Browsing by Author "Bitew Adane"

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    Antibiotic Resistance Patterns of Gram Negative Fermentative and non Bacilli isolated from patients Referred to Arsho Advanced Medical Laboratory Addis Ababa, Ethiopia
    (Addis Ababa University, 2017-06) Tsige Estifanos; Bitew Adane
    Background: Gram negative bacilli are the most frequently isolated bacteria which recoveredfrom various clinical samples. Conventionally, these microorganisms subdivided into two majorgroups’ fermentative and non-fermentative gram-negative bacteria. The aim of this study is todetermine antibiotic resistance patterns of fermentative and non-fermentative gram negativebacilli from various clinical samples in study area. Method: A laboratory based cross-sectional study conducted at Arsho Advanced Medicallaboratory,AddisAbaba,EthiopiafromJanuarytoApril2017;Study participants were required Urine , CSF, wound, Nasal fluid ,Ear ,Blood, Body fluid,Semen were collected and cultured on Blood agar, MacConkey agar and chocolate agar andincubated according to standard conditions. Then Species identification and antimicrobialsusceptibility testing of gram negative bacteria were determined by automated Vitek 2 compactsystem using GN and AST GN72 card. Result: From the total of 824 various specimens, 284(34.5%) were culture positive , of which (90.8%,258/284) of the isolates were fermentative and (9.2%), 26/284) were non fermentative Gram-negative bacteria from wide range of clinical specimens such as in urine 197(69.4%), in wound andabscess 34(11.9%), in Ear 20(7.0%), in CSF 11(3.87%), in Nasal 11(3.9%), in Blood 4 (1.4%),in Bodyfluid4 (1.4%) and in semen 3(1.1%) .The most common Gram- negative bacterial isolatesbeing Escherichia coli 152(53.5%), followed by Klebsiella pneumonia 40(14.1%), Pseudomonasaeruginosa 13(4.6%), Proteus mirabilis 13(4.6%), Acinetobacter baumannii 8(2.8%) were themost dominant isolate respectively. Among gram negative bacteria, K.pneumoniae (82.5%),E.coli (82.9%), P.aeruginosa (100%), and A. baumanii (100%) were multi drug resistance. Concussion: High antimicrobial resistance and multi drug resistance was demonstrated over thestudy period, which may be due to associated with the improper antibiotic consumption or lackof a proper guideline for empirical therapy. Keywords: Antibiogram, Enterobacteriaceae, fermentative and non-fermenting gram-negativebacilli, antimicrobial susceptibility test and antimicrobial resistant
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    Antifungal Metabolites from Submerged Culture of Ganoderna Lucidum (Polypore)
    (Addis Ababa University, 1991-06) Bitew Adane; Abate Dawit (PhD)
    About 60 different basidiomycete cultures were screened for antimicrobial secondary metabolites in submerged culture grown in four different media. Ten (17%) of them produced antimicrobial secondary metabolites. Production medium, duration of growth, and the most susceptible test organisms for each producing strain were established. Among basidiomycetes screened for antimicrobial activity, the culture filtrate extract of the Ethiopian strain of the polypore, Ganodemw lucidum produced the most effective antifungal compounds. The cu/~lral characteristics, growth in submerged culture of the polypore and isolation methods of the two antifungal antibiotics are described. Medium A (Yeast extract malt extract glucose medium) was a better medium for the production of the two antifungal agents. These compounds were released to the culture fluid and the maximum amount of antifungal compounds is obtained after 12 days of submerged growth at 120 revolution per minute (rpm). TIle two antifungal metabolites (20lA and 201B) isolated from culture filtrated were biologically characterized. TIlese metabolites had a wide spectrum of antifungal activity and affect the growth of several saprophytic as well as pathogenic fungi. The minimal inhibitory concentration (MIG) of 20lA against Candida albicans and Candida pseudotropicalis was less than 1 mcg/ml and 1-5 mcg/ml respectively. Inhibition diameter zone of 36 mm was produced when 10 mcg/disc of 20lA was applied on agar medium seeded with AspergHlus flavus. 20lA was also a potent inhibitor of spore gemlination. No spores of Aspergillus niger were germinated at a concentration of 10 mcg/ml of the antibiotic. Bacteria were affected only at high concentration. Antibiotic 20lA was more active than antibiotic 201B. A comparison of antifungal activity against dennatophytes showed that the efficacy of 20lA was comparable to griseofulvin. Treatment of sheep erythrocytes with the two antifungal antibiotics up to 100 mcg/disc did not show any lytic effect on sheep red blood cel/s. Application of 1 mg/1Ocm' of cn/de extract on a shaved rabbit skin showed no demlatotoxic reactions.
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    Antimicrobial Susceptibility Pattern of Bacterial Isolates From Wound Infections at all Africa Leprosy, Tuberculosis and Rehabilitation Training Center, Addis Ababa Ethiopia
    (Addis Ababa University, 2017-06) Tessema Asdesach; Bitew Adane
    Background: Wound develops into an infected state when the balance between microorganismand the host shifts in favour of the micro-organism. Antimicrobial resistance occurs whenbacteria change in some way that reduces or eliminates the effectiveness of drugs. Objective: The main objective of this study was to isolate etiology of wound infections anddetermine their antimicrobial susceptibility pattern. Methods: A cross-sectional study was conducted at ALERT Center from February to May 2017.Swabs from different types of wounds was taken and processed to isolate etiologic agents byusing standard microbiological techniques. Antimicrobial susceptibility tests were performed bydisc diffusion technique as per the standard modified Kirby-Bauer method. Results: In this study 171 bacterial isolates were recovered from 188 specimens showing anisolation rate of 86.2%. The predominant bacteria isolated from the infected wounds wereStaphylococcus aureus 96 (51.1%) followed by Klebsiella pneumoniae 26 (15.2%), Escherichiacoli 23(13.4%). Out of 162 positive samples 9(5.5%) were mixed infections. Staphylococcusaureus exhibited highest sensitivity against Clindamycin (95.8%), Gentamycin (94.8%),Chloramphenicol (92.7%), Ciprofloxacillin (89.6%) and Cotrimoxazole (84%). Gram negative isolates, E.coli, P.vulgaris, P.mirabilis, P.aeroginosa and Citrobacter showed the highestsensitivity against Amikacin (100 %). E.coli showed high resistance for Ampicilin (95.7%) andAugumentin (91.3%) where as P.vulgaris showed 100% resistance for Ampicilin and 90.9 % forTetracycline. Conclusion: There was high prevalence of bacterial isolates in this study. S. aureus was thepredominant isolate 96 (56.1%). Most of the isolates showed high resistance to commonly usedantimicrobials. The antimicrobial profile of drugs demonstrated that the commonly prescribeddrugs against Gram positive bacteria (Penicillin, Tetracycline) and Gram-negative bacteria(Ampicillin and Tetracycline) as a single agent for empirical treatment of wound infectionswould not cover the majority of wounds infections. Antimicrobial treatment should be based on the result of culture and sensitivity. Keyword: wound infection, bacterial isolates, drug resistance pattern.
