Browsing by Author "Asrat, Daniel (PhD)"

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    Prevalence and Antimicrobial Resistance of Bacterial Isolates With Special Emphasis on Enterobacteriaceae Among Children Suspected for Septicemia And Urinary Tract Infection in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2014-05) Hailu, Melese; Asrat, Daniel (PhD)
    Background: Blood stream and urinary tract infections are a major cause of mortality and morbidity of the pediatric population. Extended spectrum beta-lactamase (ESBL) producing and carbapenem resistant enterobacteriaceae is the challenge for controlling now days. Assessing the prevalent bacteria and their antibiotic resistance helps to provide effective therapies, develop rational prescription programs and make policy decisions. Objective: To determine the prevalence and antimicrobial resistance of bacterial isolates with special emphasis on enterobacteriaceae among children suspected for septicemia and urinary tract infection in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia. Method: A cross sectional study was conducted from January 10 to March 30/2014 at Tikur Anbessa University Hospital, Addis Ababa, Ethiopia. A total of 322 study participants who were suspected for septicemia and/or UTI were recruited. All blood and urine samples were cultured on Blood and MacConkey agar. All culture positives were characterized by colony morphology, Gram stain and biochemical tests using the standard procedure. Significant bacteriuria was determined for all culture positive urine samples. Antimicrobial susceptibility test was performed for all bacterial isolates using Kirby-Bauer method. ESBL was detected using combination disk & double disk synergy methods on Muller Hinton agar. Carbapenemase were detected by Modified Hodge method using Meropenem. All demographic & laboratory data were entered to EPI INFO & exported to SPSS version 20 for analysis. Result: The overall prevalence of bacteria isolates from blood and urine cultures was 17.1%. From 177 blood samples 13.0% (n=23/177) and from 145 urine samples 22.1% (n=32/145) were culture positives. Coagulase negative Staphylococci & Klebsiella ozaenae were the predominate bacteria isolated in blood and urine cultures respectively. Most of them 89.1% (n=49/55) developed multidrug resistance (MDR≥2 drugs) to most commonly used antibiotics. Multiple resistances were observed in 71.42% of Gram positive and 95.11% Gram negative isolates. Prevalence of ESBL producing and carbapenem resistant enterobacteriaceae was 78.57% and 12.12% respectively. Conclusion: The choice of drugs in the treatment of bacteria isolates from blood and urine is quite narrow today due to the wide scale resistance to common antibiotics. The emergence of MDR calls for continuous monitoring & reviewing of antimicrobial policy in hospitals and the country at large. Key terms: Septicemia, UTI, Bacterial isolates, antimicrobial resistance pattern, ESBL, Carbapenem resistance, Tikur Anbessa University Hospital, Addis Ababa, Ethiopia
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    Seroprevalence of Helicobacter Pylori Infection in Patients Attending Felege Hiwot Hospital in Bahir Dar, North West Ethiopia
    (Addis Ababa University, 2003-06) Tadege, Tesfahun; Asrat, Daniel (PhD)
    Infection with Helicobacter pylori occurs worldwide, but the prevalence varies greatly among countries and among population groups within the same country. H. pylori, a previously obscure organism, has now been associated with many of the most important diseases involving gastroduodenal tissues. Because dyspepsia is one of the commonest complaints in any Ethiopian Out Patient Department, this study was undertaken to determine the magnitude of H.pylori infection in adult patients with and without dyspeptic symptoms. Overall total of 200 [128(64%) males and 72(36%) females], 100 dyspeptic (48 males and 52 females) and 100 non-dyspeptic (80 males and 20 females) patients attending Felege Hiwot Hospital, Bahir Dar, Ethiopia, were investigated for H.pylori infection between mid November- mid March 2003. Sera obtained from the blood by centrifugation were tested for presence of IgG antibodies against H.pylori antigens using EIA. Of the total 200 studied subjects, 112 (56%) positive, 66 (33%) negative and 22 (11%) were borderlines for H.pylori infection by EIA. Of these 68(53.1%) of males and 44 (61.1%) of females were seropositive for H.pylori infection. There was no statistically significant difference in H.pylori seropositivity between males and females, p>0.05. All sera (200) were also tested for detection of IgG antibobies to specific H.pylori proteins by immunoblot (IB) analysis to confirm EIA results. All sera yielded positive in EIA were positive in IB assay and all sera that were negative in EIA were also negative in IB assay results. Out of 22 borderline results by EIA, 12 (6 males and 6 females) were confirmed to be positive. Combining EIA and IB, the overall seroprevalence of H.pylori in Bahir Dar, Ethiopia was 49- 70% and the seroprevalence of dyspeptics and non-dyspeptics was 63-70% and 49-54%, respectively. There was no statistically significant difference between dyspeptics and non-dyspeptics, P> 0.05. In conclusion, there was no significant difference in the rate of H.pylori infection between dyspeptic and non-dyspeptic patients, sex, ABO blood groups and presence or absence of rhesus factors. But there is insufficient evidence to confirm or refute the existence of difference in the rate of seroprevalence between dyspeptic and non-dyspeptics. The burden of illness due to dyspepsia with respect to quality of life and economic consequences is of considerable from economic, social, and personal vantage points. For this effective, safe, accessible and consistent control strategy is crucial. This study showed that serological methods (EIA and IB) could be used as diagnostic tools to determine the status of H. pylori infection and for epidemiological studies. Because Ethiopia is endowed with different ethnic groups, therefore, serological assays should be evaluated for each particular group and adjusting cutoff value is necessary to use serological tests as a screening tool.