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Assessment of Bacterial Resistance Trend and Contributing Factors to Fluoroquinolone among Patients’ Specimens Analyzed At International Clinical Laboratories in Addis Ababa

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dc.contributor.advisor Gedif, Teferi (PhD)
dc.contributor.author Mekuria, Banchirega
dc.date.accessioned 2018-06-19T06:27:12Z
dc.date.available 2018-06-19T06:27:12Z
dc.date.issued 2017-06
dc.identifier.uri http://etd.aau.edu.et/handle/123456789/1465
dc.description.abstract Introduction: Fluoroquinolones are a group of antimicrobials which are widely used globally and thus microorganisms becoming resistant to them. As there is limited current data on specific microorganisms’ resistance to fluoroquinolones in Ethiopia; this study aimed to generate information on the bacterial resistance against fluoroquinolones. Objective: To assess the bacterial resistance trend to fluoroquinolone among patients’ specimens analyzed at International Clinical Laboratories and contributing factors in Addis Ababa, Ethiopia Method: A retrospective, cross-sectional study design was employed using records from microbiology laboratory registers of International Clinical Laboratories documented from January 2013 to December 2016. Descriptive analysis and inferential statistics were computed. In addition, qualitative study using phenomenological method was conducted in health facilities of Addis Ababa to explore the contributing factors for resistance from prescribers’ and dispensers’ perspective. A thematic analysis was used to analyze the qualitative data. Result: The overall bacterial resistance to fluoroquinolones was 42.5%. The resistance was high against nalidixic acid (63.3%) followed by norfloxacin (44.4%). Enterococci and E.coli isolates were developing high level of resistance to ciprofloxacin and norfloxacin while enterococci was highly resistant to nalidixic acid (77.8%) followed by Pseudomonas (75.0%) isolates. In general, resistance to fluoroquinolone increases as patients’ age increases. Resistance against fluoroquinolones in patients of age 60 and above years were more than 5 times AOR= 5.63 (4.71, 6.73) that of the resistance in patient’s age less than 15 years. The resistance to fluoroquinolones increased from 40.4% in 2013 to 45.1% in 2014 and reached to the 49.0% in year 2015 and then declined to 46.3% in 2016(P <0.05). Key informants revealed that inappropriate practices of physicians, pharmacists and patients and incomplete diagnostic services contributed to fluoroquinolone resistances. Strengthen the regulation regarding over the counter sell of antibiotics, educating the public to improve awareness, promoting ethical practice would also help rationalizing the prescribing and dispensing practices, and instituting evidence based use of antibiotics are recommended as a solution. Conclusion: The retrospective study showed high bacterial resistance to fluoroquinolones. There was an increasing trend of bacterial resistance with time. Key informants stated that inappropriate prescribing and over the counter sell of antibiotics as well as irrational use by patients contributed to bacterial resistance to fluoroquinolones. Recommendation: The study suggests updating of health professionals on susceptibility pattern of bacteria and rational prescription to improve use of fluoroquinolones, Promoting ethical practice, improving the regulation and supervision on over the counter sell of antibiotics at private medicine retail outlet and continuous awareness raising and behavioral change communication has to be devised towards rational use to the community were some of the proposed containment mechanism for bacterial resistance to fluoroquinolones. Key word: Fluoroquinolone, resistance, bacterial isolates, resistance trends en_US
dc.language.iso en en_US
dc.publisher Addis Ababa University en_US
dc.subject Fluoroquinolone; resistance; bacterial isolates; resistance trends en_US
dc.title Assessment of Bacterial Resistance Trend and Contributing Factors to Fluoroquinolone among Patients’ Specimens Analyzed At International Clinical Laboratories in Addis Ababa en_US
dc.type Thesis en_US

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