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    Antimicrobial Susceptibility Profile of Bacterial Uropathogens Isolated from Pediatric Patients at Yekatit 12 Hospital Medical College
    (Addis Ababa University, 2014-05) Merga Yamirot; Bitew Adane
    Background: Urinary tract infection (UTI) is considered as the most commonbacterial infectious disease seen among the pediatric patients. Objective:This study was carried out in order to determine the antimicrobialSusceptibility Profile of Bacterial Uropathogens Isolates from Pediatric Patients at Yekatit 12Hospital Medical College Materials and Methods Clean voided mid-stream urine specimens were obtained frompatients in sterile universal bottles. Urine collected from each patient was inoculated ontoCLED and blood agar plats using calibrated inoculating loop with a capacity of 0.001ml,Inoculated plates were incubated for 24- 48 hours at 37°C at inverted position aerobically.Bacterial isolates were characterized/ indented by gram stain and by using an array ofstandard routine biochemical test. Antimicrobial susceptibility test was carried out by usingthe Kirby Bauer disc diffusion. Result: The data was analyzed by using SPSS, version 17. Descriptive statistics wascomputed for most of the study variables and Frequency distribution tables were used todescribe the findings. In this study a total of 384 pediatric patients (199 males and 185females) aged between 0 years to 15 years from whom urine sample were collected wereenrolled. Of these patients, 61 (15.9%) had significant bacteriuria. Of the 185 females, 36(19.5%) have positive cultures while 25 (12.6%) of the 199 males had significant bacteriuriaand the largest number of study subjects were below age 3 years and the largest positiveculture was obtained from this age group, accounting 35 (57.4%.) out of 61 positive culture.Bacterial species belonging to six generawere isolated and identified from 61 positivecultures and the genera were Escherichiai, Klebsiella, Staphylococcus, Proteus, Acnitobacterand Entrococcus. and E. coli was isolated in 28 cases (28/61, 49.5 %), followed by Klebsillaspp. in 17 cases (17/61, 27.9%), Staphylococcus spp. in 5 patients (5/61, 8.2%.) ( S. aureus inone and coagulase negative staphylococci in 4 case), Entrococcus in 7 case (7/61, 11 5%),Proteus spp. in 3 cases (3/61, 4.9%) ) and Acenitobacte in one case (1/61,1.6%). Of bacterialisolates E. coli was found out to be the most common pathogen followed by Klebsiella spp..Furthermore E. coli and klebsiella spp. were the most common pathogen in female patientsaccounting 71. 4% and 64.7% respectively. percentage resistance of Klebsilla spp was muchhigher when compared to E.coli. Eighty eight percent of Klebsiell spp. were resistant tocefotaxim, ceftazidim, trimetroprimsulfamethoxazole and cefuroxime. Acentobacter spp. was100% resistances to gentamicin,trimetroprimsulfamethoxazole , agumentin, and nalidixicacid . But they were 100% susceptible to ciprofloxacin, cefuroxime , norfloxacine,cefotaxim,chloramphenicol and ceftazidim . On the other hand, proteus spp. were 100%sensitive to all drugs except nitrofurantion. Species of Entrocuccus were resistance of 71.4%to chloramphenicol and 85.7% to both trimetroprimsulfamethoxazole and ErythromycinS .aurueswas100%susceptibletociprofloxacin,cefuroxime,gentamicin, trimetroprimsulfamethoxazole, chloramphenicol, Clindamycine and Ceftriaxone while coagulase negative staphylococci were resistance to all of the above drugs except Clindamycine and gentamicin . Multidrug resistance to two or more drugs was observed in73.7% of bacterial isolates. Conclusion: This study determines the antimicrobial Susceptibility Profile of BacterialUropathogen Isolates from Pediatric Patients and highlighted the majorbacterial uro-pathogens involved in UTI up to my knowledge for the first time in the country. Furthermore,species bacterial pathogens and their frequency was consistent with the usually reportedpattern, with E. coli being the most common organism isolated followed by Klebsiella. Spp.In this study Majority of gram negative species were susceptible to ciprofloxacin,norfloxacine and nitrofurantion (exceptproteus spp) and gram positive species weresusceptible to ciprofloxacin Clindamycine and gentamicin so this drugs can be used to treatUTI in children however Most of bacterial isolates were multidrug resistant and it is thereforesuggested that appropriate antimicrobials should be administered to reduce the risk of multidrug resistant organisms developing and avert ineffectiveness of antibiotics
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    Assessment of Diagnostic Performance of Abbott Real Time PCR for the Detection of Smear Negative Pulmonary Tuberculosis at Ethiopian Public Health Institute, Addis Ababa Ethiopia
    (Addis Ababa University, 2018-11) Hailu Million; Bitew Adane; Teklebirhan Gebreab; Kebede Abebaw
