The Prevalence of Streptococcus Pneumoniae in Pneumonia Patients in Enugu Metropolis; A Case Study of UNTH, Enugu
Chapter One
AIMS AND OBJECTIVE
The aims and objective of this work are:
- To isolate bacterial pathogens form pneumonia patients.
- To ascertain the prevalence of streptococcus pneumonia in pneumonia patient using UNTH as a cast study.
- To determine the age group and sex that are more susceptible to this infection.
CHAPTER TWO
LITERATURE REVIEW
Streptococcus pneumonia is a bacterium commonly found in the nose and throat and it is the most frequent bacterial cause of pneumonia (pneumococcal pneumonia) particularly lobar and broncho pneumonia is general practice accounts for about 60% of all bacterial pneumonia (Jawetz, et al, 1989).
Pneumotoccus is part of the normal nose and oropharyngeal flora of much healthy person. The conrierrate varies widely between different population groups and between time in the sorry some group eg from 0 to 70 % (Fraser, 1996). It generally remains harmless in the carrier unless it is provoked by a viral infection such as influenza or the common cold to spread to the lower respiratory tract (inglis, 1996). It is also a common cause of childhood pneumonia and serious infection in patiento with sickle cell disease (Watson, et al 1993). We have other of pneumonia viz:
Haemophilus influenza most commonly arises in the winter and early spring (Wisconsin, 2003). Often is associated with hosts who are debilitated. Asthna, CopD, smoking and a compromised immune system are risk factor for Haemophilus influenza (Stephen, 2002).
- Klebsiella pneumonia results in an aggressive narcotizing labour pneumonia. Patient with chronic alcoholism and diabetes are at increased risk (Bker and Silverton, 1985).
- Staphylococcus aureus also cause pneumonia and it observed in intravenous drug abusers and other individual with debilitation (Siber, 2002). In-patient who abuse intravenous drug, the infection probably is spread haematogenously to the long from contented infection sitas (Yolende and Broduam 1987).
EPIDEMIOLOGY OF PNEUMONIA
Pneumonia is an epidemological disease with a high incidence of carriers (Jawatz, et al 1989). In the development of illness, the pre- disposing factors include
- ABNORMALITIES OF THE RESPIRATORY TRACT : viral and other infection that damage surface cells, abnormal accumulation of nucleus (eg allergy) which protect pneumococci from phagocytosis, bronchial obstruction and respiratory tract injury due to irritants disturbing its mucocilary function (Nester, et al 2001).
- ALOHOL OR DRUG INTOXICATION: which depresses phagocytic activity, depresses the cough reflex and facilitates aspiration of foreign materials (Boiton et al 1988).
- ABNORMAL CIRCULATORY DYNAMICS (eg pulmonary congestion and heart failure) (inglis, 1996).
- OTHER MECHANISMS : Malnutrition general debility, sickle cell anaemia, hyposplenision nephritis’s or complement deficiency (Wiakalistein,1981) are more important than exposure to the infection and the healthy carries is more important in disseminating pneumococcus than the sick patient (Jawetz, et al. 1989).
AETIOLOGIC AGENTS OF PNEUMONIA
More than 80 capsular stereotypes of straplicoccus pneumonia have been identified and less than 15 sorotypes are responsible for pneumonia infection (Cheesbrough, 1984, in adults, type 1-8 are responsible for about 75% causes of pneumococi pneumonia and for more than half of all fatalities in pneumecoccal butercania in children type 6, 14, 19, and 23 and frequent cause (Jawetz, et al, 2001).
CHAPTER THREE
MATERIAL AND METHOD
materials
Sterile swab stick
Microscope
Spatula
Cotton wool
Incubator
Filter paper
Inoculating wire loop
Water bath
Bumsen burner
Glass rod slidea
Test tube
Conical flasks
Refrigerator
REAGENTS USED
Distilled water
Oil immersion
Sterile defibrillated blood
Nutrient agar
Sodium defibrillated blood
Hydrogen peroxide
Physiological saline
Cystal violet
Lugois iodine
Acetone alcohol
1% aqueous safranin
COLLECTION OF SAMPLES
sputurm sample were obtained from 12 patients while naspharyngeal swabs were obtaine from 38 patient that were suffering from pneumonia in UNTH Enugu. Cleaned labeled and wide mouthed sterile containers with screw caps were distributed to them and were asked to cough deeply to produce sputum. Masopheryngeal were obtained from patient with the use of sterile responsible swab sticks. The sterile swab stick was inserted into the nasopharynx through the mouth cavity from children who were inable to produce sputum. Age range of adult is 62-88 while children is 15 days 3 years immediately after collection, the sample were taken to the laboratory without delay for culturing.
