Browsing by Author "Erku Woldaregay"

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    Assessment of Antimicrobial Resistance of Bacteria Isolated from Hospital and Non-Hospital Sewarage System In Addis Ababa, Ethiopia
    (Addis Ababa Universty, 2018-03) Mohammed Redwan; Erku Woldaregay
    Background: -Large quantities of antimicrobials are used in hospitals for patient care. Antibiotics are partially metabolized and residual quantities reach hospital sewage, exposing bacteria to a wide range of biocides that could act as selective pressure for the development of resistance. Objectives: The aim of this study was to isolate selected common bacterial pathogens and assess antimicrobial resistance of bacteria isolated from sewage released from hospitals and nonhospital sewerage system in Addis Ababa, Ethiopia Methods: A cross-sectional study was conducted from August 2016-December 2017 in hospital and non-hospital sewage. A total of 220 hospital and non-hospital sewage samples were collected twice a week for five weeks for bacteriological analysis and susceptibility testing. Pathogenic and potentially pathogenic bacteria were isolated on selective bacteriologic media and antibiotic susceptibility tests were performed using Kirby-Bauer disk diffusion method. All methods were used according to standard methods for examination of water and wastewater. Results: A total of 220 waste water samples were processed for the presence of drug resistant pathogens. From these total samples 506 bacterial isolates were isolated and of these 327 (64.6%) were from hospital environment and 179 (35.4%) were from non-hospital environment. The most frequently identified bacterium was Pseudomonas spp. 160(31.6%) followed by E.coli108(21.34%); Klebsiella spp.76 (15%); Citrobacter spp. 50 (10%); Staphylococcus aureus 37 (7.3%);Enterobacter 14(2.8%); and 57(11.26%) were other gram positive and gram negative bacteria. Hospital and non-hospital isolates were subjected to antimicrobial susceptibility testing.The percent of resistance for Gram-negative bacteria to 9 antibiotics were as follows: Ampicillin (100% and 95.5%), Imipenem (0% and 0%), Ceftriaxone (75% and 26.9%), Ceftazidim (91.9% and 65.7%), Gentamicin (17.7% and 4.5%), Ciprofloxacin (36.2% and 8.9%), Kanamycin (27.3% and 4.5%), Chloramphenicol (19.6% and 6%) and Cefotaxime (96.5% and 89.9%)for hospital and non-hospital wastewater, respectively. Likewise, the rate of resistance for S.aureus against tested drugs was: Ampicillin (100% & 100%), Amoxicillin (100% & 83%) Chloramphenicol (28% & 17%), Ciprofloxacin (16% & 8%), Ceftriaxone (20% & 8%), Gentamicin (12% & 0%), Cefotaxim (40% & 25%), and Erythromycin (20% & 0%) for bacteria isolated from hospital and non-hospital wastewater, respectively. Conclusion: This study showed that both hospital and non-hospital environments harbor similar types of bacteria, but the hospital environment contains significantly higher number and antibiotic resistance rates of each bacteria types. The contamination of hospital sewage more than that of the non-hospital one by antibiotics or other pollutants lead to the rise and dissemination of multidrug resistance due to selection pressure.
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    Bacterial Isolates from External Ocular Infections and Their Antibiotic Susceptibility Status Among Patients Visiting Menelik II Referral Hospital,Ethiopia.