    Background: In 2016, an estimated 10.4 million people developed TB and of these more than 1.6million died from the disease, 374,000 (22%) of whom were HIV-positive. In most of the highburden of tuberculosis but resource poor countries, microscopy method issued in which acidfastbacilli are detected in smear using a light microscope. However, smear microscopy is not soreliable. As of other most advanced tests, molecular techniques still not implemented indeveloping countries including Ethiopia. To improve MTB case detection rate, there is a need tointroduce and implement rapid batch testing molecular methods in Ethiopia. Objective: The objective of this study was to assess the performance characteristics of Abbott realtime for the diagnosis smear negative MTB Methods: Both prospective and retrospective cross-sectional survey was carried out to enroll 127study participants’ records along with left over sputum specimens in Addis Ababa, EPHI nationalTB/HIV laboratories from March to May 2018. Performance characteristics including sensitivity,specificity and predictive values was calculated by using SPSS version 23 with 95% CI. For allstatistical significance tests, the cut-off point was 0.05 and p < 0.05 considered as statisticallysignificant association with testing performance. Results: Diagnostic sensitivity of Abbott real time for the diagnosis of smear negative was 82.9%and specificity exhibited 89.1%. Drug susceptibility testing demonstrated diagnostic specificity of87.5% and 100% for INH and RIF respectively. Abbott real time performance significantly andnegatively associated with month of treatment [Adjusted OR (95%CI) = 0.01 (0.00. 0.41)] for 1stto 6th month, 0.005 (0.00, 0.20) for 7th to 12th months and 0.001 (0.00, 0.90) for the clients ontreatment for more than a year Conclusions: The diagnostic sensitivity of the method for identification of MTB and drug resistancesensitivityand specificity similar with the previous similar studies. The method exhibited lowerspecificity for the diagnosis smear negative MTB cases. The finding also revealed the specificity ofAbbott real time the lowest as of other molecular methods for the diagnosis of smear negative MTBcases who are on MTB treatment. Therefore, we strongly recommend not to use the method for allfollow-up MTB cases except zero month and further investigation should be continued to explainexhaustively the effect of explanatory variables on Abbott MTB performance.
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    Bacterial Etiology of Blood Stream Infections, Multidrug Resistance and Extended Beta Lactamase Producing Isolates among Patients Referred to Arsho Advanced medical Laboratory.
    (Addis Abeba University, 2021-09) Abera Misgana; Bitew Adane
    Background: Blood stream infection is one of the most important causes of morbidity andmortality globally. Staphylococcus aureus, coagulase negative staphylococus, Streptococcuspneumonia are major Gram- positive bacteria in causing blood stream infection. Escherichiacoli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii are majorGram-negative bacteria in causing blood stream infections. Development of multidrug resistancein major bacteria has increased the morbidity and mortality rate of blood stream infection. Objective: To determine bacterial etiology of blood stream infection, the prevalence ofmultidrug resistance,XDR, Pan drug resistance and extended spectrum beta lactamase productionof bacterial isolates.Methods:The present study was a laboratory based cross sectional studyconducted at Arsho Advanced Medical Laboratory, Addis Ababa Ethiopia from Dec 2020 toJune 2021.A total 0f 422 blood sample was collected and inoculated onto primary isolationfollowing standards protocols. Species identification and antimicrobial susceptibility testing ofbacteria were determined by automated Vitek 2 compact system (Bio Merieux,France) by usingAST,GN72 card for gram negatives and AST,GP71 card for gram positive bacteria. Results: Out of a total 422 samples processed, bacterial pathogens were isolated from 67(16%)samples. Among the isolates,40(59.7) were gram-negative and 27(40.3) were gram-positivebacteria. Klebsiella spp and Coagulase negative staphylococci were the dominat isolates. Ofthese isolates, 6 (60%) were ESBL positive for K.pneumonae,1(50%) for K.oxytoca and4(66.7%) for E.coli.Penicillin(90.2%) was the least effective antibiotic against Gram-positive bacteriawhileAmpicillin(87.5%) were the least effective antibiotic against Gram-negativebacteria.Piperacillin(92.5%) were the most effective antibiotic against Gram-negative andTigecycline(91.7%) were the most effective antibiotic against Gram-positive bacteria. Out of 40isolate of Gram-negative bacteria 21(52.5%) were MDR and from 27 isolates of Gram-positivebacteria16 (59.3%) were MDR.Conclusion: The magnitude of blood stream bacterial infectionand the prevalence rate of multi-drug resistant bacterial strains causing blood stream infectionswere high. These findings were warranted the need for the continuous investigation of bacterialblood stream infection.
