Gram-negative bacilli are a major cause of secondary pneumonia in patients with pulmonary tuberculosis: evidence from a cross-sectional study in a tertiary hospital in Nigeria.

Background: This study was aimed at describing the profile of bacterial aetiology of secondary pneumonia in pulmonary tuberculosis (PTB) patients. Methods: A 22-month analysis of patients with PTB and secondary bacterial pneumonia was conducted. Data on isolates recovered and the antimicrobial susceptibility profile were recorded. Results: Of the 141 patients, there were 79 (56%) males and the mean age was 35.98±15.93. Gram-negative bacilli were isolated with equal frequency as Streptococcus pneumoniae (63 [44.7%]). Most of the isolates tested were sensitive to levofloxacin, ceftriaxone or chloramphenicol. Conclusion: Gram-negative bacilli are a major cause of pneumonia in patients with PTB on treatment.

Antimicrobial Susceptibility Pattern of Invasive Pneumococcal Isolates in North West Nigeria.

BACKGROUND: An alarming increase in infections due to penicillin non-susceptible pneumococci (PNSP) has been documented in nearly all countries. Increasingly, PNSP are also resistant to other antibiotics, and a growing number of clinical failures following the use of these agents have been reported. AIMS: To determine the resistance pattern of pneumococcal isolates from patients with invasive pneumococcal infection in North West Nigeria. MATERIALS AND METHODS: In a cross-sectional study clinical specimens were obtained from patients with community acquired pneumonia (CAP), meningitis and bacteraemia over a 2 year period. Pneumococcus strains were identified. Isolates were tested against a panel of antibiotics using E-test strips, and interpreted according to the CLSI criteria. 0.06 µg/ml was used as break point for penicillin. Analysis was carried out using descriptive statistics; relationships determined using chi-squared or Fisher's exact tests, with P < 0.05 regarded as significant. RESULTS: Total number of isolates was 132. Twenty-two (16.7%) of the isolates were fully sensitive to penicillin while 73 (55.3%) and 37 (28.0%) were intermediately and fully resistant, respectively. One hundred and twenty-seven (96.2%) of the isolates were fully resistant to trimethoprim-sulphamethoxazole. Eleven (8.5%) were fully resistant to amoxicillin and 104 (78.8%) and 17 (12.9%) were intermediately resistant and fully susceptible. One hundred and six (80.3%) of the isolates were fully susceptible to chloramphenicol. Resistance to penicillin was shown to infer resistance to other antibiotics. CONCLUSIONS: Pneumococcal resistance is common in North West Nigeria. Ceftriaxone retains excellent activity against most of the invasive isolate, while trimethoprim-sulphamethoxazole is almost uniformly resistant.