Master of Medicine in Internal Medicine

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http://hdl.handle.net/20.500.12493/14838

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    Identification, susceptibility pattern and factors associated with antibiotic resistance of bacterial pathogens in productive cough among adult patients attending Hoima Regional Referral Hospital
    (Kampala International University, 2024-01) Winnie Ezekiel Mwamtobe
    Background: Antibiotic resistance is one of the most pressing public health and societal issues of our time. This is complicated by a paucity of information regarding the patterns of bacterial pathogens, antibiotic susceptibility, and the factors associated with the emergence and spread of antibiotic resistance in patients with a productive cough in Uganda. Objective. To identify the bacterial pathogens and to determine the antibiotic susceptibility patterns of bacterial isolates and the associated factors in the sputum among patients with a productive cough in a regional referral hospital in Uganda. Methodology: A cross-sectional study involved 216 adult outpatients and employed standard questionnaires to determine the socio-demographic, lifestyle, and medical characteristics of the patients and microbiological tests to identify bacterial isolates and their antibiotic susceptibility. The relationship between patient factors and antibiotic resistance was determined by bivariate and multivariate logistic regression analyses. Results: Out of the 216 specimens collected, 139 (64.4%) demonstrated bacterial growth, with a few patient samples having more than one bacterial pathogen species. The most predominant bacteria isolate was Streptococcus pneumoniae (40.8%), followed by Staphylococcus aureus (28.6%), Klebsiella pneumoniae (12.2%), Streptococcus pyogenes (10.2%), Streptococcus viridans (3.4%), Pseudomonas aeruginosa (2%), Moraxella catarrhalis (1.4%), and Haemophilus influenza (1.4%). Most bacterial isolates were sensitive to imipenem (75.5%), ceftazidime (66.7%), and cefepime (58.5%), and the least sensitivity was observed to ampicillin (9.5%), amoxicillin (9.5%), and chloramphenicol (19%). Factors that were significantly associated with antibiotic resistance were smoking (aOR=2.89, 95%CI=1.074-7.784, P =0.036), and antibiotic use (aOR=2.65, CI=1.103-6.369, P =0.029). Conclusion: Streptococcus pneumoniae, Staphylococcus aureus, and Klebsiella pneumoniae were the most dominant bacterial isolates in outpatients with a productive cough at Hoima Regional Referral Hospital. The isolates were most susceptible to ceftazidime and imipenem, while resistant to ampicillin and amoxicillin. The antibiotic resistance was significantly associated with smoking and antibiotic use. Molecular studies are needed to understand the mechanisms of antibiotic resistance.