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    Bacterial Vaginosis and Vulovvaginal Candidiasis Among Women Complaining Genital Tract Infections at St. Paul Hospital Millennium Medical College and Family Guidance Association of Ethiopian Model Clinic, Addis Ababa, Ethiopia, 2016
    (Addis Ababa University, 2016-10) Abebaw Yeshiwork; Bitew Adane
    Background: Bacterial vaginosis and vulvovaginal candidiasis are major health problemsassociated with gynecologic complications Objective: To determine the prevalence bacterial vaginosis and vulovvaginal candidiasis amongwomen complaining genital tract infection at SPHMMC and FGAEMC Addis Ababa, Ethiopia. Methods: A health facility based cross sectional study was conducted from February,2016 toJuly, 2016. Demographic variables were collected using a structured questionnaire. Two vaginalswab specimens were collected from each participant. For diagnosis of bacterial vaginosis ,gramstain Nugent score was used. All fungal and bacterial pathogens were isolated and characterizedby employing conventional techniques. Antimicrobial susceptibility profile of bacterial isolateswas Performed using disc diffusion technique as per the standard Kirby-Bauer method. Theresults were analyzed using SPSS version 20. Result: The overall vaginal infection was 70% .The overall prevalence of bacterial vagnosis was102(48.6%).Bacterial vaginosis was statistically significant associated with odor (p=0.007),frequency vaginal bathing (p=0.045) and frequency of changing of pants (p=0.01). The overallprevalence of vulvovaginal candiasis was 87(41.4%).Vulvovaginal candidiasis was statisticallysignificantly associated with illiterate patients (p=0.021), number of life time male sex partner(p=0.037), number of sex partner in the last 12 months (p=0.001) and with previous bacterialvaginosis (p= 0.004). A total 151 bacterial isolates were recovered, of which 105(69.5%) of theisolates were gram negative and 46 (30.5%) isolates were gram positive bacteria. The overalldrug resistance rates of gram negative bacterial isolates ranged from 14.3% to Amikacin 77.3%to Tetracycline. The overall drug resistance rates of gram positive bacterial isolates ranged from0% to vancomycin and 67.4% to penicillin. Conclusion and recommendation: Both bacterial vaginosis and vulvovaginal candidiasis washigh and hence many such types of studies are recommended to be conducted across the country. Keywords: Bacterial Vaginosis and Fungi isolate
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    Bacterial and Fungal Infection and their Drug Susceptibility Pattern in Burn Patients Admitted to Yekatit 12 Hospital Medical College and AABET Hospitals
    (Addis Abeba University, 2021-06) Garedew Andualem; Bitew Adane; W/Senbet Zerihun
    Background: Managing the burn wound is necessary to heal the wound early but the infectedone not only needs appropriate management of burn therapy, in addition to that, doing culture forthe potential bacteria and their antimicrobial susceptibility pattern necessary. Furthermore Largewound surface, impaired immune systems, and broad-spectrum antibiotic therapy contribute tothe growth of opportunistic fungal species. Mycosis in burns is likely to be underestimated. Objectives: To determine the magnitude of bacterial and fungal infections and the irantimicrobial susceptibility pattern of burn patients at Yekatit12 and AABET Hospital, AddisAbaba, 2021. Methods: A cross-sectional study was conducted in Y12HMC and AABET hospital fromJanuary to June 2021. Burn Wound swab specimen was collected using sterile cotton swab andprocessed and analyzed for bacteriological and fungal culture medias like Potato dexterous agar,Chrome agar, Blood agar, MacConkey agar, Biochemical test and AST. The data was analyzedusing SPSS version 25. Results: 240 burn patients were included in the study a total of 154(64.2%) bacterial pathogenswere recovered. Among the isolated 154 (64.2%) bacteria 110 (71.4 %) were gram-positive and44 (28.5 %) gram-negative bacteria. From gram-positive bacteria, predominant bacteria isolateswere CoNs 55 (22.9 %), followed by S.aureus 54 (22.5%) while gram Negative bacteria isolatedthe most predominant bacteria were Pseudomonas aeruginosa 17(7.1%)from 66 (27.5%).Fungus isolation 38 (57.5%) were yeast and 28 (42.2 %) mold .The susceptibility patterns ofisolates 60% of resistance to the antibiotics tested. Klebsiella species demonstrated high level ofresistance to Ampicilin and ceftazidime each 5(100%), Tobramycin, ciprofloxacin andgentamicin each 3(60%). Amikacin was relatively effective against 23(95.8%) of the Klebsiellaspecies. CONCULUSION: The wounds were contaminated with various types of bacteria. This might bea reflection of inappropriate use of antibiotics. The presence of MDR in the wound may be afactor for persisted infection. Some of the participants in the study area had a positive fungalresult. It is not contemptible it an alarming finding that needs more focus and follow-up on thefungal infection.
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    Bacterial and Fungal Pathogens from External Ocular Infection at St. Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia
    (Addis Ababa University, 2016-10) Aklilu Addis; Bitew Adane
    Background:-Ocular infection is a major public health problem in developing countries.Bacteria and fungi associated with external ocular infection are responsible for increasedincidence of morbidity and blindness worldwide. Objective:-The aim of this study was to determine the profile of bacterial and fungal pathogensfrom external ocular infection at St. Paul HospitalMillennium Medical College, Addis Ababa,Ethiopia. Methodology:-A cross sectional study conducted using convenient sampling technique. A totalof 215 patients recruited from April to August, 2016. Conjunctival and eyelid margin swabs andcorneal scraping were collected. Demographic data were collected using structured questionnaire. All Specimens were processed for microbiological analysis as per standardprocedures and antibiotic susceptibility test was done using disc diffusion technique. The datawas analyzed by using SPSS version 20 and appropriate statistical tools were used. Result: - A total of 215 patients were enrolled in this study. Of which 133(61.4 %) were culturepositive. Of this 118(54.9%) and 24(11.2%) were bacterial and fungal pathogens respectively.There were 9 (6.8%) bacterial and fungal co-infections. Majority were males 109 (50.7%). Themean age of the study participants was 42.34 (Sd. +20.55) and majority of participants age werewithin the age range of 25-44 years 72(33.5%). Majority had conjunctivitis 87(40.5%) followedby blepharitis 48(22.3%). The predominant bacterial pathogen isolated were gram positives88(74.6%). Of this S. aureus 32(27.1%) was the commonest isolate and K. pneumoniae 9(7.6%)was the predominant from gram negative bacterial pathogens. Aspergillus species 14(58.3%)were the most predominant fungal isolates. Gram positive cocci and gram negative rods werehighly resistant for Penicillin 66/88(75%) and Ampicilin 20/27(81.5%) respectively. 71.2% ofMDR bacteria were isolated. There was statistically significant association between prevalenceof bacterial isolates and age variation (P=0.023) and trauma with fungi prevalence (P=0.002). Conclusion:-The prevalence of bacterial and fungal pathogens was higher among external ocularinfection. The drug resistance among ocular bacterial infection was also higher. Keywords: - External ocular infections, conjunctivitis, blepharitis, keratitis, dacryocystitis,susceptibility
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    Bacterial and Fungal Profile, Antibacterial Drug Susceptibility Pattern, and Associated Factors of Isolates Recovered from Kidney Transplant Recipients' Urine Samples at Saint Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia.
