TMSS Medical College Journal

Background: Respiratory tract infections (RTIs) contribute substantially to morbidity and healthcare burden in Bangladesh, where overcrowding, high antibiotic misuse, and limited diagnostic capacity accelerate the emergence of antimicrobial resistance. Despite this, local data on pathogen distribution and resistance patterns remain limited. To address this gap, this study investigates the bacterial profile and antimicrobial resistance patterns in sputum samples from patients with suspected RTs Materials and Methods: A retrospective cross-sectional study was conducted at Mount Adora Hospital, Sylhet, Bangladesh, from July 2023 to February 2024. A total of 342 sputum samples were collected, and sample quality was assessed using the Bartlett scoring system. Only culture-positive specimens with Bartlett score 1 were included. Bacterial identification was performed using standard microbiological techniques, and antimicrobial susceptibility testing (AST) was conducted by the Kirby Bauer disk diffusion method following Clinical and Laboratory Standards Institute (CLS) Results: Out of 342 sputum samples, 259 (76%) acceptable-quality specimens were analyzed. Gram-negative bacteria predominated (61%), with Klebsiella pneumoniae (41.7%) being the most frequent isolate, Among gram-positives, Streptococcus pneumoniae (23.6%) was common. Gram-negative isolates showed highest resistance to azithromycin (80.1%) and cefixime (79.9%). Gram-positive isolates exhibited high resistance to cefixime (80.2%) and azithromycin (80.2%). Conclusion: A high level of resistance to commonly used antibiotics was observed, indicating a growing threat of antimicrobial resistance. Continuous surveillance, rational antibiotic use, and implementation of antibiotic awareness programs are essential to combat resistant pathogens.

Lower respiratory tract infections (LRTIs) are a major cause of global morbidity and mortality, responsible for approximately 2.74 million deaths each year. They account for nearly 4.4% of hospital admissions for severe illness worldwide’ The primary bacterial pathogens implicated in LRTIs vary geographically but commonly include Gram-positive cocci such as Streptococcus pneumoniae and Staphylococcus aureus, as well as Gram-negative bacilli like Klebsiella pneumoniae, Pseudomonas aeruginosa, Haemophilus influenzae, and Acinetobacter baumannii. A five-year hospital-based surveillance from Maly identified A. baumannii (18.6%), S. aureus (15.2%), P. aeruginosa (14.2%), and K. pneumoniae (10.9%) as the leading LRTI pathogens, with 72.5% of isolates being Gram-negative.