Aerobic Bacterial Profile and Their Antibiotic Susceptibility Patterns of Sterile Body Fluids Among Patients at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia

Abstract

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.

Bacterial etiologies, antimicrobial susceptibility pattern and associated factors among patients suspected sterile body site infections at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia

“…Being an inpatient, comorbidity, and the habit of drinking alcohol had a statistically significant association with bacterial infection of sterile body fluids. This finding is consistent with a study from Harar, Ethiopia ( 8 ). This could be due to the hospital’s level of environmental hygiene and surgical invasive procedures.…”

“…In this study, high rates of multi-drug resistance (MDR) (78.57%) (95% CI: 56.30–99.70%) were reported, which is comparable to the findings in Addis Ababa, Ethiopia (75%) ( 6 , 36 ), Harar, Ethiopia (76.4%) ( 8 ), Mekelle, Ethiopia (90%) ( 5 ) and India (62.9%) ( 40 ). But higher than study conducted in Nepal (40%) ( 32 ).…”

“…In this study, E. cloacae was the most frequent bacterial etiologies causing sterile bodies infection, in contrast. E. coli was the most prevalent isolated bacteria in a previous study conducted in EPHI, Ethiopia ( 36 ), Harar, Ethiopia ( 8 ), India ( 33 ), and Nepal ( 32 ). The detection of E. cloacae may be an indication of an opportunistic pathogen associated with hospital-acquired infections, due to poor infection prevention practices such as overcrowding, lack of standard facilities with controlled ventilation, and poor sterilization of all gowns and surgical equipment.…”

Bacterial profile, their antibiotic susceptibility pattern, and associated factors of urinary tract infections in children at Hiwot Fana Specialized University Hospital, Eastern Ethiopia

“…The antimicrobial resistance (AMR) emergence of bacterial uropathogenic has challenged the current therapies to treat and control the spread of infections [ 16 ], and treatment has not improved and does not prevent reinfections [ 17 ]. Especially, UTIs caused by resistant bacteria are an important global medical cause of severe infections with increasing rates of morbidity and mortality [ 18 ], and they can also result in prolonged hospital stays and poverty for pediatric patients [ 19 , 20 ]. In third-world countries, the problem is immense, as most healthcare facilities lack culture-based diagnostic facilities [ 20 , 21 ].…”

“…Especially, UTIs caused by resistant bacteria are an important global medical cause of severe infections with increasing rates of morbidity and mortality [ 18 ], and they can also result in prolonged hospital stays and poverty for pediatric patients [ 19 , 20 ]. In third-world countries, the problem is immense, as most healthcare facilities lack culture-based diagnostic facilities [ 20 , 21 ]. Recently, multidrug-resistant (MDR) and carbapenem-resistant Enterobacterales (CREs) have emerged and gradually become a significant public health challenge [ 22 ].…”