    (Addis Abeba University, 2021-09) Tesfaye Lemlem; Bitew Adane
    Background: Urinary tract infections (UTIs) are the most infections in renal transplantrecipients and it has serious consequences in several countries including Ethiopia. Objective: To determine the bacterial and fungal profile, antibacterial drug susceptibilitypatterns and risk factors for urinary tract infections caused by bacteria and fungal etiologicalagents from urine of kidney transplanted patients at SPHMMC Addis Ababa, Ethiopia. Method: A hospital-based cross-sectional study was conducted from Novemb2021. A structured questionnaire was used to collect data on socio-demographic factors andclinical conditions. Blood, MacConkey, and brain heart infusion agar were used to culture allurine samples. Gram stain, biochemical tests, and chromagar for yeast were used to characterizeall culture positives were done according to the standard technique. All bacterial isolates weretested for antibiotic susceptibility using the Kirby-Bauer method. The possible risk factors wereassessed using simple and multivariate logistic regressions. Results: 63 pathogenic microorganisms were found in 207 clinical specimens. Gram negativebacteria accounted for 63.5 %, Gram positive bacteria for 23.8% and fungal isolates represented12.69 %. The most common bacteria identified in urinary tract infections (UTIs) were E. coli,Klebsiella pneumoniae, and Coagulase negative staphylococcus. Candidia krusei and Candidiaalbicans was among fungal isolates. Multidrug resistances were observed among 82% of Gramnegativebacteria. The highest rates of antimicrobial resistance were observed inAminoglycosides and 3rd generation cephalosporins. Carbapenem, Nitrofurantoin, Nalidixicacid, Amikacin and Fluoroquinolones were the most effective antibiotic to treat UTIs. Conclusion: Candidia albicans and Candidia krusie funguria were shown to be prevalent UTIsin people who had their kidneys transplanted, according to the study. Bacterial isolates showedresistance to commonly used antibiotics. These data are essential for identifying future potentialprevention strategies against UTI in kidney transplant recipients, as well as the causal agent,related factor and antibiotic resistance pattern.
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    Bacterial Bloodstream Infections and their Antimicrobial Susceptiblity Pattern among Hiv/Aids Patients At Felege Hiwot Referral Hospital, Bahir Dar, Amahara Regional State, North West Ethiopia
    (Addis Ababa University, 2017-04) Jemal Mohabaw; Bitew Adane
    Background: Bacterial bloodstream infections are important opportunistic infections which causehigh morbidity and mortality among HIV infected individuals. Bacterial bloodstream infectionsamong HIV/AIDS Patients in Ethiopia is poorly known. Therefore, determining the etiologicalagents of bacterial bloodstream infections and their in vitro antimicrobialsusceptibility patternamong HIV infected patients in Ethiopia is one of the highest priorities. Objective: The aimed of this study was to determine the extent of bacterial bloodstream infectionsand their in vitro antimicrobial susceptibility pattern among HIV/AIDS patients attending ART-clinic from July 15, 2016 to December 15, 2016 G.C at Felege Hiwot Referral Hospital, Bahir Dar,Amhara National Regional State North West Ethiopia. Methods and Materials: A hospital based cross sectional study was conduct among 384 HIV/AIDS patients attending ART- clinic at Felege Hiwot Referral Hospital during the studyperiod. Venous blood samples were collected under strict aseptic condition. Collected bloodsamples were inoculated on blood culture bottles and incubated aerobically at 37o c for seven daysfor the presence of visible sign of microbial growth. Sub cultures were done on the BAP, CAP andMAC (Oxoid). Microorganisms were isolated and identified using standard biochemicaltechniques. Antimicrobial susceptibility tests for each isolated bacteria were determined by discdiffusion method. Quality of the data was assured through standard operational procedures (SOPs).Data was entered, checked for completeness and analyzed using SPSS version 20. Result: This study confirmed that among HIV/AIDS patients, 123 (32%) were infected withbacteremia. Prevalence of blood stream infection was higher in 1-14 years of age group (53.8%)than other age group. Higher percentage of positive blood culture isolates among HIV/AIDSpatients having CD4 count of <200 cells/μL (76.5%) and used of intravenous catheter (68.6%).Themajor isolates were Staphylococcus aureus 49.3% (38/77), Coagulase Negative Staphylococcus35% (n=27/77) and Klebsiella pneumoniae 41.3% (19/46). Majority of isolates 50(40.7%) wereresistant to five and above antimicrobial agents Conclusion: Prevalence of bacterial blood stream infections (32%) among HIV/AIDS patients washigher in this study. Positive blood culture isolates was higher among hospitalized HIV/AIDSpatients with intravenous catheter and low CD4+ lymphocyte count. The most leading pathogenswere S. aureus, CONS and K. pneumonia and majority of isolates were multidrug resistant bacteria. Key words: Bacteremia, HIV, Antimicrobial Susceptibility patter
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    Bacterial Etiology of Bloodstream Infections, Prevalence of Multidrug Resistance and Extended Beta Lactamase Production among Patients Referred to Arsho Advanced Medical Laboratory.
