Epidemiological Profile of Acute Typical Bacterial Pneumonia at The National Reference University Hospital Center of N’Djamena: Risk Factors and Antibiotic Resistance

Abstract

Acute bacterial pneumonias are non-tuberculous bacterial infections of the lung. They constitute a common pathology in children and adults. The objective of this study was to promote microbiological diagnosis for optimal treatment in terms of antibiotic therapy. This is a prospective observational and analytical study running from June 2022 to February 2023 based on cytobacteriological examinations of sputum from patients of all genders and ages admitted to the pulmonology and infectious diseases department of the National Reference University Hospital Center (CHURN) from N’Djamena. The isolation, identification and antibiogram of the bacteria responsible for acute pneumonia were carried out according to standard clinical microbiology techniques. Of the 207 patients receiving sputum cytobacteriological screening, 121 bacterial agents were isolated, representing a prevalence of bacterial pneumonia of 58.45%. The most isolated bacterial strains were Staphylococcus (45.25%) followed by Streptococcus pneumoniae (34%) and Escherichia coli (10%). Significant differences were observed in terms of predominance of participation of men in the survey compared to women, the origin of patients from N’Djamena and Provinces, schooled and non-schooled patients and Gram-positive and Gram-negative bacteria with the probabilities of 0.01, 0.001, 0.01 and 0.001 respectively. The average age of the patients was 40.9 years with a sex ratio of 1.9. The antecedents associated with pneumonia were HIV infection, respiratory diseases, diabetes, smoking, alcoholism and cough with the proportions of 8.7%, 7.7%, 4.8%, 11.1% and 72.5 % respectively. The sensitivity of isolated bacterial strains gradually decreases from aminopenicillins to 3rd generation cephalosporin. The proportions of resistance were completely variable. Among Staphylococcus, resistance was very remarkable with erythromycin (68%), oxacillin (64.51%), ciprofloxacin (60%) and 96.15% of Staphylococcus were sensitive to fusidic acid. Oxacillin and amoxicillin clavulanic acid were almost inactive. Resistance of Escherichia coli remains high with amoxicillin clavulanic acid (66.7%) and ceftazidime (83.3%). Pseudomonas aeruginosa was 100% susceptible to ceftazidime. This study not only revealed the high prevalence of bacterial pneumonia and high resistance of the antibiotics tested. The importance of the sensitivity test allows the adaptation of antibiotic therapy to microbiological results.