Acta Scientific Microbiology (ISSN: 2581-3226)

Research Article Volume 4 Issue 11

The Prevalence of Potential Pathogens of Pneumonia in Sputum Specimens from Adult Patients at the University Teaching Hospital in Lusaka, Zambia

John Amos Mulemena1,2*, Chileshe Lukwesa-Musyani3,7, James C.L. Mwansa3,8, Victor Daka4,6, Warren Chanda1, Geoffrey Kwenda5

1Pathology and Microbiology Department, School of Medicine and Health Sciences, Mulungushi University, P.O Box 60009, Livingstone Zambia
2Ndola College of Biomedical Sciences, Postal Agency, Ndola Zambia
3University Teaching Hospital, Pathology and Microbiology Department, P/B Rw 1X, Lusaka Zambia
4Tropical Diseases Research Centre, P.O Box 71769, Ndola Zambia
5School of Health Sciences, University of Zambia, P.O. Box 50110, Lusaka, 15101, Zambia
6Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola Zambia
7Lusaka District Health Management Team, P.O. Box 36079 Lusaka, - 10101 Lusaka Zambia
8Lusaka Apex Medical University, P. O. Box 31909, Lusaka, Zambia

*Corresponding Author: John Amos Mulemena, Pathology and Microbiology Department, School of Medicine and Health Sciences, Mulungushi University, Livingstone, Zambia.

Received: September 29, 2021 ; Published:



Background: Pneumonia is a leading cause of morbidity and a significant cause of mortality worldwide. Although information is available on pneumonia in children in Zambia, the incidence in adults in many parts of Africa including Zambia is unknown. Knowledge of the aetiological agents of pneumonia in low-income countries is critical for making rational decisions regarding treatment as aetiology may differ to that of high income countries and result in poor response to therapy.

Objective: The purpose of this study was to identify aetiological agents of pneumonia in adult patients who sought health care at the University Teaching Hospital in Lusaka, Zambia.

Methodology: We conducted a cross-sectional study from March 2014 to August 2014. Conventional cultured methods and real-time Polymerase Chain Reaction (PCR) were employed in identifying aetiological agents. Demographic data were collected from patients’ laboratory request forms and all data were analysed using SPSS version 16.

Results: A total of 312 samples were received and cultured, 52.9% (165/312) yielded potential pathogens with the most common being Moraxella catarrhalis [26.7% (47/176)], Pseudomonas aeruginosa [25.6% (45/176)], and Klebsiella pneumoniae [18.2% (32/176)]. Using PCR, 146 samples were analysed and the most common organisms were Human cytomegalovirus [24.3% (44/181)], Klebsiella pneumoniae [17.7% (32/181)], Haemophilus influenzae non-type b [16.0% (29/181)], Streptococcus pneumoniae [9.4% (17/181)] and Staphylococcus aureus [9.4% (17/181)]. Other agents, mostly viruses, were also detected. More than one agent was detected in 42% of the specimens analysed by PCR. Detection rates of probable pathogens by Culture and PCR methods were about 30.1% and 69% respectively.

Conclusion: Our study showed a wide variety of potential pathogens including; bacteria, viruses and fungi in sputum specimens obtained from patients attending the University Teaching Hospital. Polymerase Chain Reaction detected more organisms than culture. Some of the specimens yielded multiple organisms which reflects the possibility of multiple causative agents for pneumonia. These data show the importance of employing better diagnostic methods, such as molecular tools, for identifying potential pathogens associated with pneumonia.

