The prevalence and antimicrobial responses of <i>Shigella</i> isolates in HIV-1 infected and uninfected adult diarrhoea patients in north west Ethiopia

Abstract

Background: Shigella is one of the diarrhoea causing organisms found in HIV positive patients. But so far, the pattern of diarrhoeal agents caused by Shigella in AIDS patients has not been determined Objective: This study is thus aimed at determining the prevalence, antimicrobial susceptibility and resistance of Shigella isolates in HIV positive subjects. Methods: All stool samples taken from the subjects of this study were plated on the MacConkey agar and incubated at 35-37 0 C for 24 or 48 hrs. Biochemical and antimicrobial sensitivity testing were carried out by using the standard methods. Result: Out of the 391 subjects included in the study, 199(63.8%) HIV seropositive and 113 seronegative patients had acute and chronic diarrhoea while 79 were HIV seropositive without diarrhoea. Of the 27 (8.7) Shigella isolates taken from the diarrhea patients, 11 (3.5%) were from HIV positive subjects. All Shigella isolates were found to be sensitive against norfloxacin (100%), gentamicin (97%), polymyxin B (97%) and kanamycin (93%). The most frequent resistance observed was to chloramphenicol (62%), tetracycline (86%) and ampicillin (100%). The frequency of resistance of Amp, Sex, Ch, TTc was found to be very high when compared with other patterns of resistance. Conclusion: The high proportion of HIV seropositive patients who had diarrhea in the absence of identified Shigella strains strongly indicates the existence of other diarrhoeagenic agents or mechanisms. Detailed investigation is important to get comprehensive information for better treatment of diarrhoea in HIV /AIDS patients. According to this finding, norfloxacin, gentamicin, polymyxin B, kanamycin and nalidixic acid might be used as drugs of choice for empirical treatment. On the other hand, amplicilin, tetracycline and chloramphenicol may not be used as the drugs of choice for the treatment of Shigella infection unless culture and sensitivity tests are done prior to treatment.

Prevalence of Shigella, Salmonella and Cmpylobacter Species and Their Susceptibility Patters Among Under Five Children With Diarrhea in Hawassa Town, South Ethiopia

“…The prevalence rate of Shigella species in this study was 7% which is closer to the studies conducted in Jimma by Beyene et al (9), in Gondar by Mitikie et al (8) , in North west Ethiopia by Andualem et al (24) and in Harar, by Reda et al (14), in which the prevalence rates were 5%, 5.2%, 8.7% and 6.7% respectively. But, it is lower than the rate reported in studies carried out at Tikur Anbessa, Ethio-Swedish Children's Hospital by Asrat et al (21), in Jimma by Mache (25), in Hawassa by Roma et al (10), in Indonesia by Herwana et al (26), and in Iran by Mashouf et al (27) where the prevalence rates were 11.7%, 20.1%, 34.5%, 9.3% and 9.8% respectively.…”

Diarrheagenic Escherichia coli in sub-Saharan Africa: Status, Uncertainties and Necessities

“…In north-west Ethiopia, Shigella was recovered from 3.5% of HIV-1-seropositive patients, 5.1% of HIV-1-negative patients with diarrhea, and 2.5% of healthy controls. Shigella showed no association with disease or with diarrhea in HIV-1-positive patients [142]. Similar findings were made in Senegal and the Central African Republic [143,144].…”

Sudden Outbreak of Shigella Among Food Handlers Working at University Student`s Cafeteria

“…However, this finding is lower resistance when compared to a study reported in the University of Gondar Hospital [16] which shows high resistance to tetracycline (90%), cotrimoxazole (84.6%), ampicilin (78.9%) and chloramphenicol (67.8%) and lower resistance to gentamycin (12.2%) (19). As opposed to the 62% resistant to chloramphenicol that has been reported in a study in Gondar (25),the frequency of shigella strain resistant to against chloramphenicol was 0%. This is may be due to the former study is done in HIV /AIDS patients that were taking antibiotics frequently.…”