Prevalence of Multidrug-Resistant Bacteria Pneumonia in Kaduna, Nigeria

Abstract

Background: studies have shown that pneumonia accounts for approximately 16-19% annual deaths, resulting in an estimated 162,000 annual deaths at 18 deaths per hour in Nigeria, and it’s triggered by low vaccination coverage, antimicrobial resistance, indoor air pollution and malnutrition. As part of strategies to develop and implement effective pneumonia control that strives to reduce mortality and morbidity, it is important to assess the prevalence of bacterial pneumonia infection, which accounts for 35 – 60% pneumonia globally, and its susceptibility profile to commonly prescribed antibiotics within our locality. This mechanism has been linked to stimulate protective, cost-effective, treatment and preventative interventions that save lives and sustain children's health.

Aim: This study evaluated the prevalence of bacterial pneumonia in Kaduna and the susceptibility of the isolated bacteria against commonly prescribed antibiotics in Kaduna metropolis for a better treatment option.

Methods: A total of 250 samples (consisting of sputum (128)) and deep throat swab (122) suspected of pneumonia were randomly collected from patients attending Barau Dikko Teaching Hospital, Kaduna, after ethical approval was obtained from October, 2024 – March, 2025 (6 months). Bacteria were identified using microscopy, Gram staining and Microbat bacterial identification kits. Antimicrobial susceptibility of the isolates was carried out to determine the resistance profile and percentage multidrug resistance to conventional antibiotics.

Results: High percentages (62%) of the population with pneumonia cases at Barau Dikko Teaching Hospital were male, while 38% were female. Children aged 0-5 years (48%) were the most infected, followed by the elderly aged ≥70 (16%). The populations within the active life stage are 19 – 57 years old. Out of a total of 250 samples collected, 51.2% were from sputum, while 48.8% were obtained from a deep swab of the throat source. Sputum samples (43.8%) had more bacterial growth than the deep throat swab (36.1%). The prevalence of bacterial pneumonia was 40.8%. The highest occurring bacteria were Streptococcus pneumoniae (30.4%), followed by K. pneumoniae (22.6%), E. coli (16.7%), and S. aureus (11%), while the least isolated was Pseudomonas aeruginosa (5.9%). Significant percentages (13.7%) of the isolates were unclassified. Overall assessment of the isolated bacteria antimicrobial susceptibility profile showed that the isolates were most resistant to amoxicillin (71.6%), tetracycline (62.5%), amoxicillin-clavulanic acid (55.7%), cefotaxime (47.7%) and cotrimoxazole (43.2%) but highly susceptible to imipenem (85.2%), ciprofloxacin (73.9%), chloramphenicol (69.3%) and azithromycin (60.2%). Significant percentages of the isolates (57.9%) were multidrug resistant, while 82.9% had MARI of ≥ 0.2. Ps. aeruginosa isolates (83.3%) had the highest multidrug-resistant profile, followed by K. pneumoniae (82.6%), Streptococcus pneumoniae (71%) and E. coli (58.8%), while the least multidrug-resistant bacterium was S. aureus (45.5%).

Conclusion: The study recorded a 40.8% prevalence of bacterial pneumonia in Kaduna, consisting of a high multidrug-resistant profile with children ages 0-5 years and males being the most infected.