We conducted a hospital-based cross-sectional study among children aged <5 years in Thi-Qar Governorate, south-eastern Iraq, in order to examine the prevalence, risk factors and antimicrobial resistance associated with gastroenteritis caused by Salmonella infection. From 320 diarrhoea cases enrolled between March and August 2016, 33 (10·3%, 95% confidence interval (CI) 8·4-12·4) cases were stool culture-positive for non-typhoidal Salmonella enterica. The most commonly identified serovar was Typhimurium (54%). Multivariable logistic regression analysis indicated that the odds of Salmonella infection in children from households supplied by pipe water was 4·7 (95% CI 1·6-13·9) times higher compared with those supplied with reverse osmosis treated water. Similarly, children from households with domestic animals were found to have a higher odds (OR 10·5; 95% CI 3·8-28·4) of being Salmonella stool culture-positive. The likelihood of Salmonella infection was higher (OR 3·9; 95% CI 1·0-6·4) among children belonging to caregiver with primary vs. tertiary education levels. Lower odds (OR 0·4; 95% CI 0·1-0·9) of Salmonella infection were associated with children exclusively breast fed as compared with those exclusively bottle fed. Salmonella infection was three times lower (95% CI 0·1-0·7) in children belonging to caregiver who reported always washing hands after cleaning children following defecation, vs. those belonging to caregivers who did not wash hands. The antimicrobial resistance profile by disc diffusion revealed that non-susceptibility to tetracycline (78·8%), azithromycin (66·7%) and ciprofloxacin (57·6%) were the most commonly seen, and 84·9% of Salmonella isolates were classified as multi-drug resistant. This is the first study on prevalence and antimicrobial resistance of Salmonella infection among children in this setting. This work provides specific epidemiological data which are crucial to understand and combat paediatric diarrhoea in Iraq.
Cholera is an acute disease caused by Vibrio cholerae; it’s affected to all aged groups. Cholera infection is outbreaks in Iraq as reported for several years. The recent cholera outbreak, emerged throughout 2015-2016, was investigated by using bacteriological laboratory tests, singleplex and multiplex PCR technique for the detection of V. cholerae from stool samples. Furthermore the antibiotic susceptibility test for cholera was also investigated coupled with the toxigenic potential. A total of Twenty Vibrio cholerae isolates were isolated from diarrheal patients in Thi-Qar province. These isolates were diagnosis by conventional biochemical test, API20 E system and molecular methods by using 16SrRNA. The isolates were characterized for gene traits; antimicrobial susceptibility. The results appeared all 20 isolates were positive for 16S rRNA. Multiplex PCR analysis revealed that 65%, 35% and 15% of isolates were positive for tox R, tcp and ctx B genes respectively. The antimicrobial susceptibility testing to isolates revealed high levels of resistance to ampicillin (100%), nalidixic acid (90%), sulfamethoxazoletrimethoprim (80%), tetracycline and ciprofloxacin (55%) and chloramphenicol (45%) in addition to increase the prevalence of multidrug resistant (MDR) between Vibrio cholerae isolates.
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