The Prevalence Of Streptococcus Pneumoniae In Pneumonia
Patients In Enugu Metropolis (A Case Study Of UNTH
Enugu)
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TABLE OF CONTENTS
Title page
Certification
Dedication
Acknowledgement
Abstract
Table of content
Lists of table
List of figures
CHAPTER ONE
1.0
Introduction
1.1
Pathophysiology of bacterial pneumonia
1.2
Classification of pneumonia
1.3
Causes of pneumonia
1.4
Justification
1.5
Aims and objective
1.6
Hypothesis
1.7
Statement of problem
1.8
Diagnosis
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CHAPTER TWO
2.0
Litterateur review
2.1
Epidemiology of pneumonia
2.2 Actiologic Agents of pneumonia
2.3
Pathogenesis
2.4
Mode of Transmission
2.5
Risk group
2.6
mortality morbidity
2.7
Symptoms of pneumonia
2.8
Treatment / management
2.9
prevention
CHAPTER THREE
3.0
Materials and Method
3.1
Material
3.2
Collection of Samples
3.3
Method of Sample Analysis
3.4
Biochemical test to identify bacteria
3.5
Antimicrobial susceptibility test
CHAPTER FOUR
4.0
result
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4.1 Sources of sample and type of bacteria isolated
4.2
Age and sex distribution
CHAPTER FIVE
5.0
Discussion conclusion
5.1
Discussion
5.2
conclusion
5.3
Recommendation
REFERENCES
APPENDIX 1
APPENDIX II
LIST OF TABLES
TABLE 1: Appearance of the growth in the plates
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TABLE 2: Characteristics of isolates
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Table 3:
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Abbreviations
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LIST OF FIGURES
FIGURE I: presentation of the age distribution of patients in pie chart.
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FIGURE II: Presentation of the sex distribution of patients in pie chart
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FIGURE III: Presentation of percentage of frequency of organization
isolated in Bar chart.
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CHAPTER ONE
1.0
INTRODUCTION
Bacterial an something cause severe infection in children the elderly and
other people with weakened immune system is people that are more
susceptible to infection because of an overal impairment of the immune
response example Hiv infection chronic resease advanced aged and or
function of defense mechanisms (example smoking chronic obstructive
pulmonary disease (copd) tumours inhaled toxins and aspiration (Stephen
2002).
The trachea, bronchi and lungs are normally free from communal and
potentially pathogenic bacteria, but when their reference are upset they
are liable to be invaded by organization from the throat or nose (fraser,
1996) one of the commonest infection of the lower respiratory tract is
pneumonia (Jawetz, et ,2001).
1.1
PATHOPHYSIOLOGY OF BACTERIAL PNEUMONIA
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It is known that the inflammation of the lengs is called pneumonia it is
pneumonia’s that result in the filling of alveoli with pus and fluid is called
pneumonia (Naster et al 2001). Macrophages are numerous in the long
issues and reality move into the alveoli and air ways to engaful infection
agents, thus helping to prevent pneumonia from developing but when
there is upset of the defense mechanism, causative agents are then likely to
enviable the host (Yolande and Broduem 1987).
Pneumonia is an infection caused by different bacterial like streptococcus
pneumonia, staphylococcus aureus, pneumococci etc. and in several case
can lead to death for instance, William henry Harrison, the with president
of the united states, contracted pneumonia during his inauguration in 1841
and ride after being in office for only 31 days. Other notable persons to
succumb to pneumonia include sir Francis bacon in 1626, who died after
staffing chikens with now while conducting freezing experimente and
Thomas stonewal Jackson in 1863, whose arm required amputation after he
was shot by one of his own sentries (Stephen 2002). Pneumonia is
prevalent in cold weather and during raing season.
1.2
CLASSIFICATION OF PNEUMONIA
Pneumonia can be classified into three
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-Acute, hospital –acquired
- Acute, community –acquired
- Chronic pneumonia (Inglis 1996)
a).
ACUTE COMMUNITY ACQUIRED:
this
is
defined
as
pneumonia whose onset occurs either prior to or immediately after mission
to hospital. It is one of the classics of pneumonia that cause death
worldwide (Fraser, 1996).
Patients with acute pneumonia usually have cough, chest signs and fever.