    (Addis Ababa University, 2019) Sodere Seble; Bitew Adane
    Background:Bloodstream infection is one of the most important causes of morbidityand mortalityglobally. Staphylococcus aureus, coagulase negative staphylococci ,Streptococcus pneumonia aremajor Gram- positive bacteria in causing blood stream infectionEscherichiacoli,Klebsiellapneumoniae, Pseudomonas aeruginosa,Acinetobacterbaumannii are major Gramnegativebacteria in causing blood stream infections. Development of multidrug resistance inmajor bacteria has increased the morbidity and mortality rate of blood stream infection. Objective: To assess the distribution of bacteria implicated in causing blood stream infections andprevalence of their multidrug resistance profile and Extended spectrum betalactamase production. Method: The present study was a laboratory based cross-sectional study conducted atArsho Advanced Medical laboratory, Addis Ababa, Ethiopia from January to April 2019; Atotal of 422 blood samples was collected and inoculated on to primary isolation culture followingstandards protocols. Species identification and antimicrobial susceptibility testing of bacteriawere determined by automated Vitek2 compact system (bio Merieux, France) using AST, GN72card for gram negatives and AST,GP71 card for gram positive bacteria. Result :Out of a total of 422 samples processed, bacterial pathogens were isolated from89(21.1%) samples. Among the isolates, 52 were Gram- positive and 37 were Gram negativeBacteria Coagulasenegative staphylococci and Klebsiellaspp were the dominant isolates.Penicillin (92.3%) was the least effective antibiotic against Gram-positive bacteria whilecephalotin (91.1%) and cephazolin (89.2%) were the least effective antibiotic against Gramnegativebacteria. Linzolid and Tigcyclne(98.1%) were the most effective antibiotic against Grampositive and piperacillin(86.1%) were the most effective antibiotic against Gram-negativebacteria, Out of 52 isolate of Gram-positive bacteria 30(57.7%) were MDR and out of 37 isolatesof gram negative bacteria 20(54%) were MDR. Conclusion:The magnitude of blood stream bacterial infection and the prevalence rate of multid rugresistant bacterial strains causing blood stream infections were high. These findingswarranted the need for continuous investigations bacterial blood stream infection.
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    Bacterial Etiology, Antimicrobial Susceptibility Patterns and the Prevalence of Nosocomial Infection in Different Clinical Sample from Patients Attending Intensive Care unit in Tikur Anbessa Hospital,Addis Ababa,Ethiopia
    (Addis Ababa University, 2019-06) Mohammed Jemal; Bitew Adane; Teklebrahan Gebreab
    Background: Nosocomial infections are widespread health problems in the world including in developed and developing countries which are the most important aggravating agents of mortality, morbidity, length of hospital stay and cost in the world. Nosocomial infections are becoming difficult to treat due to the increasing trend of antibiotics resistance, especially the critically ill patients in the intensive care unit (ICU). Relatively, few data are available from Ethiopia to indicate present health care associated infections (HAIs) status of situation. Objective: To determine bacterial etiology, antimicrobial susceptibility patterns and the prevalence of nosocomial infection in different clinical sample from intensive care unit patients in Tikur anbessa hospital Methods: A cross-sectional study was conducted from January to December 2018 in intensive care unit of Tikur Anbessa Specialized Hospital. Among 612 patients admitted to intensive care unit, 192 study participants (patients) who were suspected of bacterial nosocomial infections were included based on WHO guidelines for nosocomial infections using convenient sampling technique. Bacteria were isolated using culture and biochemical tests. Antimicrobial susceptibility testing was performed using Kirby-Bauer disc diffusion method as per CLSI. ESBLs confirmation was done by double disk synergy diffusion method. Data was analyzed with SPSS version 23.0. Results: During a 12 months period from January to December 2018, 612 patients admitted to intensive care unit to Tikur Anbessa Hospital were studied for prevalence of nosocomial infection. A total of 192 patients were selected based on their clinical ground as per WHO 2002 guidelines. Total 14 % (87/612) patients were confirmed by culture to have nosocomial infection. Of the 77 patients were 70.1 %( 61) male and 29.9% (26) females. The distribution of nosocomial infection among positive cases was blood stream infection (38.5%). Respiratory tract infection(20.2%),urinary tract infection(17.4%) and surgical site infection(11.0%).A total of 109 bacterial strains were isolated ,K.pneumoniae accounted for (26.6%) of total isolates, followed by Acinitobacter spps (17.4%), E.coli (16.5%) and CoNS (9.2%). A large majority of bacteria isolates (82.6%) were gram negative. High multi drug resistances (MDRs) bacteria were observed in ICU and Overall, multi drug resistance was observed in 71.6 %( 78/109) of isolates. Gram positive and Gram negative isolates showed 52.6% and 75.6% MDR respectively. Both Gram-positive and-negative isolates expressed resistance to most of the penicillin and cephalosporins tested. Amikacin and Meropenem were the most effective antibiotics against gram negative bacteria isolates (except Acinitobacter spps). Acinitobacter Spps showed highly resistance for most drugs including amikacin and meropenem.High rates of the extended spectrum beta lactamases (ESBLs) of K. pneumonia and E. coli were observed (31.9% and 21.3% respectively). Low rates (1.8%) of methicillin resistant staphyloccus aures (MRSA) was observed, whereas no vancomycin resistance Enterococcus spps were detected.