CHAPTER FOUR
RESULTS
A total number of 50 samples were collected period of six months (January to July, 2005) from patients attending microbiology laboratory department of university of Nigeria Teaching Hospital (UNTH) Enugu. After collection of the sample maculation and incubation for 24 hours at 370c, the inoculated and incubated and chocolate agar were observed thus:
CHAPTER FIVE
DISCUSSION
Result of analysis showed that the frequency of staphylococcus aurens is greater than streptococcus pneumoniae in pneumonia patients. This contradicted work by yoland and broduem 1987, which showed that streptococcus pneumonia was predominant in pneumonia patients. Scanty pneumococci was detected because they are mixed assumed they have a pathogenic role. They many have entered and contented the specimen from site of harmless carriage in the lower respiratory tract (Fraser, 1996) Streptococcus viridens was also isolated, this is due to continuation from the throat and mouth, that is, commeabals of the upper respiratory tract. They may be found with streptococcus pneumonia in sputum as commenbals (Cheesbrough 2000). This mixed growth of staphylococcus and streptococcus specie many also be due to contamination (commensals) from the upper respiratory tract. The occurrence of non significant growth may be that the patients were on antibacterial therapy before the time of sample collection, that the causative organism was not bacterial origin. It is observed that the incidence of pneumonia is higher in the elderly and in little children. This may be as a result of decrease in their immunity.
CONCLUSION
In conclusion, this research having shown that the frequency of staphylococcus aureus is greater than streptococcus pneumonia, effort should therefore be geared toward the production of vacine which will aid in prevention of pneumonia caused by staphylococcus aureus in order to reduce spread of this bacterium as in case of streptococcus pneumoniae where it is shown that PCV 7 has decrease the incidence rate among children les than 2years of age and among adult of 60 years older (stephen, 2002).
RECOMMENDATION
Public health measures should be maintained. In case Pneurmococcal pneumonia, vaccinating with a polyvalent vaccine to capsular polysaccharide, that is through expanded use of 23 valiant polysaccharide vaccine among adult and through use of the cogitate vaccine for infants and young children. Immunization is especially important for contain high risk individual such as those suffering from chorine high risk individual, such as those suffering from chronic heart or lung disease or from alcoholism (Nester, et al 2001). The use of Antimicrobial therapy such as, penicillin deviates, amoxycillin teracytines and erythromycin are drugs of choice for pneumonia caused by streptococcus pneumoniae.
REFERENCE
- Baker, F.J and Silvertion, R.E (1985). Introduction to medical Laboratory Technology 6th ed. London Butterworth, page 40-41
- Boiter, F, Hutchison D.W and parker, G (1988). Infection Diseases, European Journal of clinical Microbiology. Page 155.
- Cheesbrough Monica. (1984). Medical Laboratory Manual for tropical countries II, cambridge university press, page 179-181.
- Cheesbrough Monica (2000). District laboratory practice in Tropical countries II, covmbridge University press, page 177-187.
- Cook,. G. (1996). Manson tropical disease, 20th ed. WB saunders company, page 28-31.
- Frasch, C.E and cocepcion, N.F (2000). Clinical and diagnostic Laboratory immunology, journal on American society for Microbiology. Page 2667-269.
- Fraser, A.G (1996) bacteria pneumonia in practical medical Microbiology. Edited by Mackie and Mccartney, 13th ed. Churchhill livingstone, page 67-70.
- Gilks C.F (1997) HIV and Pneurmococcal infection in Africa, clinical, Epidemiology and preventive aspect, WB Saunders company, page 627-628.
- Greenwood, D., Slack, R. and Peutherer J (1997) Medical Microbiology Guide to Microbial infections, pathogenesis immunity, laboratory diagnosis and control. 15th ed. Charchhill livingstone, page 5-6.
