Prevalence and Multi-Drug Resistance of Streptococcus pneumoniae Infection Among Presumptive Tuberculosis Adult Cases at Dilla University Referral Hospital, Dilla, Ethiopia

Abstract

Introduction

Streptococcus pneumoniae is the leading cause of community-acquired pneumonia in Africa. The simultaneous occurrence of both infections leads to delayed diagnosis and inadequate treatment. The study aimed to determine the prevalence, antimicrobial susceptibility pattern and associated factors of Streptococcus pneumoniae infection among presumptive Tuberculosis adult cases at Dilla University Referral Hospital, Dilla, Ethiopia.

Methods

An institution-based cross-sectional study was conducted on 422 presumptive TB cases visiting TB clinic at Dilla University Referral Hospital from April to June 2021. Following the Bartlett’s criteria, the accepted sputum samples were cultured on Blood agar plate and chocolate agar plate. Streptococcus pneumoniae was identified and confirmed by typical colony morphology, alpha-hemolysis, gram staining, optochin susceptibility and bile solubility tests. Antimicrobial susceptibility test was done by using the Kirby-Bauer disc diffusion method. Semi-structured questionnaires were used to collect data. Bivariate and multivariate logistic regression analyses were done by using SPSS version 23.0, computer software.

Results

The overall prevalence of S. pneumoniae in presumptive tuberculosis adult cases was 21.4% (95% CI: 17.7–25.5). S. pneumoniae has a high level of resistance to penicillin (74.1%), tetracycline (78.7%) and Trimethoprim-sulfamethoxazole (46%). Multidrug resistance was observed in 46.1% of bacterial isolates. Being primary education, more than five family size and one or two rooms in the house had more likely to cause S. pneumoniae infection.

Conclusion

This study revealed a relatively high prevalence of multidrug resistance of Streptococcus pneumoniae infection. Primary educational status, living in a crowded family, below two rooms in the house, had a significant association with S. pneumoniae infection.

Keywords:

• S. pneumoniae
• antimicrobial susceptibility
• tuberculosis
• Dilla
• Ethiopia

Abbreviations

LRTI, Lower respiratory tract infection; MDR-TB, Multi-Drug Resistant Tuberculosis; OPD, Outpatient department; SPSS, Statistical Package for Social Science; TB, Tuberculosis; WHO, World Health Organization.

Data Sharing Statement

The data that support the findings of this study will be available from the corresponding author upon reasonable request.

Ethics Approval and Informed Consent

Before initiation of the study, ethical clearance was obtained from the Institution Review Board Hawassa University College of Medicine and Health Sciences (Ref. No IRB/126/13). Participants were recruited after informed written consent was obtained. This study was conducted in accordance with the Declaration of Helsinki.

Acknowledgments

The authors would like to thank Hawassa University College of Medicine and Health Sciences and School of Medical Laboratory Science and Dilla University Referral Hospital for the material and reagent supply that made the study possible. We acknowledge all data collectors for their cooperation.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that there are no competing interests.

Additional information

Funding

There is no funding to report.