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    Bacterial Profile And Antimicrobial Susceptibility Pattern Of Blood Culture Isolates At Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2017-03) Eshetu Seneshat; Bitew Adane
    Back ground: Bloodstream infections are major health problems that lead to morbidity andmortality of patients unless treated with appropriate antimicrobial treatment. Drug resistance ofbacterial pathogens is challenging to alleviate sepsis. Blood culture is a gold standard techniquewhich provides essential information for the diagnosis and proper medication. Objective: The Aim of study was to assess bacterial profile and antimicrobial susceptibilitypattern of blood culture isolates at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia Method: A cross-sectional study was conducted from April 2016 to September 2016. Usingconvenient sampling technique a total of 422 blood sample were collected from study participant who were suspected for blood stream infection. Bacterial isolates were identified by colonymorphology, gram staining reaction, biochemical tests such as catalase, coagulase, optochin,PYR, triple sugar iron agar (TSI), citrate utilization, urease, motility, Indole were used forbacterial identification and susceptibility to antibiotics was done using Kirby Bauer discdiffusion technique method according to CLSI guidelines in Microbiology Laboratory of TikurAnbessa Specialized Hospital. The data were analyzed by using SPSS version 20. Result: About 66(15.6%) microbial were isolated. Out of this 64 (96.9%) were bacterial and2(3.03%) were fungal (Candida albicans) isolates. The predominant bacterial isolates wereS.aureus (22.72%) and K.pneumoniae (16.66%). Gram positive cocci were highly resistance toPenicillin (86.7%), followed by Ceftriaxone (46.7%), and 40% were MRSA.While clindamycin(80 %), erythromycin (73.3%), and Trimethoprim-Sulfamethoxazole (66.7%) were effectiveantibiotics. Most of gram negative rods were highly resistance to ampicillin (85.7%), amoxicillinclavulanic acid (77.14%), Ceftriaxone (75%), and Ceftazidimen (62.8%). Nevertheless amikacin(97.1%), meropenem (91.5%), and ciprofloxacin (77.1%) were sensitive antibiotic. Most ofbacterial isolates (73.4%) were multidrug resistance to most frequently used antibiotics. Conclusion: Overall, there was a high prevalence of blood stream infection with high resistancerate to the most commonly used antibiotics. Hence, timely investigation of blood streaminfection and regular surveillance of antimicrobial resistance pattern is important to reducemorbidity and mortality due to blood stream infection. Keywords: Blood stream infection, Bacterial profile, Antimicrobial sensitivity pattern
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    Bacterial Profiles and Drug Resistance Patterns of Bacteria Recovered from Blood Samples of Hospital Admitted Patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2023-06) Tamere Eleni; Bitew Adane; Mitiku Mequanint
    Background: One of the leading causes of illness and mortality worldwide, bloodstreaminfections are frequently acquired in hospitals. As a result of the circulatory system's rapid spreadof microorganisms and their toxins, it is a serious, perhaps fatal illness that gets worse with time. Objective: To determine bacterial isolates and drug resistance patterns of bacteria recoveredfrom blood samples of hospital-admitted patients at Tikur Anbessa Specialized Hospital, AddisAbaba, Ethiopia. Methods: A cross-sectional study was conducted between January 2021 and December 2022among hospitalized patients at Tikur Anbessa Specialized Hospital in Addis Abeba, Ethiopia,who were suspected of having septicemia. To isolate the bacteria, blood samples were taken.Bacterial culture was conducted following standard microbiological procedures. Agar diffusionwas used to isolate bacteria, and the Kirby-Bauer disc diffusion technique was used to determinedrug susceptibility patterns on Muller Hinton agar. Data input and processing were conducted using version 26 of the Statistical Package for Social Science. Results: The study included 218 paired samples in total, and 66 (30.3%) of the blood samplescontained positive bacterial growth. Gram-positive and Gram-negative bacterial isolates werefound in 62.2% and 37.8%, respectively, of positive blood culture findings. Staphylococcusaureus (34.8%) and coagulase-negative Staphylococcus (15.2%) were the two most commonlyencountered gram-positive bacteria. Among gram-negative bacteria, the majority were Escherichia coli (15.2%) and Klebsiella pneumoniae (10.6%). E. coli and Klebsiella pneumoniaewere resistant to most antibiotics, whereas Staphylococcus aureus was identified as beingresponsive to oxacillin (78.1%) and resistant to penicillin (73.9%). Conclusion and Recommendation: This study identified a higher number of positive bacterial growths and resistance to penicillin and cephalosporin found for most bacteria. Therefore, thereis a need to perform blood cultures and sensitivity tests before empirical treatment and alsoimplementation of infection prevention should be strengthened.
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    Characterization of Dermatophytes and Non-Dermatophytes Isolated from Patient with Onychomycosis, Attending at Rank Dermatology Clinic, Addis Ababa, Ethiopia.
    (Addis Abeba University, 2021-03) Osman Feruza; Bitew Adane
    Background: Onychomycosis a chronic nail infection caused by dermatophyte, yeast, and non-dermatophyte molds, is one of the most usual forms of people disease, Onychomycosis in adultscontribute around 50% of wholly nail illnesses. Nail mycoses give until 2-9% global and itsoccurrence is regularly growing mainly in poor state. Even though Onychomycosis is minorillness, it affects patient psychology and also it is expensive disease by means of absenteeism fromjob due to seeking medication and also it has job discomfort. Regardless of recent advanced in thedevelopment of anti-fungal drugs and therapy Onychomycosis is still difficult to treat conventionaltreatments often fail and it has been suggested that many reasons such as age, peripheral vascular disease, nail growth, poor drug penetration into the nail lesions and fungal growth patterns adversely affect clinical result. Objective: This research was designed to assess the prevalence of Onychomycosis and spectrumof fungal etiologic agent’s associate with the nail mycosis among patients attending at Rankdermatologic clinic from February-July 2019 G.C Addis Ababa, Ethiopia. Material and methods: The present study was a single institutional cross-sectional study wasconducted among a total of 200 patients visiting dermatology clinic from Feb 2019 to July 2019at Rank dermatology clinic in Addis Ababa. Nail scrapings that was collected from studyparticipants following standard procedure. A small amount nail scraps specimen was put on a slidethen added droplet of 20% KOH and stay for a minimum of 5 minutes, then detection wasperformed by direct microscope for the positive or negative of fungal pathogen. The rest of nailscraped of every specimen was inoculated on culture media. At same time culture processed forevery positive or negative result of detection. Every nail scraps specimen was inoculated on twopetredishe Mycosel agar and Sabouraud’s dextrose agar prepare with antimicrobial antibiotics butnot added cycloheximide. All culture media performed based on the manufacture’s guide and inoculated media stay at room temperature (25-30 C 0) aerobically and put the inoculated plate by inverted part up to six weeks. The processed media which incubate in the incubator were checked 3 times per week for the presence or absence of any growth. Culture growth supposed fordermatophytes were sub-cultured onto potato dextrose agar to generate pure isolate. Molds werefound by investigative macroscopic and microscopic analysis. Microscopic detection of Moldswas done by small amount from growth culture putting to new slide and added lactophenol cottonblue reagent then cover by a cover slip and examined by microscope. Yeast investigation of C.albicans by performed by germ tube production. Datawas evaluated by performing excel and SPSSversion 20 software. Results: Out of 200 nail scrap samples processed, 161(80.5%) yielded significant Onychomycosisof which 106(65.8) obtained from female patients and 55(34.2%) were from male patients. Theages of research participant were from 2 to 72 year. From 200 study participant, 61(30.5%) fungalelement was detected by direct microscopy whereas 161(80.5%) nail scraps specimen was isolatedby culture and Six specimens become negative for culture whereas positive by KOH detection.Non dermatophyte were the main pathogen that contribute 99(61.5%) after that mixed pathogenin 26 (16.1%) patient and then dermatophytes were identified in 22(13.7%) next by yeasts thatcontributed 14(8.7%) of the isolates. Aspergillus fumigatus was the predominate fungal pathogenidentified from non-dermatophytes and from dermatophyte, T.mentagrophyte was the leadingfungal pathogen and also Candida albican was the chief fungi identify from yeast. Conclusion: The prevalence Onychomycosis was high, that was 161/200 (80.5%). However non-dermatophytes were the most common causative agents for Onychomycosis, dermatophyte andyeasts fungi also representing the reason for Onychomycosis are diverse. Clinical diagnosis, directmicroscopy and culture isolate are essential for appropriate analysis. These highlight the need fornationwide study on the spectrum.
