BackgroundUrinary tract infection (UTI) is one of the most common bacterial infections encountered by clinicians in developing countries. Area-specific monitoring studies aimed to gain knowledge about the type of pathogens responsible for urinary tract infections and their resistance patterns may help the clinician to choose the correct empirical treatment. Therefore, the aim of this study was to determine the type and antibiotic resistance pattern of the urinary pathogens isolated from patients attending Jimma University Specialized Hospital from April to June 2010.MethodsA hospital based cross sectional stud was conducted and urine samples were collected using the mid-stream “clean catch” method from 228 clinically-suspected cases of urinary tract infections and tested bacteriologically using standard procedures. Antimicrobial susceptibility test was performed for the isolated pathogens using Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute guidelines.ResultsSignificant bacteria were detected from 9.2% of the total patients. The most common pathogens isolated were Escherichia coli (33.3%), Klebsiella pneumoniae (19%) and S. saprophyticus (14.3%). E. coli and Klebsiella pneumoniae showed the highest percentage of resistance to ampicillin and amoxacillin (100%) however, all isolates of E. coli and K. pneumoniae were susceptible to ciprofloxacin. S. saprophyticus and S. aureus were resistant to ampicillin (100%) and amoxicillin (66.7%). For all UTI isolates, least resistance was observed against drugs such as ceftriaxone, gentamycin and chloramphenicol.ConclusionThis study finding showed that E. coli isolates were the predominant pathogens and the presence of bacterial isolates with very high resistance to the commonly prescribed drugs that in turn leaves the clinicians with very few alternative options of drugs for the treatment of UTIs. As drug resistance among bacterial pathogens is an evolving process, routine surveillance and monitoring studies should be conducted to provide physicians knowledge on the updated and most effective empirical treatment of UTIs.
BackgroundMalaria kills millions around the world. Until recently it was believed to be a disease of rural areas, since the Anopheles mosquito, which transmits Plasmodium species breeds in rural areas. Urban malaria is emerging as a potential, but "avertable" crisis, in Africa. In view of the rapidly growing number of small and medium-sized towns in Ethiopia there is a pressing need to improve the understanding of the epidemiology of malaria. Therefore, the aim of this study was to determine malaria prevalence and associated risk factors in Jimma town.MethodsA cross-sectional study was carried out in Jimma town from April 1 to May 28, 2010. 804 study participants were included from 291 households for microscopic examination of malaria parasites. Socio-demography data and risk factors were collected using structured questionnaires. Logistic regression analysis was done using SPSS 15.0 statistical software.ResultsFrom a total of 804 study participants in current survey only 42 (5.2%) were positive for malaria parasites. Plasmodium vivax, Plasmodium falciparum and mixed infection accounted 71.4%, 26.2% and 2.4%, respectively. Higher malaria prevalence rate was observed among under-five children (11%). Those who do not use insecticide-treated bed nets (ITN) were more likely to be infected with malaria (OR = 13.6; 95% CI 4.9-37.2, p < 0.001) compared with those who use the ITN. Living in areas where stagnant water existed (OR = 2.1; 95% CI 1.00-4.2, p = 0.047) and its distance of existence <1 km from the house(OR = 2.1; 95% CI 2.0-15.8, p = 0.001) were more likely to be infected with malaria parasite compared with those who live away from stagnant at a distance greater than 1 km.ConclusionMalaria is a major health problem with P. vivax becoming a predominant species in the town. The prevalence was strongly associated with proximity of residence to potential mosquito breeding sites. Malaria is affecting significant proportions of the urban settlers and human activities nevertheless play an important role in bringing the mosquito breeding sites closer to residences.
Ethiopia is one among the nations that possesses the largest number of livestock population in the African continent estimated to be 33 million cattle, 24 million sheep and 18 million goats. In contrast to the huge livestock resource, the livestock productivity is however, found to be very low. The major biological and socioeconomical factors attributing to the low productivity includes: the low genetic potential and performance, poor nutrition (in quality and quantity terms), the prevailing of different diseases, traditional way of husbandry systems and inadequate skilled manpower, among others. Ethiopia is one of the African countries where tuberculosis is wide spread in both humans and cattle and the endemic nature of tuberculosis in humans and cattle has long been documented. The disease is considered as one of the major livestock diseases that results in high morbidity and mortality, although the current status on the actual prevalence rate of bovine tuberculosis (BTB) at a national level is yet unknown. Detection of BTB in Ethiopia is carried out most commonly on the basis of tuberculin skin testing, abattoir meat inspection and very rarely on bacteriological techniques. Recently undertaken studies indicated the prevalence rate of BTB with a range of 3.4% (in small holder production system) to 50% (in intensive dairy productions) and a range of 3.5% to 5.2% in slaughterhouses in various places of the country. BTB in cattle remains to be a great concern due to the susceptibility of humans to the disease. The infections mainly take place by drinking raw milk and occur in the extra-pulmonary form, in the cervical lymphadenitis form in particular. The aim of this paper is to review the status of BTB in Ethiopia in relation with the existing animal husbandry systems and abattoir meat inspection surveillances. Control measures, economic impacts and the zoonotic aspect of the disease are also briefly addressed.
