Bacterial Profile and Antimicrobial Susceptibility of Isolates Recovered from Lower Respiratory Tract Infection for Patients in Rizgary Hospital, Erbil

worldwide (Madhi and Klugman, 2006; Troeger, et al., 2019). Bacterial-induced LRTI includes bronchitis and pneumonia and increases the risk of pulmonary complications (Kasper, et al., 2006). LRTIs are occurring in children and adult alike, peaking among patients in intensive care units (ICUs). The LRTI acquired in ICUs is best known as hospital-acquired LRTI (Yan, et al., 2018; Karlowsky, et al., 2020). LRTI adverse effects are not limited to population health, but they cause a tangible economic burden on the health-care systems (Ehlken, et al., 2005; Sinha, et al., 2013; Trucchi, et al., 2019). The majority of bacterial-induced LRTIs are caused by Gram-negative bacteria (GNB), and lower case numbers caused by Gram-positive bacteria (GPB). Pseudomonas aeruginosa and Haemophilus influenzae (GNB) and Streptococcus pneumoniae (GPB) are among the most common bacterial isolates recovered from LTRIs (Kohlenberg, et al., 2008; Khan, et al., 2015). Viruses are also responsible for the development of LRTIs (Ren, et al., 2009; Huang, et al., 2020) and antibiotics are often unnecessarily prescribed for treating these cases that may contribute to the emergence of antibiotic resistance (Pavia, 2011; Shiley, et al., 2015). Uncovering the etiologies of LRTI has a key role in making the right therapeutic decisions while dealing with this pathological condition (Brookes-Howell, et al., 2012; Langelier, et al., 2018). Unfortunately, in most cases, LRTI treatment is started before culture sensitivity tests are performed (Ali and Butt, 2017). Development of antibiotic resistance may also emerge once patients are given empiric therapy (Yin, et al., 2003; Fatima, et al., 2012; Claeys, et al., 2017). Hence, establishing standard guidelines to deal with LRTIs and their complications are vital to save lives, especially for those who already suffer from antibioticresistant bacteria. In more server cases, LRTI patients may suffer from multidrug-resistant pathogens which may make their treatment even more challenging (Woodhead, et al., 2011; Feldman and Richards, 2018). There are guidelines in place and practiced in a few countries for LRTI management (Christiansen, 1996; Baturin, Abstract—Recognition of etiologies of lower respiratory tract infection (LRTI) may help in delivering effective treatment options and circumvent emergence of antibiotic resistance. This study is carried out to uncover bacterial profile and antibiotic sensitivity patterns among 310 LRTI patients attended Rizgary Hospital between January 2014 and December 2016. Standard laboratory techniques are applied in collecting, processing, and culturing sputum and bronchial wash specimens. VITEK® 2 compact systems are used to identify bacteria and their antibiotic sensitivity patterns. The results show that Streptococcus parasanguinis and Acinetobacter baumannii are the most abundant Gram-positive and Gram-negative bacteria (GPB and GNB), respectively, isolated from sputum specimens. From bronchial wash specimens, only GNB are detected and Serratia marcescens is the most abundant one. Antibiotic sensitivity tests reveal that Streptococcus parasanguinis is the most resistant GPB and Acinetobacter baumannii is the most resistant GNB. Sputum recovered GPB are highly resistant to ampicillin, erythromycin, levofloxacin, trimethoprim/ sulfamethoxazole, and tetracycline. Bronchial wash recovered GNB are highly resistant to ampicillin, minocycline, pefloxacin, piperacillin, and ticarcillin. In conclusion, LRTIs are mainly associated with GNB rather than GPB. The recovered Streptococcus parasanguinis and Acinetobacter baumannii are found to be multidrug resistant pathogens. Ampicillin is ineffective against any of recovered pathogenic bacteria.