Title: Study of Secondary Lung Infections in Newly Diagnosed Pulmonary Tuberculosis

Authors: Dr Anila Jose, Dr R Vedavathi, Dr Preethi R Gandhi, Dr Tharuni Latha.A, Dr Hilas, Dr Vijaykumar S S

 DOI: https://dx.doi.org/10.18535/jmscr/v7i11.83

Abstract

Background:  Tuberculosis (TB) is one of the most highly infectious diseases in India. Secondary lung infection is one of the most important complications in patients with pulmonary tuberculosis. However, very little literature is available regarding secondary lung infections in pulmonary tuberculosis and hence, the need for our study.

Aims and Objectives: To determine the pathogenic organisms causing secondary lung infection in newly diagnosed pulmonary tuberculosis and  to determine the antibiotic susceptibility pattern among bacterial pathogens

Methods: Sputum samples or BAL samples of the patients who are highly suspicious of pulmonary tuberculosis by history, clinical examination and, radiological evaluation has been collected and send for sputum AFB, gram staining, bacterial culture sensitivity and, fungal culture. Only AFB positive samples have been included in the study. Bacteria were identified according to standard microbiological techniques. The results of the gram stain, culture along with culture sensitivity pattern of bacteria has been recorded.

Results: Of 100 patients included in the study, 20% of patients have a secondary infection. Among those who have secondary infection 90% is male population and rest 10% only is seen in females. The most common risk factor found to be smoking / Chola inhalation ( 80 %) and the next common risk factor was found to be diabetes mellitus (55%). 65% of secondary infection was bacterial whereas 35%  was found to be the fungal infection. The most common secondary bacterial infection in newly detected pulmonary TB is found to be Klebsiella (53.89%). It is also found to have Gentamycin is the most sensitive antibiotic.

Conclusion: In our study, the most common secondary infection is Klebsiella pneumonia and the most effective antibiotic was found to be Gentamycin. Since it was found that 20% of patients have secondary lung infection; we have to send for sputum culture sensitivity for all patients who have been diagnosed with pulmonary tuberculosis and appropriate antibiotic treatment will prevent further complications.

Keywords: secondary lung infection, tuberculosis.

References

  1. Barberis, N.L Bragazzi, L. Galluzzo, et al The history of tuberculosis: from the first historical records to the isolation of Koch’s bacillus. J PREV MED HYG 2017; 58: E9-E12
  2. Thomas M Daniel et al The History Of Tuberculosis: Respiratory Medicine (2006) 100.1862-1870
  3. E Shaddock (Cert in Pulmonology, Cert in Crit Care, Consultant), N Bosman (Consultant), T Nana (Consultant) & C Feldman (Principal Specialist, Head of Department) Southern African Journal of Infectious Diseases, 29:1, 23-26 https://doi.org/10.1080/23120053.2014.11441562
  4. JOYNAL ABEDIN KHAN & ZAKARIA AHMED International Journal of General Medicine and Pharmacy (IJGMP);ISSN 2319-3999;Vol. 2, Issue 2, May 2013, 11-16
  5. Amaryllis Langbang1, Nabajit Deka, Hafizur Rahman1 and Devjyoti Kalita et al J.Curr. Microbiol. App.Sci(2016) 5(8): 197-203 
  6. Lidia Arcavi, Neal L. Benowitz, et al cigarette smoking and infection Arch Intern Med. 2004;164:2206-2216
  7. Simon E. Prince, MS, Karen Ann Dominger, Burke A. Cunha and Natalie C. Klein et al Klebsiella pneumoniae pneumonia, https://doi.org/10.1016/S0147-9563(97)90028-5
  8. Nazia Begum, Vasudha Bakshi, Vijayalaxmi A , Devender Gaud P , K Sunand, K Sharath Kumar , Sana et al Protective Role of Piperine and Metformin on Gentamicin Induced Hepatorenal Toxicity ,Int. J. Pharm. Sci. Rev. Res., 35(2), November – December 2015; Article No. 16, Pages: 83-89

Corresponding Author

Dr Anila Jose

Junior Resident, Department of General Medicine, KIMS, Bangalore, India