BackgroundUrinary tract infections (UTIs) are among the most common bacterial infections in humans, both in the community and hospital settings. It is a serious health problem affecting millions of people each year and is the leading cause of Gram-negative bacteremia. We previously conducted a study on “Urinary Bacterial Profile and Antibiotic Susceptibility Pattern of UTI among Pregnant Women in North West Ethiopia” but the study did not address risk factors associated with urinary tract infection so the aim of the study was to assess associated risk factors of UTI among pregnant women in Felege Hiwot Referral Hospital, Bahir Dar, North West Ethiopia.MethodsA total of 367 pregnant women with and without symptoms of urinary tract infection(UTI) were included as a study subject from January 2011 to April 2011. Midstream urine samples were collected and processed following standard bacteriological tests. Data concerning associated risk factors were collected using structured questionnaires and were processed and analyzed using Statistical Package for Social Science (SPSS version 16).ResultBivarait analysis of socio-demographic characteristics and associated risk factors of UTI showed that family income level (family monthly income level ≤ 500 birr($37.85); P = 0.006, OR = 5.581, CI = 1.658, 18.793 and 501–1000 birr ($37.93-$75.70), P = 0.039, OR = 3.429, CI = 1.065, 11.034), anaemia (P = 0.003, OR = 4.388, CI = 1.776, 10.839), sexual activity (P = 0.032, OR = 3.520, CI = 1.197,10.363) and past history of UTI (P = 0.000, OR = 3.397, CI = 1.672, 6.902) were found to be factors significantly associated with increase prevalence of UTI. In contrast multiparity, history of catheterization, genitourinary abnormality, maternal age, gestational age and educational status were not significantly associated with UTI among pregnant women.ConclusionIn this study UTI was high among pregnant women in the presence of associated risk factor such as anaemia, low income level, past history of UTI and sexual activity.
BackgroundUntreated bacteriuria during pregnancy has been shown to be associated with low birth-weight and premature delivery. Therefore, routine screening for bacteriuria is advocated. The decision about how to screen pregnant women for bacteriuria has always been a balance between the cost of screening versus the sensitivity and specificity. This study was designed to evaluate the diagnostic accuracy of the rapid dipstick test to predict urinary tract infection in pregnancy against the gold standard urine culture.MethodA total of 367 mid stream urine samples were collected, inoculated on MacConkey, Manitol salt agar (MSA) and blood agar and incubated aerobically at 37°C for overnight. Specimens were classified as “positive” for urinary tract infection (UTI) if the growth of the pathogen(s) was at a count ≥ 105 colony-forming units per milliliter (cfu/mL) of urine and classified as “negative” with growth of <105 cfu/mL. Urine samples were tested for the presence of nitrite and leukocyte esterase using dipstick rapid test in accordance to the manufacturer’s instructions.ResultsFrom the total study participants, 37 pregnant women were symptomatic and the remaining 330 pregnant women were asymptomatic. The sensitivity and specificity of dipstick tests of leukocyte esterase was 50% and 89.1% for pregnant women with asymptomatic UTI(ABU) and 71.4% and 86.7% for symptomatic UTI respectively and for nitrite 35.7% and 98.0% for ABU and 57.1% and 96.7% symptomatic UTI.ConclusionThis study revealed that the use of dipstick leukocyte esterase and nitrite for screening UTI particularly asymptomatic bacteriuria was associated with many false positive and negative results when it was compared against the gold standard culture method. The low sensitivity and positive predictive value of urine dipstick test proved that culture should be used for the diagnosis of UTI.
BackgroundPaediatric tuberculosis (TB) is poorly addressed in Ethiopia and information about its magnitude and the genotype distribution of the causative Mycobacterium tuberculosis strains responsible for its spread are scanty.MethodsGastric lavage or sputum samples were collected from consecutively enrolled TB suspect children visiting Jimma University Hospital in 2011 and cultured on Middlebrook 7H11 and Löwenstein-Jensen media. Acid fast bacterial (AFB) isolates were subjected to molecular typing targeting regions of difference (RDs), 16S rDNA gene and the direct repeat (DR) region using multiplex polymerase chain reaction (mPCR), gene sequencing and spoligotyping, respectively. Molecular drug susceptibility testing of M. tuberculosis isolates was performed by Genotype®MTBDRplus line probe assay (LPA) (Hain Life Sciences, Germany).ResultsGastric lavage (n = 43) or sputum (n = 58) samples were collected from 101 children and 31.7% (32/101) of the samples were positive for AFB by microscopy, culture and/or PCR. Out of 25 AFB isolates, 60% (15/25) were identified as M. tuberculosis by PCR, and 40% isolates (10/25) were confirmed to be non-tuberculous mycobacteria (NTM) by genus typing and 16S rDNA gene sequencing. Lineage classification assigned the M. tuberculosis strains into Euro-American (EUA, 66.7%; 10/15), East-African-Indian (EAI; 2/15), East-Asian (EA; 1/15) and Indio-Oceanic (IO; 1/15) lineages. Seven M. tuberculosis strains were new to the SpolDB4 database. All of the M. tuberculosis isolates were susceptible to isoniazid (INH) and rifampicin (RIF), except for one strain (of spoligotype SIT-149 or T3_ETH family) which had a mutation at the inhA locus which often confers resistance to INH (low level) and ethionamide.ConclusionsAnalysis of the genetic population structure of paediatric M. tuberculosis strains suggested similarity with that of adults, indicating an on-going and active transmission of M. tuberculosis from adults to children in Ethiopia. There were no multidrug-resistant TB (MDR-TB) strains among the isolates.
