Abstract
Introduction: Lower respiratory tract infection (LRTI) is one of the common major health problems, causing morbidity and mortality. Aims: The study was conducted to determine the current trends of bacterial etiology of LRTIs among patients who attended the University Teaching Hospital (UTH) and their antimicrobial susceptibility profile with special interest on drug resistance. Study Design: The study was a Cross sectional study. All patients’ files were selected as diagnosed with LRTIs and their demographic data, other illness, prescribed treatment /antibiotic used previously. Place and Duration of Study: This study is designed to collect data from files of lower respiratory tract infection patients following in units of university hospital in Tripoli. Methodology: The study was conducted between January to December 2019. at the unit in university hospital in Tripoli city in Libya. Sputum samples of 465 patients with suspected LRTIs were received, after obtaining patients' informed consent and ethical clearance from the UNTH. The samples were collected and processed according to standard laboratory procedures. Results: Of the total 465 sputum samples, 366 (78.7%) were positive for micro-organisms. Four main types of bacteria have been identified: acinetobacter spp. 25.6%, Klebsiellla pneumoniae 25.6%, P. saeroginosa (1.39%), Candida (9.03%). The distribution of lower respiratory tract infections within the hospital department indicated that the isolated strains revealed a higher infection rate of Gram-negative bacteria in the Pediatric Intensive Care Unit (PICU) and General Surgical Intensive Care Unit (GSICU) compared to other departments, with statistical significance. Notably, there was a significant difference in the infection rates of Pseudomonas in the Special Care Baby Unit (SCBU) with 7 cases, and in the Medical Intensive Care Unit (MICU) with 6 cases, as well as in the Neonatal Intensive Care Unit (NICU) with 2 cases. The infection rates for Candida and Streptococcus pneumoniae in the NICU were recorded at 2, 1, and 2, respectively, which were significantly different from those observed in other departments. The prevalence of antimicrobial resistance among Gram-negative and Gram-positive bacterial isolates indicated a very high resistance rate (98–100%) among Acinetobacter baumannii isolates to various antibiotics including AK, AMC, ATM, CAZ, CRO, CIP, GN, MEM, TOB, PRL, and CZ. However, for SXT, the isolate demonstrated the highest sensitivity, with a resistance rate of less than 53%. Conclusion: Understanding the variety of pathogens that cause lower respiratory tract infections (LRTIs) and their patterns of susceptibility to antibiotics, in addition to monitoring antibiotic resistance, is crucial for the effective management of LRTIs. This includes timely clinical and laboratory diagnoses, as well as the implementation of the appropriate treatment strategies.