Sputum Bacteriology And In - Vitro Antibiotic Susceptibility In Hospitalized Patients With Community Acquired Pneumonia In A State Tertiary - Referral Hospital – A Retrospective Study
- Author:
Yow-Wen Chin
;
Li-Cher Loh
;
Thim-Fatt Wong
;
Abdul Razak Muttalif
- Publication Type:Journal Article
- Keywords:
Antibiotic sensitivity, Community-acquired pneumonia, Penang hospital, Sputum bacteriology
- From:International e-Journal of Science, Medicine and Education
2007;1(2):74-79
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: To review the sputum bacteriology and its
in-vitro antibiotic susceptibility in patients hospitalized
with community-acquired pneumonia (CAP) in a state
tertiary-referral Hospital (Penang hospital, Malaysia) in
order to determine the most appropriate empiric
antibiotics.
Methods : From September 2006 to May 2007,
68 immunocompetent adult patients [mean age: 52
years (range 16-89); 69% male] admitted to respiratory
wards for CAP with positive sputum isolates within 48
hours of admission were retrospectively identified and
reviewed.
Results: 62 isolates were Gram(-) bacilli (91%) &
6 were Gram(+) cocci (9%). The two commonest
pathogens isolated were Pseudomonas aeruginosa
(n=20) and Klebsiella pneumoniae (n=19)
together constituted 57% of all positive isolates.
Among the Pseudomonas isolates, 84.2% were fully
sensitive to cefoperazone and cefoperazon/sulbactam;
95% to ceftazidime, cefepime, piperacillin/tazobactam,
ciprofloxacin and amikacin, and 100% to gentamycin,
netilmycin, imipenem and meropenem. Among the
Klebsiella isolates, 5.3% were fully sensitive to
ampicillin; 84.2% to amoxicillin, ampicllin/sulbactam,
cefuroxime and ceftriazone; 89.5% to piperacillin/
tazobactam; 93.3% to cefoperazon/sulbactam and 100%
sensitive to ceftazidime, cefepime, ciprofloxacin,
all aminoglycosides and carbopenems.
Conclusion : In view of the high prevalence of
respiratory Pseudomonas aeruginosa, ampicillin/
sulbactam, currently the most prescribed antibiotic to
treat CAP in our respiratory wards, may not be the most
appropriate empiric choice. Higher generation
cephalosporins with or without beta-lactamase
inhibitors, ciprofloxacin or carbapenem may be the
more appropriate choices. The lack of information on
patients’ premorbidities such as recent hospitalization
and prior antibiotic exposure, limits the interpretation
of our findings and may have biased our results towards
higher rates of Gram negative organisms.
- Full text:W020150928382146691612.pdf
