Background: Lower respiratory tract infections (LRTIs) are a major cause of death and morbidity worldwide,especially among young children and the elderly. Rising antimicrobial resistance further complicates their management. Methods: In this 18-month cross-sectional study, 327 respiratory samples (sputum, bronchoalveolar lavage, endotracheal aspirate, pleural fluid) from clinically suspected LRTI patients were cultured. Isolates were identified by standard microbiological and biochemical methods. Antimicrobial susceptibility testing was performed by the Kirby–Bauer disc diffusion method according to CLSI 2022 guidelines. Results: Of 327 samples, 192 (58.7%) yielded Gram-negative and 135 (41.3%) Gram-positive isolates.Klebsiella pneumoniae (21.1%) and Pseudomonas aeruginosa (15.6%) predominated among Gram-negatives, while Streptococcus pyogenes (8.3%) and Staphylococcus schleiferi (7.3%) were the most frequent Gram-positives. High resistance rates were noted against ampicillin (100% of Gramnegatives), first- and second-generation cephalosporins (up to 100%), and penicillin (82.2% of Gram-positives). Carbapenems (imipenem 75% sensitivity; meropenem 76.6%) and glycopeptides (vancomycin 95.6%) retained good activity. Conclusion: The substantial burden of drug-resistant pathogens in LRTIs underscores the necessity for ongoing local surveillance, judicious antibiotic use, and robust stewardship programs to guide empirical therapy and curb resistance.
Kumar et al. (2025) studied this question.