Keywords: Pneumonia; Culture; Polymerase Chain Reaction; Sputum; University Teaching Hospital; Zambia



  1. Black AD. “Community-acquired pneumonia-a clinical approach to assessment and management”. South African Family Practice 50 (2008): 15-23.
  2. Peto L., et al. “The bacterial aetiology of adult community-acquired pneumonia in Asia”. Transactions of the Royal Society of Tropical Medicine and Hygiene 10 (2014): 1093.
  3. Ezzati M and Kammen D. “Indoor air pollution from biomass combustion and acute respiratory infections in Kenya: an exposure-response study”. Lancet 358 (2001): 619-624.
  4. Lozano R., et al. “Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010”. Lancet 380 (2013): 2095-2128.
  5. Acharya VK., et al. “Microbiological Profile and Drug Sensitivity Pattern among Community Acquired Pneumonia Patients in Tertiary Care Centre in Mangalore, Coastal Karnataka, India”. Journal of Clinical and Diagnostic Research 8 (2014): 4-6.
  6. WHO report on Projections of mortality and causes of death, 2015 and 2030 (2015).
  7. Welte T. “Risk factors and severity scores in hospitalized patients with community-acquired pneumonia: prediction of severity and mortality”. European Journal of Clinical Microbiology and Infectious Diseases 31 (2012): 33-47.
  8. Holter JC., et al. “Etiology of community-acquired pneumonia and diagnostic yields of microbiological methods: a 3-year prospective study in Norway”. BMC Infectious Diseases 15 (2015): 64.
  9. Barrow GI., et al. “Cowan and Steel’s manual for the identification of medical bacteria”. 3rd ed. Cambridge (UK): Cambridge University Press (2003).
  10. Reynolds JH., et al. “Pneumonia in the immunocompetent patient”. The British Journal of Radiology 83 (2010): 998-1009.
  11. Egbe CA., et al. “Microbiology of Lower Respiratory Tract Infections in Benin City, Nigeria”. Malaysian Journal of Medical Science 18 (2011): 27-31.
  12. Khalil MM., et al. “Pattern of community and hospital acquired pneumonia in Egyptian military hospitals”. Egyptian Journal of Chest Diseases and Tuberculosis 62 (2013): 9-16.
  13. Mustafa MIA., et al. “The use of multiplex real-time PCR improves the detection of the bacterial etiology of community acquired pneumonia”. Tropical Biomedicine 28 (2011): 531-544.
  14. Regasa B. “Aetiology of Bacterial Pathogens from Adult Patients with Community-Acquired Pneumonia in Arba Minch Hospital, South Ethiopia”. Science Journal of Clinical Medicine 3 (2014): 33-36.
  15. Egbagbe EE and Mordi RM. “Aetiology of lower respiratory tract infection in Benin City, Nigeria”. Journal of Medicine and Biomedical Research 2 (2006): 22-27.
  16. Okesola AO and Ige OM. “Trends in bacterial pathogens of lower respiratory tract infections”. Indian Journal Chest Disease Allied Sciences 50 (2007): 270-272.
  17. Larsen MV., et al. “Bacteriology in acute exacerbation of chronic obstructive pulmonary disease in patients admitted to hospital”. Scandinavian Journal of Infectious Diseases 41 (2009): 26-32.
  18. Hashemi SH., et al. “Bacterial etiology and antimicrobial resistance of community-acquired pneumonia in the elderly and younger adults”. Tropical Doctor 40 (2010): 89-91.
  19. Fiberesima FP and Onwuchekwa AC. “Community-acquired pneumonia in Port Harcourt Rivers State of Nigeria”. Central Africa Journal Medicine1-4 (2008): 1-8.
  20. Bartlett JG and Mundy LM. “Community-acquired pneumonia”. New England Journal of Medicine 24 (1995): 1618-1624.
  21. Janssens JP and Krause K. “Pneumonia in the very old”. Lancet Infectious Diseases 4 (2004): 112-124.
  22. Valones MAA., et al. “Principles and applications of polymerase chain reaction in medical diagnostic fields: a review”. Brazilian Journal Microbiology1 (2009): 1-11.
  23. Johansson N., et al. “Quantitative detection of Streptococcus pneumoniae from sputum samples with real-time quantitative polymerase chain reaction for etiologic diagnosis of community-acquired pneumonia”. Diagnosing Microbiology Infectious Diseases 60 (2008): 255-261.
