Background: Diarrhoeal illness remains one of the leading causes of morbidity and mortality among children<5 years of age worldwide. In Ethiopia, about 230,000 deaths estimated to occur. Shigella and Salmonella are major causes of gastroenteritis in children and is associated with high resistance levels. Thus, the aims of this study was to isolate and determine susceptibility patterns of Shigella and Salmonella, isolated from under five children with diarrhoea attending at some selected health facilities in Addis Ababa, Ethiopia. Methods: A total of 253 children 115 males and 138 females with acute diarrhoea were enrolled. Stool samples were cultured and isolated Shigella and Salmonella species were run for antimicrobial susceptibility testing using disk diffusion method. Results: A total of 190 entropathogens were isolated. Sixty one (24.1%) was E. coli, (9.1%) was Shigella followed by (3.95%) Salmonella and Citrobacter species and 86 (34.0%) was parasites. The overall resistance rates of isolated Shigella and Salmonella spp were high for Ampicillin (95.7%, 80.0%) and Augmentin (91.4%, 80) respectively. However, high sensitivity was observed among both isolates for Ciprofloxacin (91.3%, 100%) and Ceftraxion (91.4%, 100%). More than 87% of Shigella species were multiple resistances (resistance for two or more antibiotics). Whereas, 70.0% for Salmonella species. The prevalence of Shigella species was significantly varied among children with different employment parent's status. Raw meat consumption was an independent predictor variable for exposures of Salmonella infection (P≤0.05). Conclusion: Isolation of high frequency of multidrug resistant Shigella and Salmonella spp. from children in the study area is an alarming for the present situation of emerging drug resistance. However, there is still a chance to use ciprofloxacin and ceftriaxone in area of no culture and sensitivity test performed.
BACKGROUND: The resistance of bacteria causing urinary tract infection (UTI) to commonly prescribed antibiotics is increasing both in developing and developed countries. Resistance has emerged even to more potent antimicrobial agents. This study was undertaken to determine the current antibiotic resistance pattern among common bacterial uropathogens in St.paul's Hospital Millennium Medical College. METHODS: Using cross sectional study design, a total of 217 female and 207 male participants were consecutively recruited. Mid-urine samples were collected from all patients using wide mouthed urine cup. Inoculation was performed onto blood agar and MacConkey agar symoultaniously, and isolated organisms were identified by conventional methods. Antibiotic susceptibility was done by Kirby Bauer disk diffusion method. Thirteen different antibiotics representing different families of antibiotics were tested on all isolated organisms. RESULT: Of the total 424 samples, 95(22.4%) showed significant growth. Gram negative organisms totaled 85(20.05%), and 10(2.4%) isolates were gram positive. The most frequently isolated gram negative bacterium was E. coli followed by Protues and Klebsiella spp. 53(12.5%), 8(8.4%), and 7(7.4%) respectively. Resistance to Tetracyclin, Ampicilin, Amoxycilin and Nalidixic Acid was more than 70% of all isolates of E.coli strains. There was relatively low resistance rate to Nitrofurantoin, Gentamycin and Trimethoprim-Sulfamethoxazole. However, there was emerging resistance to Ciprofloxacilin and Ceftriaxone especially for common bacteruria. CONCLUSIONS: In this study setting, resistant rates to Tetracyclin, Ampicilin, Amoxycilin and Nalidixic Acid were high. Since most isolates were sensitive for Nitrofurantoin, Gentamycin and Trimethoprim-Sulfamethoxazole, they are considered as appropriate antimicrobials for empirical treatment for urinary tract infections with the absence of culture and sensitivity setting. Increasing antibiotic resistance trends indicate that it is imperative to rationalize the use of antimicrobials in the community and use these conservatively.
Background Diagnosis using reliable tools and treatment following in vitro antimicrobial susceptibility tests are critical to proper addressing of antibiotic-resistant Salmonella infection. Methodology A cross-sectional study was conducted to assess the practice of diagnosis and treatment of salmonellosis in Addis Ababa. Tube Widal test (for blood samples only), culture, biochemical and carbohydrate fermentation, serotyping, and antimicrobial susceptibility tests were employed for both blood and stool samples. Results Of all the diseases listed in the diagnosis, nontyphoidal (n = 72, 13.71%) and typhoidal (n = 47, 8.95%) salmonellosis were the second and third common diseases. Among the 288 blood samples, almost half were positive for O, H, or both antigens. However, only 1 (0.68%) of the positive blood samples yielded Salmonella isolate during culture. The study demonstrated low specificity (0.68%) and positive predictive value (48.78%) of Widal test. Conversely, the test showed 100% sensitivity and negative predictive values. Salmonella isolates were identified from 7 (7.07%) of 99 stool samples. Two-thirds of salmonellosis suspected patients received antibiotic treatment. However, only half of the confirmed salmonellosis patients were treated with appropriate antibiotics. All of the isolates were susceptible to ciprofloxacin and ceftriaxone but resistant to ampicillin. Conclusions Majority of the patients who participated in this study were wrongly diagnosed using symptoms, clinical signs, and tube Widal test. Consequently, most of the patients received inappropriate treatment.
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