupt file, a wrong file or irregularities in the table of contents and content of the file you received. 

ProjectShelve.com shall either provide the appropriate file within 48hrs or send refund excluding your bank transaction charges. Term and Conditions are applied.

Buyers are expected to confirm that the material you are paying for is available on our website ProjectShelve.com and you have selected the right material, you have also gone through the preliminary pages and it interests you before payment. DO NOT MAKE BANK PAYMENT IF YOUR TOPIC IS NOT ON THE WEBSITE.

In case of payment for a material not available on ProjectShelve.com, the management of ProjectShelve.com has the right to keep your money until you send a topic that is available on our website within 48 hours.

You cannot change topic after receiving material of the topic you ordered and paid for.