Browsing by Author "Ayenew Zeleke"

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    Enteric Pathogens and Antimicrobial Susceptibility Profile among Pediatric Patients with Diarrhea: A Cross Sectional Study in Selected Health Facilities, Addis Ababa, Ethiopia
    (Addis Ababa University, 2017-06) Ayenew Zeleke; Gebre Selassie; Abebe Tamrat
    Background: Diarrheal disease remains a major public health problem in developing countries including Ethiopia. The current study was designed to isolate medically important enteric pathogens and assess the antimicrobial susceptibility testing of bacteria causing diarrhea in pediatrics for those antibiotics were prescribing in Integrated Management of Childhood illness (IMCI). Methods: Across-sectional study to determine enteric pathogenic microorganisms that cause diarrhea and antimicrobial susceptibility profile was carried out in selected health facilities of Addis Ababa, Ethiopia from November 2016 to May 2017. Stool specimens from pediatric patients aged 0-14 years were collected randomly from two health centers and one specialized hospital to identify enteric pathogens. Antimicrobial susceptibility tests were performed on all bacterial isolates using the Kirby-Bauer disc diffusion method. Results: In this study, the major etiologic agents of diarrhea in pediatrics were intestinal parasites and bacterial infection accounting for 93(32%) and 42(14.5%) respectively. Out of 290 study patients complain of diarrhea examined, E.histolytica/dispar 75(25.8%), G.lamblia 13(4.5%) and H.nana 4(1.4%) were identified. The majority of bacterial enteropahogens isolated in the study were Shigella spp 22(7.6%) followed by enterohemorrgic E.coli O157:H7 13(4.5%), Salmonella spp 7(2.4%). The overall co-infection rate between parasite-parasite, parasite-bacteria and bacteria-bacteria was observed in 12(4.1%) children. All the bacterial isolates from diarrheal patients were 100% susceptible to meropenem, cefepime, azithromycin and showed antimicrobial resistance to ampicillin, Augmentin, trimethoprim-sulphamethoxazole and ciprfloxacillin. Salmonella spp showed resistance to trimethoprim-sulphamethoxazole and chloramphenicol, 42.9% and 14.3% respectively. Another enteric bacteria Shigella spp were resistant to 77.3%ampicillin, 68.2% trimethoprim-sulphamethoxazole and 36.4%Augmentin whereas E.coliO157:H7 resistance anti-biogram showed 69.2%ampicillin,46.1% trimethoprim-sulphamethoxazole,38.5%Augmentin, 23.1%ciprfloxacillin and Amikacin, ceftriaxone and gentamycin were resistant with the same rate of 15.4%.. Conclusion: The results showed that E.histolytica, G.lamblia and H.nana and bacterial isolates Salmonella spp, enterohemorrhagic E.coli O157:H7, Shigella spp were the most frequently isolated pathogens in Children. The most frequently prescribing drugs ampicillin, amoxicillin+clavulic acid and trimethoprim-sulphamethoxazole showed high resistance for Salmonella and Shigella isolates in the study. It was found that ciprofloxacin was the best drug of choice for the treatment of diarrhea caused by Salmonella and Shigella. Chloramphenicol was a drug of choice for the treatment of shigellosis. So it calls more attention to conduct extensive continuous surveillance to revise and update the prescribing policy in Integrated Management of Childhood illness and Clinicians should rely on stool culture and antimicrobial susceptibility testing. Key words: Enteric pathogens, diarrhea, antimicrobial susceptibility, pediatrics, Addis Ababa, Ethiopia