Detection of causative agents of bacterial pneumonia in hospitalized hajj and umrah cases by multiplex real-time polymerase chain reaction
Abstract
Background and Objectives: Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is commonly detected in pneumonia patients who travel from the Middle East regions. Besides MERS-CoV, many other pathogenic agents cause pneumonia. Detection of such organisms must be done swiftly, especially in case of the negative MERS-CoV samples. The aim of this study was to identify the pathogenic agents that might account for bacterial pneumonia, from Hajj and Umrah pneumonia cases.
Materials and Methods: We conducted a cross-sectional study, 38 pneumonia clinical samples from suffering of Hajj and Umrah in 2017 with negative MERS-CoV were selected. The laboratory testing was done at National Reference Laboratory in Jakarta and performed by multiplex real-time PCR using a FTD respiratory pathogens.
Results: Haemophilus influenzae (26.4%) was the most frequent bacteria detected. Other causative agents of bacterial pneumonia identified were Moraxella catarrhalis (20.8%), Klebsiella pneumoniae (13.2%), Streptococcus pneumoniae (9.4%), and Staphylococcus aureus (5.7%). From 38 samples showed that 25 (65.79%) samples were positive with bacteria, including five samples with coinfection. The coinfection were combinations among S. aureus and S. pneumoniae (1/20), S. pneumoniae and K. pneumoniae (1/20), S. pneumoniae and M. catarrhalis (2/20), S. pneumoniae and H. influenzae (2/20), K. pneumoniae and H. influenzae (5/20), and M. catarrhalis and H. influenzae (5/20).
Conclusion: Haemophilus influenzae is the most recurrent bacteria to be identified in samples of pneumonia of hajj and umrah cases.
2. Memish ZA, Almasri M, Turkestani A, Al-Shangiti AM, Yezli S. Etiology of severe community-acquired Pneumonia during the 2013 Hajj-parts of the MERS-CoV surveillance program. Int J Infect Dis 2014; 25: 186-190.
3. Saad M, Omrani AS, Baig K, Bahloul A, Elzein F, Matin MA, et al. Clinical aspects and outcomes of 70 patients with Middle East respiratory syndrome coronavirus infection: a single-center experience in Saudi Arabia. Int J Infet Dis 2014; 29: 301-306.
4. Pane M, Kong FYM, Purnama TB, Glass K, Imari S, Samaan G, Oshitani H. Indonesian Hajj cohorts and mortality in Saudi Arabia from 2004 to 2011. J Epidemiol Glob Health 2019; 9: 11-18.
5. Loebinger MR, Robert W. Bacterial Pneumonia. Medicine 2008; 36: 285-290.
6. Murdoch DR, O’Brien KL, Driscoll AJ, Karron RA, Bhat N, Pneumonia Methods Working Group; PERCH Core Team. Laboratory methods for determining Pneumonia etiology in children. Clin Infect Dis 2012; 54 Suppl 2: S146-S152.
7. Lee H, Ki CS, Sung H, Kim S, Seong MY, Dong Y, et al. Guidelines for the laboratory diagnosis of Middle East respiratory syndrome coronavirus in Korea. Infect Chemother 2016; 48: 61-69.
8. Shirah BH, Zafar SH, Alferaidi OA, Sabir AMM. Mass Gathering Medicine (Hajj Pilgrimage in Saudi Arabia): The clinical pattern of Pneumonia among Pilgrims during Hajj. J Infect Public Health 2017; 10: 277-286.
9. Puig C, Calatayud L, Marti S, Tubau F, Garcial-Vidal C, Carratalia J, et al. Molecular epidemiology of nontypeable Haemophilus influenzae causing community-acquired Pneumonia in adults. PLoS One 2013; 8(12): e82515.
10. Blain A, MacNeil J, Wang X, Bennett N, Farley MM, Harrison LH, et al. Invasive Haemophilus influenzae disease in adults ≥65 years, United States, 2011. Open Forum Infect Dis 2014; 1(2): ofu044.
11. Asghar AH, Ashshi AM, Azhar EI, Bukhari SZ, Zafar TA, Momenah AM. Profile of bacterial Pneumonia during Hajj. Indian J Med Res 2011; 133: 510-513.
12. Chastre J, Blasi F, Masterton RG, Rello J, Torres A, Welte T. European perspective and update on the management of nosocomial Pneumonia due to methicilin-resistant Staphylococcus aureus after more than 10 years of experience with linezolid. Clin Microbiol Infect 2014; 20 Suppl 4: 19-36.
13. Kumagai S, Ishida T, Tachibana H, Ito Y, Ito A, Hashimoto T. Impact of bacterial coinfection on clinical outcomes in Pneumococcal pneumonia. Eur J Clin Microbiol Infect Dis 2015; 34: 1839-1847.
14. Tikhomirova A, Kidd SP. Haemophilus influenzae and Streptococcus pneumoniae: Living together in a biofilm. Pathog Dis 2013; 69: 114-126.
15. de Steenhuijsen Piters WA, Sanders EA, Bogaert D. The role of the local microbial ecosystem in respiratory health and disease. Philos Trans R Soc Lond B Biol Sci 2015; 370: 20140294.
16. Ito R, Shindo Y, Kobayashi D, Ando M, Jin W, Wachino J, et al. Molecular epidemiological characteristics of Klebsiella pneumoniae associated with bacteremia among patients with Pneumonia. J Clin Microbiol 2015; 53: 879-886.
17. Haarmann H, Steiner T, Schreiber F, Heinrich A, Zweigner J, N'Guessan PD, et al. The role and regulation of Moraxella catarrhalis-induced human beta-defensin 3 expression inh pulmonary epithelial cells. Biochem Biophys Res Commun 2015; 467: 46-52.
Files | ||
Issue | Vol 14 No 3 (2022) | |
Section | Original Article(s) | |
DOI | https://doi.org/10.18502/ijm.v14i3.9759 | |
Keywords | ||
Pneumonia; Multiplex real-time polymerase chain reaction; Bacteria; Hajj and umrah |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |