Background Infections of sterile body fluids are susceptible to serious invasive bacterial infections and critical, with high morbidity and sequelae risk. This study has not been conducted previously in eastern Ethiopia. Objective The present study was designed to determine the bacterial profile, associated factors, and their susceptibility to antimicrobial agents of isolates among patients with sterile body fluids at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia. Methods Hospital-based cross-sectional study was conducted from April to June 2021 among 204 patients selected using a convenient sampling technique. Data were collected using a pretested structured questionnaire. All consenting patients submitting body fluid specimens for testing at the clinical laboratory were included and analyzed using standard microbiology methods. Antimicrobial susceptibility testing was performed using the disk diffusion method and interpreted as per Clinical and Laboratory Standards Institute guidelines. Data were double entered into Epi data version 4.6, exported, and analyzed using Statistical Package for Social Science version 25. Bivariate and multivariable logistic regressions were used to assess the association between outcome and predictor variables. P-value <0.05 was considered to be statistically significant. Results The overall prevalence of bacteria among different sterile body fluid samples was 16.7% (95% CI: 12–22%). Most of the bacterial isolates (70.6%) were Gram-negative bacteria, mainly K. pneumoniae (26.5%) and E. coli (20.6%) . Multidrug resistance was identified in 76.5% of the isolates. Being inpatient (AOR = 3.59; 95% CI: 1.52, 8.51) and turbid appearance (AOR = 4.35; 95% CI: 1.67, 11.29) were significantly associated with culture growth rate. Conclusion The prevalence of bacterial isolates in this study comprises about 17%. Gram-negative bacteria, particularly K. pneumoniae and E. coli, were the major etiologic agents. Being inpatient and the turbid appearance of the specimen were significantly associated with the culture-positive result. Significant numbers of multidrug-resistant bacteria were isolated, mainly against beta-lactams. Therefore, culture and susceptibility testing should be an integral part of the laboratory investigation.

Background Group A Streptococcus has been recognized as an important human pathogen and it remains among the top ten causes of mortality from an infectious disease. Group A Streptococcus throat carriage plays an important role in the development of infection and transmission to contacts. In Ethiopia, there is little information about screening of children for group A Streptococcus carriage. Objective This study was aimed to assess the magnitude of throat carriage, associated factors, and antimicrobial susceptibility pattern of group A Streptococcus among healthy school children in Jigjiga city, Eastern Ethiopia from 12 April to 27 May 2021. Method A cross-sectional study was conducted enrolled by simple random sampling. Data on socio-demographic and related characteristics were gathered using pretested structured questionnaire. The throat sample was collected from 462 healthy school children and immediately transported to Jigjiga University Sultan Sheik Hassan referral hospital laboratory for investigation. Identification of group A Streptococcus was done by colony characterstics, gram staining, catalase negativity, bacitracin sensitivity, and Pyrrolidonyl arylamidase tests. Antibiotic susceptibility test was done on Muller-Hinton agar containing 5% sheep blood by modified Kirby-Bauer disc diffusion method. The data were coded, cleaned, and entered onto EpiData Version 3.1 then exported to SPSS version 26.0 for analysis. Bivariate and multivariable logistic regression through adjusted odds ratio (AOR) was used to determine the relationship between culture-positivity rates of GAS and predictor variables. A p-value < 0.05 was taken as statistically significant on multivariable analysis. Results The overall prevalence of group A Streptococcus throat culture rate was 10.6% (95%CI; 8.1%—13.7%). Previous family member who had a sore throat, children living with larger families (more than 11 members), and children living with non-immediate families were significantly associated with culture-positivity rates of GAS. Children who live with a family member with a sore throat compared with those who lived with in a family with no history of sore throat (AOR = 2.51; 95%CI 1.09–5.73), children who live with a large family comared to children living in families with less members (AOR = 4.64; 95% CI 1.53–14.1), and children who live with non-immediate families compared to children living with their mothers (AOR = 3.65; 95% CI 1.39 – 9.61), showed significant association with group A Streptococcus carriage rate. Resistance to all other antibiotics tested was low (< 5%). Multidrug resistance was found in 4.1% of isolates. Conclusion The present study showed 10.6% throat carriage of group A Streptococcus. Family member with a sore throat, having a large family, and living with non-immediate families have all been identified as independent predictors of carriage prevalence.

Background: In Ethiopia, multidrug resistant tuberculosis is a major public health problem. However, information is scarce regarding MDR-TB and associated factors. Objective: The study was aimed to assess the magnitude of multidrug resistance and associated factors of pulmonary tuberculosis among adult smear-positive patients in Harari regional state health facilities, eastern Ethiopia. Methods: A cross-sectional study was conducted among 395 adult smear-positive pulmonary tuberculosis patients attending health facilities from March to October 2019. Smearpositive sputum samples were collected from health facilities, and transported to Harari Health Research and Regional Laboratory, and tested for drug susceptibility using a line probe assay. Data were analyzed using Statistical Package for Social Sciences version 20. Bivariate and multivariable logistic regression analyses with 95% confidence intervals were carried out to identify factors associated with multidrug-resistant tuberculosis. Results:The overall magnitude of multidrug-resistant tuberculosis was 3.8% (15/395) (95% CI: 2.0-5.8%). Being male (AOR = 4.9; 95% CI: 1.16, 20.5), patients with a previous history of tuberculosis (AOR = 4.9; 95% CI: 1.5, 29.6), treatment failure (AOR = 8.5; 95% CI: 1.61, 45.3), treatment default (AOR = 10.38; 95% CI: 1.86, 58.0), human immunodeficiency virus co-infection (AOR = 9.83.95% CI: 3, 21, 30.1) and a previous history of contact with multidrug-resistant tuberculosis patients (AOR = 14.4; 95% CI: 3.1, 67.6) had higher odds of multidrug-resistant tuberculosis. Conclusion:The overall magnitude of multidrug-resistant tuberculosis was high. Strengthening the tuberculosis control program by giving special attention to HIV co-infected patients, treatment failure and default, previously infected patients as well as to those individuals who have a history of contact with multidrug-resistant tuberculosis infected patients .

Background Urinary tract infections (UTIs) are common pediatric infections and contribute to high morbidity and mortality. At present, the antimicrobial resistance emergency has quadrupled worldwide and poses a serious threat to the treatment of patients. However, there have been few studies on UTIs in children in Ethiopia, particularly in the east. Objective This study aimed to assess the bacterial profile of urinary tract infections, their susceptibility to antimicrobial agents, and associated factors in under-five children at Hiwot Fana Specialized University Hospital, eastern Ethiopia. Method We conducted hospital-based quantitative study on 332 consecutively selected under-five children from March 20 to June 10, 2021. Parents and guardians were interviewed to collect data using a structured questionnaire. Random urine samples were collected aseptically, and standard microbiological techniques were used to identify the bacteria and test for susceptibility to various antibiotics. Data were entered into Epi Info version 7 and exported to Statistical Package for the Social Sciences (SPSS) version 25 for analysis. Data were analyzed using descriptive analysis, bivariate, and multivariable logistic regression analysis. The crude odds ratio (COR) and adjusted odds ratio (AOR) with their respective 95% confidence intervals (CI) were used to determine the significance of the predictors. A p-value at a 95% confidence interval of less than 0.05 was considered statistically significant. Results The overall prevalence of bacterial urinary tract infections was 80 (24.1%) 95% CI:19.40–29.00%). Most of the bacterial isolates 55 (68.75%) were gram-negative bacteria, predominantly E. coli 23 (28.75%) and K. pneumoniae 10 (12.50%). Being a rural resident (AOR: 4.10, 95%CI: 1.45 11.54), uncircumcised male (AOR: 3.52, 95%CI: 1.33, 9.39), previous history of antibiotic usage (AOR: 7.32, 95%CI: 2.11, 25.37), indwelling catheterization (AOR: 10.35, 95%CI: 3.74, 28.63), previous history of urinary tract infections (AOR: 5.64, 95% CI: 1.36, 23.38), and urinary frequency (AOR: 5.56, 95%CI: 2.03, 15.25) had higher odds of culture positive result. The majority of the isolates have shown high levels of antibiotic resistance. Meropenem, ciprofloxacin, and amoxicillin-clavulanic acid were effective against gram-negative uropathogens, whereas rifampin and ciprofloxacin were the most sensitive drugs for gram-positive isolates. From the tested bacterial isolates, 53/86 (61.6%), 11/86 (11.6%), and 2/86 (2.3%) were found to have multidrug resistance (MDR), extreme drug resistance (XDR), and pan drug resistance (PDR), respectively. Conclusions About one-fourth of the children were culture-positive for many types of bacterial uropathogens; this is higher compared with most of the previous studies in Africa. Rural dwellers, uncircumcised males, indwelling catheterization, a history of antibiotic use and urinary tract infection, and frequent urination all had a higher risk of bacterial infections. Many isolates were resistant to multiple drugs, primarily beta-lactams. Urinary tract infections as well as the growth and spread of resistant bacterial pathogens should be monitor regularly.

Background. External ocular infection is a global public health problem. Frequently, bacteria cause an ocular infection that ranges from morbidity to loss of vision. The increasing bacterial resistance in ocular infections leads to the risk of treatment failure with possibly serious consequences. Objective. The study aimed to assess the bacterial profile of external ocular infections, their associated factors, and antimicrobial susceptibility pattern among patients admitted to Karamara hospital, Jigjiga, Eastern Ethiopia. Method. Institutional-basedcross-sectional study was conducted on 288 conveniently selected patients among patients admitted to Karamara hospital from May 1 to June 30, 2020. Data were collected using a structured questionnaire. The ocular sample was collected and cultured in the appropriate culture media and identified using a series of biochemical tests. Antimicrobial susceptibility testing of isolates was performed by using the disk diffusion method. Data were double entered onto EpiData version 3.1 then exported to SPSS version 20 and analyzed to calculate descriptive frequency and odds ratio, and p value ≤0.05 was taken as the significant value. Result. The prevalence of bacterial infection in external ocular samples was 62.2% (95% CI: 56.6%, 68.4%). Out of the 179 isolates, the majority of the bacterial isolates (87.7%) were Gram-positive. Staphylococcus aureus (53.1%) was the predominant isolate. Using soap for washing the face (AOR = 0.43; 95% CI: 0.29, 0.95), having diabetes mellitus (AOR = 3.11; 95% CI: 1.45, 6.75), and history of hospitalization (AOR = 2.82; 95% CI: 1.44, 5.54) were significantly associated with external ocular infection. Most (95.5%) of the Gram-positive bacteria showed resistance to penicillin, but they were susceptible to vancomycin, clindamycin, and ciprofloxacin. Conclusion. The study showed a high prevalence of bacterial infections with the predominant isolate was S. aureus. Penicillin-resistant bacteria were identified among Gram-positive bacterial isolates. Soap usage, hospitalization, and diabetes mellitus were associated with the infection. Antibiotics that were susceptible to the specific bacteria should be used as a drug of choice and using soap for washing the face is advisable to protect against external ocular infection.

Background: Group A Streptococcus has been recognized as an important human pathogen and it remains among the top ten causes of mortality from an infectious disease. Group A Streptococcus throat carriage plays an important role in the development of infection and transmission to contacts. In Ethiopia, there is little information about screening of children for Group A Streptococcus carriage.Objective: This study was aimed to assess the magnitude of throat carriage, associated factors, and antimicrobial susceptibility pattern of Group A Streptococus among healthy school children in Jigjiga city, Eastern Ethiopia from 12 April to 27 May 2021.Method: A cross-sectional study was conducted among 462 healthy school children in ages ranging from 7 to 14 years. The throat sample was collected using a sterile cotton swab. Identification of Group A Streptococcus was done by colony characterstics, gram staining, catalase negativity, bactricin sensitivity and Pyrrolidonyl arylamidase tests. Antibiotic susceptibility test was done on Muller-Hinton agar containing 5% sheep blood by modified Kirby-Bauer disc diffusion method. Data on socio-demographic and related characteristics were gathered through interviews using a questionnaire. The data were double-checked, coded, cleaned, and entered onto EpiData Version 3.1 then exported to SPSS version 26.0 for analysis. Bivariate and multivariable logistic regression was used to determine the relationship between outcome and predictor variables. A p-value < 0.05 was taken as statistically significant.Results: The overall prevalence of Group A Streptococcus carriage was 10.6% (95%CI; 8.1% - 13.7%). Children who live with a family member with a sore throat (AOR=2.51; 95%CI 1.09–5.73), children who live with a large family (AOR=4.64; 95% CI 1.53–14.1), and children who live with non-immediate families (AOR= 3.65; 95% CI 1.39 – 9.61), showed significant association with Group A Streptococcus carriage. Tetracycline resistance was shown to be high, while antimicrobial drugs such as penicillin, amoxicillin, ceftriaxone, erythromycin, azithromycin, chloramphenicol, and vancomycin were found to be effective. Multi-drug resistance was found in 4.1 % of the isolates. Conclusion: The present study showed a significant throat carriage of Group A Streptococci/S. pyogenes in Jigjiga city school children. Family member with a sore throat, having a large family, and living with non-immediate families have all been identified as independent predictors of carriage prevalence. It is recommended that regular screening and surveillance should be conducted in schools.

Background: Group A Streptococcus has been recognized as an important human pathogen and it remains among the top ten causes of mortality from an infectious disease. Group A Streptococcus throat carriage plays an important role in the development of infection and transmission to contacts. In Ethiopia, there is little information about screening of children for Group A Streptococcus carriage.Objective: This study was aimed to assess the magnitude of throat carriage, associated factors, and antimicrobial susceptibility pattern of Group A Streptococus among healthy school children in Jigjiga city, Eastern Ethiopia from 12 April to 27 May 2021.Method: A cross-sectional study was conducted among 462 healthy school children in ages ranging from 7 to 14 years. The throat sample was collected using a sterile cotton swab. Identification of Group A Streptococcus was done by colony characterstics, gram staining, catalase negativity, bactricin sensitivity and Pyrrolidonyl arylamidase tests. Antibiotic susceptibility test was done on Muller-Hinton agar containing 5% sheep blood by modified Kirby-Bauer disc diffusion method. Data on socio-demographic and related characteristics were gathered through interviews using a questionnaire. The data were double-checked, coded, cleaned, and entered onto EpiData Version 3.1 then exported to SPSS version 26.0 for analysis. Bivariate and multivariable logistic regression was used to determine the relationship between outcome and predictor variables. A p-value < 0.05 was taken as statistically significant.Results: The overall prevalence of Group A Streptococcus carriage was 10.6% (95%CI; 8.1% - 13.7%). Children who live with a family member with a sore throat (AOR=2.51; 95%CI 1.09–5.73), children who live with a large family (AOR=4.64; 95% CI 1.53–14.1), and children who live with non-immediate families (AOR= 3.65; 95% CI 1.39 – 9.61), showed significant association with Group A Streptococcus carriage. Tetracycline resistance was shown to be high, while antimicrobial drugs such as penicillin, amoxicillin, ceftriaxone, erythromycin, azithromycin, chloramphenicol, and vancomycin were found to be effective. Multi-drug resistance was found in 4.1 % of the isolates. Conclusion: The present study showed a significant throat carriage of Group A Streptococci/S. pyogenes in Jigjiga city school children. Family member with a sore throat, having a large family, and living with non-immediate families have all been identified as independent predictors of carriage prevalence. It is recommended that regular screening and surveillance should be conducted in schools.