    (Addis Ababa University, 2019-06) Nitsuh Asmamaw; Selassie Solomon; Erku Woldaregay
    Background:Infection of the external structures of the eye is one of the commonest types of eye disease worldwide including Ethiopia.Generally, infection of the eye can lead loss or impairment of visual function causing major disability. Therefore, prompt isolation and testing susceptibilityof bacterial isolates are necessary for bettertreatment of bacterial ocular infection. Objective: the aim of this study was to assess the magnitude of bacterial isolates from external ocular infections and their antibiotics susceptibility status among patients visiting ophthalmology unit of Menelik II Referral Hospital, Ethiopia. Methods: A Hospital based cross sectional prospective study was conducted at the Menelik II Referral Hospital among patients seeking health services at the department of ophthalmology from Januaryto April, 2019. All patients confirmed of external ocular infections were included. External ocular samples were collected using aseptic techniques. All samples were investigated for the presence of bacterial growth and bacteria were identified using gram stain, colony morphology, and disk sensitivity and biochemical tests. Drug susceptibility test was done using the Kirby-Bauer Disk diffusion method according to the guidelines of clinical and laboratory standard institute (CLSI). Result:In this study,the magnitudes of bacterial isolates were 175/323 (54.2%. The proportion of gram positive bacterial isilates was 171/184 (92.9%).Coagulase negative staphylococci (CoNS)76/184 (41.3%) were the predominant bacterial isolatefollowed by Staphylococcus aureus, Streptococcus Viridianand Klebsiella spp., 67/184 (36.4%),16/184 (8.7%) and 6/184 (3.3%) respectively. The dominant clinical feature was Blepharitis accounting 122/323 (37.8%). Gram positive bacterial isolates were susceptible to, Tobramycin, Gentamycin, chloramphenicol, Vancomycin and ceftriaxone. However, 94.0% of these gram positive bacterial pathogens showed resistance to penicillin. Multidrug resistance (MDR) were observed in gram positive and gram negative bacteria isolates 136/184 (67.4%)and 12/13 (92.1%) respectively. Conclusion: Blepharitis was the leadingEOI followed by conjunctivitis. The predominant bacteria species was CoNS followed byS. aureus. The higher prevalence of MDR 135/184 (73.4%)and increasing of MRSA23/67 (34.3%) bacterial pathogens dictates the need for continuous surveillance apart from routine antibiotic susceptibility testing.
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    Bacteriological Analyses of Weaning Foods and Growth Potential of Some Food borne Pathogens in Weaning Foods
    (Addis Ababa University, 1997-06) Erku Woldaregay; Ashenafi Mogessie (PhD)
    One hundred samples of feeding-bottles were collected from infants and young children coming to four clinics in Addis Ababa, from November, 1996 to April, 1997. Information on sex, age, number of bottles used, educational status of the mother and ingredients of bottle content were collected through interview. The bacteriology of these samples was analysed using standard microbiological techniques. The analyses showed that all the samples had heavy bacterial contamination, the mean count being in the levei of 107 c.f.u / ml. Only 17% of the samples had count l'O6 c. f. u /ml. The two most *commonly encountered bottle contents (cow's milk and cereal blend) were the most heavily contaminated. About 52% of the milk and 93% of cereal blend had count more than 107 c.f.u/ml. The contamination level was found to be affected by ingredients of bottles used and educational status of mothers. About 90% of the samples prepared by illiterate mothers had count over 107 c.f.u/ml. The percentages for elementary and high school educated mothers for the corresponding load were 85 and 79, respectively. Three hundred and sixty-nine bacterial isolates, grouped into 12 genera were identified from the bottle content. Thirty-seven per cent of the samples had 3 isolates, whereas 21% and 16% of the samples were contaminated with 4 and 2 isolates, respectively. The dominant organisms were coliforms (34%) followed by Staphylococci (28 %), Bacillus spp . (19%) Micrococcus spp. (14%) and other (3%). Three isolates of Salmonella spp. of the same serogroup were also identified. Cow's milk harboured 219(59%) of the isolates followed by gruel made of cereal blend(16%). A total of 30 factory-produced weaning foods (product A, B and C), and 20 of the two most frequently encountered home-made bottle-contents (cow's milk and cereal blend) were prepared at home by mothers under close supervision. The bacteriological analyses of these foods showed that only 30% of the factory-produced weaning foods had bacterial count over 102 c.f.u/ ml(g). The count from the two home-made bottle contents was also low; only 15% of the samples had bacteria 102 c.f. u/ml. These signifies that food handling and the gap between consumption and preparation must be important in this regard. The organisms isolated from the above 50 samples were Bacillus spp., for they were the only organisms that could tolerate the heat treatment. The growth potential of Salmonella sp. in products 'C' and cereal blend was determined. It was found out that it reached to a level of 107 c.f.u ./ml(g) in 12 hours and 10s c.f.u/ml(g) in 16 hours. If weaning foods have initial contamination of 103 c.f.u./ml (g) (which by itself is beyond the threshold level for infants) it reaches to unacceptably high level within 8 hours (10G c.f.u/mlg)In order to intervene with food borne diseases of infants and children, mothers must be taught of food safety principles. Increasing the number of bottles used to feed infants to three or more could also be helpful in reducing food borne bacterial contamination . More important is teaching and encouraging mothers to consider the use of fermented food products as alternatives, which are cost-effective means of reducing bacterial pathogens in weaning foods.