The cough may or may not be productive of purulent sputum (Stephen,
2002). The most important consequence of actuate pneumonia is
improvement of respiratory function, which should be assessed as a first
priority ( Frasch and concopcion, 2000).
b.
ACUTE HOSPTAL ACQUIRED: This type of pneumonia affects
smoker, patient with prior chest disense or following operation
(especially thoracis and upper abdominal) and ventillated critically
patient (inglis, 1996). The last group have the highest relative risk
(Ross, 1994).
c.
CHRONIC PNEUMONIA: This have a more insidious onset and
prolong course than actuate pneumonia. There is no single symptom
complex, so the diagnosis is often bused on radiological finding
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(Frasch and cocaplion, 2002). Cough may productive of parnlent
sputum occasionally blood stained.
1.3
CAUSES OF PNEUMONIA
Cause for the development of pneumonia are extrinsic or intrinsic
and various bacteria causative against exist (Nester et al 2001).
Extrinsic factor include exposure to a causative agent pulmonary
irratante, or direct pulmonary injury, while intrinsic
factor are
related to the host.
In most cause, the primary infection is casued by qa virus eg Rhinovirus,
Adanovirus etc. but there is often a secondary infection with a bacteria
pathogen from the upper respiratory tract, most ommon is streptococcus
pneumonia Gawatz et al, 2001) the streptococcus pneumonia also know as
pnumococcus appears to be the primary cause of many cases of pneumonia,
particularly ldorar and bronche pneumonia with Homophiles influenza as a
frequent co- pathogen (Fraser, 1996) but often these pneumonic infection
are triggered by a proceeding viral infection of the upper respiratory tract
such as common cold (Wisconsin, 2003).
Other secondary invaders of the lower respiratory tract that can cause
pneumonia are staphylococcus aureus, which may cause fatal pneumonia
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after streptococcus pneumonia (Staphen, 2002). Haemophilus influenza,
Kiabsiella pneumonia etc Jawetz at al 2001).
1.4
JUSTIFICATION
Pneumonia infection is one of the major cause of death world wide and the
infection is increasing rapidly in Enugu metropolis with streptococcus
pneumoniae as the major pathogen (Okafor 1992). Therefore there is need
to find out if this virulent organism is actually the primary bacterium that
causes premnonia in Enugu metropolis. Although, many persons carry
these bacteria harmlessly in their threat, mouth and nasopharyux and these
are likely to contaminate the sputum as it is expected through the throat and
mouth so as the commensal in nasopharynx which can equally contaminate
the nasopharyueal swab (Ross, 1994).
1.5
AIMS AND OBJECTIVE
The aims and objective of this work are:
1.
To isolate bacterial pathogens form pneumonia patients.
2.
To ascertain the prevalence of streptococcus pneumonia in
pneumonia patient using UNTH as a cast study.
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3.
To determine the aga group and sex that are more susceptible to this
infection.
1.6
HYPOTHESIS
Ho streptococcus pneumonia’s causes pneumonia
H1 streptococcus does not cause pneumonia
H2 Streptococcus Pneumoniae have insight relationship on sex and
age
1.7
STATEMENT OF PROBLEM
Streptococcus pneumoniae is regarded as the commonest cause of
pneumonia both in children and adults. Other bacteria have also been
implicated as the cause of disease in severe case pneumonia can lead 15
death.
1.8
DIAGNOSIS
In pneumonia patients streptococcus pneumoniae and other organisms
(Causative pathogens) are diagnosed when they are grown from cultures of
sterile fluids such as sputum from adult and nasopherynged swab as in case
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of children who are unable to produce sputum the clinical presentation
varies from the mildly to extremely ill patients (Wisconsin 2003).
Straptococcue pneumonia and other causative bacteria can be isolated from
specimens when cultured on blood agar and chocolate agar plates. Media
have been described which facilitate the isolation of small numbers of
pneumococci from sputum heavily contaminated with secondary invaders
form
throat and mouth commensals of 5% horse blood is affective
incubation should be in 5-10 % coq (Gilks, 1997) .
A list of biochemical tests are used in identify the presence of these
bacteria. Catalase optochin sensitive test and bile solubility test for
streptococcus pneumonia’s congulase test for staphylococcus aureus
satellition test for Haemophilus influenza and citrate utilization for
Klebsiella pneumoniae (Cheesbrough 1984).
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