  24. Jennings LC., et al. “Incidence and characteristics of viral community-acquired pneumonia in adults”. Thorax 63 (2008): 42-48.
  25. Charles PG., et al. “The etiology of community-acquired pneumonia in Australia: why penicillin plus doxycycline or a macrolide is the most appropriate therapy”. Clinical Infectious Diseases 46 (2008): 1513-1521.
  26. Lieberman D., et al. “Respiratory viruses in adults with community-acquired pneumonia”. Chest 138 (2006): 811-816.
  27. Johansson N., et al. “Etiology of community-acquired pneumonia: increased microbiological yield with new diagnostic methods”. Clinical Infectious Diseases 50 (2010): 202-209.
  28. Micek ST., et al. “Clinical implications for patients treated inappropriately for community-acquired pneumonia in the emergency department”. BMC Infectious Diseases 14 (2014): 61.
  29. Huijskens AJM., et al. “Viral and bacterial aetiology of community-acquired pneumonia in adults”. Influenza and Other Respiratory Viruses 7 (2013): 567-573.
  30. Liu Y., et al. “Causative agent distribution and antibiotic therapy assessment among adult patients with community acquired pneumonia in Chinese urban population”. BMC Infectious Diseases 9 (2009): 31.
  31. de Roux A., et al. “Mixed community-acquired pneumonia in hospitalised patients”. The European Respiratory Journal 27 (2006): 795-800.
  32. Gencay M., et al. “Single and multiple viral infections in lower respiratory tract infection”. Respiration 80 (2010): 560-567.
  33. Liu YF., et al. “Etiological analysis and predictive diagnostic model building of community-acquired pneumonia in adult outpatients in Beijing, China”. BMC Infectious Diseases 13 (2013): 309.
  34. Small CL., et al. “Influenza infection leads to increased susceptibility to subsequent bacterial superinfection by impairing NK cell responses in the lung”. Journal Immunology 184 (2010): 2048-2056.
  35. Ruuskanen O., et al. “Viral pneumonia”. Lancet 377 (2011): 1264-1275.
  36. Van der Sluijs KF., et al. “Bench-to-bedside review: bacterial pneumonia with influenza - pathogenesis and clinical implications”. Critical Care 14 (2010): 219.
  37. Wunderink RG. “Influenza and bacterial pneumonia-constant companions”. Critical Care 14 (2010): 150.
  38. Templeton KE., et al. “Improved diagnosis of the etiology of community-acquired pneumonia with real-time polymerase chain reaction”. Clinical Infectious Diseases 41 (2005): 345-351.
  39. Oosterheert JJ., et al. “Impact of rapid detection of viral and atypical bacterial pathogens by real-time polymerase chain reaction for patients with lower respiratory tract infection”. Clinical Infectious Diseases 41 (2005): 1438-1444.
  40. Stralin K., et al. “Design of a multiplex PCR for Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae and Chlamydophila pneumoniae to be used on sputum samples”. Acta Pathologica, Microbiologica et Immunologica Scandinavica 113 (2005): 99-111.
  41. Kee C., et al. “Specificity of a quantitative real-time polymerase chain reaction assay for the detection of invasive pneumococcal disease: identifying Streptococcus pneumoniae using quantitative polymerase chain reaction”. Chest 137 (2010): 243-244.
  42. Loens K., et al. “Optimal sampling sites and methods for detection of pathogens possibly causing community-acquired lower respiratory tract infections”. Journal of Clinical Microbiology 47 (2009): 21-31.


Citation: John Amos Mulemena., et al. “The Prevalence of Potential Pathogens of Pneumonia in Sputum Specimens from Adult Patients at the University Teaching Hospital in Lusaka, Zambia”. Acta Scientific Microbiology 4.11 (2021): 02-10.


Acceptance rate33%
Acceptance to publication20-30 days

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is July 30, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US