BackgroundSurgical site infection is the second most common health care associated infection. One of the risk factors for such infection is bacterial contamination of operating rooms' and surgical wards' indoor air. In view of that, the microbiological quality of air can be considered as a mirror of the hygienic condition of these rooms. Thus, the objective of this study was to determine the bacterial load and antibiotic susceptibility pattern of isolates in operating rooms' and surgical wards' indoor air of Jimma University Specialized Hospital.MethodsA cross sectional study was conducted to measure indoor air microbial quality of operating rooms and surgical wards from October to January 2009/2010 on 108 indoor air samples collected in twelve rounds using purposive sampling technique by Settle Plate Method (Passive Air Sampling following 1/1/1 Schedule). Sample processing and antimicrobial susceptibility testing were done following standard bacteriological techniques. The data was analyzed using SPSS version 16 and interpreted according to scientifically determined baseline values initially suggested by Fisher.ResultsThe mean aerobic colony counts obtained in OR-1(46cfu/hr) and OR-2(28cfu/hr) was far beyond the set 5–8cfu/hr acceptable standards for passive room. Similarly the highest mean aerobic colony counts of 465cfu/hr and 461cfu/hr were observed in Female room-1 and room-2 respectively when compared to the acceptable range of 250–450cfu/hr. In this study only 3 isolates of S. pyogenes and 48 isolates of S. aureus were identified. Over 66% of S. aureus was identified in Critical Zone of Operating rooms. All isolates of S. aureus showed 100% and 82.8% resistance to methicillin and ampicillin respectively.ConclusionHigher degree of aerobic bacterial load was measured from operating rooms' and surgical wards' indoor air. Reducing foot trafficking, improving the ventilation system and routine cleaning has to be made to maintain the aerobic bacteria load with in optimal level.
Background Salmonella is one of the most common foodborne pathogens globally, and it remains a major public health concern with the increasing concern of the emergence and spread of antimicrobial-resistant strains. In Ethiopia, the information on the prevalence of Salmonella is scarce in export abattoirs. Objective To estimate the magnitude and antimicrobial susceptibility profile of Salmonella recovered from export abattoirs located in East Shewa, Ethiopia. Methods A cross-sectional study was conducted from January to October 2020. In the study, 345 samples were collected from five export abattoirs using a systematic random sampling method. There were 150 carcass swabs (100 from goats and 50 from sheep), 60 goat skin swabs, 60 knife swabs, and 75 human stools. The isolates were identified and characterized using standard bacteriological procedures and confirmed using Salmonella genus-specific primer by polymerase chain reaction. Isolates were subjected to antimicrobial susceptibility to 14 antibiotics using the Kirby–Bauer disk diffusion method, and the results were assessed by using Clinical and Laboratory Standards Institute 2018. Results Of the 345 samples, 21 (6.08%; 95% CI 4.9–11.2%) were positive for Salmonella . The specific prevalence of Salmonella in carcass, skin, and knife swabs were 10 (6.67%; 95% CI 3.5–11.19%), 7 (11.67%; 95% CI 5.70–23.00%), and 4 (6.67%; 95% CI 2.50–16.64%), respectively. There was no statistically significant difference in the occurrence of Salmonella among export abattoirs and types of samples (P>0.05). In the current study, Salmonella was not isolated from sheep carcass and human stool samples. Among the 21 Salmonella isolates, 7 (33.3%) were resistant to at least 1 of the 14 antimicrobial agents tested and 2 (9.04%) of isolates were resistant to two antibiotics, tetracycline, and streptomycin. All isolates were susceptible to kanamycin, chloramphenicol, cephalothin, gentamycin, and ceftriaxone. Conclusion Salmonella was detected in carcass, skin, and knife samples from export abattoirs, which can have serious public health consequences. Some commonly used drugs in veterinary medicine have developed antimicrobial resistance. Therefore, sufficient sanitation at abattoirs, appropriate cooking of carcasses, and rational drug use is strongly advised. Further in-depth study such as serotyping and antimicrobial-resistant gene identification is recommended.
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