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    Molecular Epidemiology and Drug-resistance Pattern of Mycobacterium Tuberculosis Isolates from Amhara, Gambella and Benishangul-Gumuz Regions of Ethiopia
    (Addis Ababa University, 2022-03) Yenew Bazezew; Erku Woldaregay; Kebede Abebaw
    Background: Globally, tuberculosis (TB) has affected human beings for thousands of years and the emergence of drug-resistant tuberculosis has been a major obstacle to control the disease, especially in developing countries including Ethiopia. Objective: The study investigated the molecular epidemiology and drug resistance pattern of M. tuberculosis circulating in the Amhara, Gambella and Benshangul-Gumuz regions of Ethiopia. Methods: A cross-sectional study was conducted using 128 MTBC isolates that were obtained from presumptive TB/MDR-TB patients. A total of 127 recovered isolates were used to investigate drug resistance patterns with the indirect proportion method using the MGIT 960 system and the genotypic method at the Ethiopian Public Health Institute. Further, identification of mycobacterial strain types and mycobacterial lineages was done using spoligotyping. Data were managed using the Epi-info, SPSS version 25, SITVIT2, MIRU-VNTRplus and TBInsight databases. Results: Of the 127 recovered mycobacterial isolates, 100 (78.7%) were sensitive to the four firstlineanti-TB drugs, but 27 (21.3%) were resistant to at least one anti-TB drug,20 (15.7%) were poly-resistant, 17 (13.4%) were multi-drug resistant and 2 (10.5%) were Pre-XDR. The highest gene mutations associated with INH and RIF resistance were observed in the katG MUT1 gene (S315T1) [20 (76.9%)] and rpoB gene (S531L) [10 (52.6%)], respectively. Further, the two preXDR cases showed mutations in the gyrA gene. Among the 127 spoligotyped isolates, 119 generated 43 different spoligotyping patterns; 87 (73.1%) generated 26 distinct spoligotype patterns; and 31 (26.0%) generated 17 different spoligotype patterns. The predominantly identified strains, family, lineages and sublineages were the SIT149 (19, 15.9%), T family (54, 45.4%), EuroAmerican (72,60.5%) and CAS1-Delhi (24, 20.2%), respectively. Additionally, Mycobacterium Africanum (12,10.1%) was identified. Furthermore, drug resistance was significantly associated with previous TB history(X2=46.59; p<0,001) and previous TB treatment outcome (X2=47.677;p<0.001). Conclusion: The study identified a significant proportion of drug resistant TB (monoresistance, MDR, Pre-XDR) which could imply the drug resistant TB is a major public health problem in the country. Although a diversified mycobaterium lineages were observed in this study, the Euro American lineage and East-African-Indian lineages were the predominant lineages with the respective CAS1-Delhi and T3-ETH sublineages that are strongly associated with the druresistant TB. Consequently, the country should focuse on the strategies that help for early detection and treatment of drug-resistant TB to halt the transmission of the disease. We recommend further molecular characterization of the unknown mycobacterial isolates, particularly using sequencing platforms and phenotypic drug susceptibility testing to first- and second-line drugs. Besides, the country’s tuberculosis control program should monitor patient adherence to ensure the patients complete the full course of treatment.