Vol 11, Issue 9, 2018 Online - 2455-3891 Print - 0974-2441 IDENTIFICATION OF BACTERIA ASSOCIATED WITH LOWER RESPIRATORY TRACT AMONG PATIENTS ATTENDING IN GENERAL HOSPITAL DR. PIRNGADI MEDAN JEFRI NALDI 1 *, ROSIDAH ROSIDAH 1 , RICKE LOESNIHARI 2 1 Department of Pharmacology, Faculty of Pharmacy, University of Sumatera Utara, Medan, Indonesia. 2 Department of Clinical Pathology, Faculty of Medicine, University of Sumatera Utara, Medan, Indonesia. Email: jefri_naldi03@yahoo.com Received: 16 April 2018, Revised and Accepted: 18 May 2018 ABSTRACT Objective: The aim of this study was to establish cases of bacteria associated with lower respiratory tract infections (LRTIs) in General Hospital Dr. Pirngadi Medan with the view to identify the bacteria well as to assess their antibiotics susceptibility. Methods: An observation and prospective study were analyzed to patients with lower respiratory tract infection in respiratory and internal wards Dr. Pirngadi Hospital Medan. For the identification method of bacteria was using optochin test, catalase test, Mannitol salt agar, coagulase, indole, methyl red, Voges–Proskauer test, citrate, urease, and Triple Sugar Iron test. Results: The bacteria that cause lower respiratory tract infection were Pseudomonas aeruginosa (25.53%), Klebsiella pneumoniae (17.02%), Proteus sp. (14.89%), Staphylococcus aureus (12.77%), Escherichia coli (10.64%), Streptococcus pneumoniae (10.64%), and Haemophilus influenzae (8.51%). The result of sensitivity testing showed that gentamicin is more sensitive and the resistant antibiotic is chloramphenicol among all the tested antibiotics. Conclusion: P. aeruginosa was the most common isolated from LRTIs patients with gentamicin is the most sensitive antibiotics while chloramphenicol is the most resistant antibiotics among all the tested antibiotics. Keywords: Bacteria, Antibiotic, Lower respiratory tract infection, Susceptibility. INTRODUCTION Infection of the respiratory system is a common disease in the community. Respiratory infections based on the region of the infection are divided into upper respiratory infections and lower respiratory tract infections (LRTIs). In general, the cause of respiratory tract infections is various microorganisms, but the most are due to bacterial and viral infections. The mortality rate is very high in baby, children, elderly, and especially in countries with low- and medium-income per capita [1]. LRTIs are among the most common infectious diseases affecting humans worldwide [2]. They are important causes of morbidity and mortality for all age groups, and each year approximately 7 million people die as a direct consequence of acute and chronic respiratory infections [3]. The World Health Organization report in 2012 said that LRTIs, especially pneumonia rank fourth as the leading cause of death in the world and at the same time, the leading cause of death from infectious diseases class [4]. In research conducted in RSUP. H. Adam Malik Medan found that around 50% of bacterium Streptococcus viridans and Streptococcus pneumonia (14.6–20%) isolated from sputum, while Gram-negative bacteria obtained Klebsiella pneumonia, Pseudomonas, and Escherichia coli [5]. One of the fastest growing treatments is treated with antibiotics. This drug is able to cope with various types of infectious diseases caused by bacteria. The high use of antibiotics of more than one type and in the long term generally used for handling complications of severe infections in hospitals is one of the factors triggering the occurrence of bacterial resistance [6]. Bacterial resistance is one of the world’s problems. Every year the number of resistant bacteria always increases. The United States alone recorded at least 2 million people got the disease with the bacteria that have been resistant to some antibiotics, and about 23,000 people died from the bacteria resistant [7]. In some Asian countries such as China, Taiwan, Hong Kong, the Philippines, and Singapore found the prevalence of bacteria such as Staphylococcus aureus which has been resistant to some antibiotics is high, with prevalence rates in China (20%), Taiwan (60%), Hong Kong (70%), The Philippines (5%), and Singapore (60%). Some bacteria other than S. aureus, such as E. coli, Klebsiella spp., Serratia spp., Citrobacter freundii, and Morganella spp. also show a fairly high rate of resistance [8]. Current knowledge of the organisms that cause LRTIs and their antibiotic susceptibility profiles are therefore necessary for the prescription of appropriate therapy [9]. Changes in the characteristics of the population as it ages and the swelling numbers of patients with immunocompromising conditions have increased the number of individuals at risk [2]. The clinical laboratory plays a key role in the diagnosis of these infections with lots of challenges due to the complexity of LRTIs including quality of specimen and diversity; contamination of specimens with oropharyngeal flora; a diverse pathogen population that includes bacteria, viruses, and fungi; and the complex pathophysiology of respiratory tract infections [10]. There are numerous organisms causing LRTI including bacteria, fungi, and viruses. Diagnosis of LRTIs is often missed or misdiagnosed due to the procedures involved. The aim of this study was to establish cases of bacteria associated with LRTIs in General Hospital Dr. Pirngadi Medan with the view to identify the bacteria well as to assess their antibiotics susceptibility. METHODS Study area This study was conducted in General Hospital Dr. Pirngadi Medan between September and December 2016. The samples in this study were those that met the inclusion and exclusion criteria. The inclusion criteria of the study are the patient with a clinical diagnosis is a lower respiratory tract infection, adult patients (over 18 years), and patients © 2018 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons. org/licenses/by/4. 0/) DOI: http://dx.doi.org/10.22159/ajpcr.2018.v11i9.26722 Research Article