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    Evaluation of Antibacterial and Antifungal Activity, Phytochemical Content and Acute Oral Toxicity of Impatiens Tinctoria A. Rich Root Extracts
    (Addis Ababa University, 2019-10) Degu Sileshi; Bitew Adane; Gemeda Negero; Abebe Abiy
    Background: Infectious diseases, caused by different microorganisms such as bacteria and fungi, are the major contributors of morbidity and mortality. The emergence of microorganisms’ new resistance mechanism, and the emerging and re-emerging of new infectious disease aggravated the problem and have threatening our ability to treat infectious diseases. Therefore, researches for the development of new antimicrobials to combat resistant microbes and newly emerged infectious diseases are warranted. Hence, the best candidate is using plants for innovation of new drugs which are used in traditional medicine. Objectives: To investigate the antimicrobial activities, acute oral toxicity and phytochemical screening of aqueous, ethanol and ethyl acetate root extracts of Impatiens tinctoria A. Rich. Methods: The roots of Impatiens tinctoria A. Rich were collected from Gurage Zone around Butajira town and processed and extracted using solvents of ethyl acetate, ethanol and water. Agar well diffusion and agar dilution methods were used for screening the antimicrobial activity of the extracts and for determination of minimal inhibitory concentration, respectively. The minimum bactericidal and fungicidal concentration of the extracts was determined. Finally, the plant extracts were subjected to phytochemical screening and oral acute toxicity study. All these activities were carried out from January to October/2019. Result: Gram positive bacteria were more susceptible to the extracts compared to gram negative bacteria whereas from tested fungi T. rubrum and T. mentagrophytes were more susceptible. The study screened the presence of at least 7 phytochemicals (alkaloids, flavonoids, anthraquinens, terpenoids, glycosides, quinones and saponins) and 6 compounds in the roots of the study plant. Ethyl acetate extract was more potent and broader spectrum of antimicrobial activities than ethanol and aqueous extracts. The LD50 was above 9600 mg/kg. Conclusion: The roots of the study plant showed notable antibacterial and antifungal potency. However, further research should be undertaken to elucidate the involved phytochemicals and compounds present in the extracts and mechanism of action which clear out the road for developing new antimicrobial drugs.
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    Investigation on Antibacterial and Antifungal Activity of some Selected Medicinal Plants in Ethiopia
    (Addis Ababa Universty, 2018-06) Abebe Abiy; Bitew Adane
    Background: Cognizant of the fact that, there has been an alarming increase in the incidences ofinfectious diseases, emerging and re-emerging antibiotic resistance organisms; there is an urgentneed of novel antimicrobial compounds with new mode of action, effective and inexpensive. One potential source for the search of such agent is medicinal plants due to the presence of widerange secondary metabolites in their tissue. Objectives: The aim of this study was to investigate the antimicrobial activity of 12 traditionallyused Ethiopian medicinal plants for their potency, spectrum of antibacterial, antifungal activityand acute toxicity. Methods: Ethnobotanical literature survey was conducted to select 12 medicinal plants.Antimicrobial activities of 80% Ethanol extracts of all plants were investigated by agar welldiffusion techniques against 22 organisms. Agar dilution techniques were employed to determinethe Minimum Inhibitory, Bactericidal and Fungicidal Concentrations. The Oral acute toxicitystudy was determined on the most active plant extract B. abyssinica. Results: Among investigated medicinal plants, B. abyssinica, X. strumarium, R. natalensis, Z.scabra, E. cymosa, C. abyssinica and S. abyssinica, showed strong antibacterial activity withinhibition zone ranging from 9-27 mm; while, B. abyssinica (42 mm) and X. strumarium (48mm) showed strong antifungal activity. The extracts of B. abyssinica showed most potentantimicrobial activity with MIC value ranging 0.250-16 mg/ml. Staphylococcus aureus was themost sensitive organism against B. abyssinica with MIC value of 0.25 mg/ml. Nevertheless, K.pneumoniae and Citrobacter species were the least sensitive bacteria with 16 mg/ml MIC andMBC value. T. mentagrophytes and T. rubrum were the most susceptible fungal organism to thetreatment of B. abyssinica, X. strumarium while, A. niger was the most resistant fungus. The LD50 of B. abyssinica was found to be 4103.175 mg/kg. Conclusion: The majority of the plants tested showed promising antibacterial and antifungalpotency, especially on gram positive bacteria and dermatophytes. Furtherstudies arerecommended to explore in-vivo efficacy, mechanism of action and toxicological studies of the most promising plant.
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    Microbial Profile, Drug Susceptibility Pattern and Associated Risk factor of Urinary Tract Infection in Intensive Care Unit Patients at Public Hospitals, Addis Ababa, Ethiopia
    (Addis Abeba University, 2021-10) Bizuayehu Hiwot; Bitew Adane
    Background; Healthcare-associated urinary tract infections are one of the most commoncomplications in hospitalized patients particularly in intensive care unit patients. Both bacteriaand yeast, are implicated as the etiological agents of urinary tract infections. Objective: To determine the spectrum of the etiology (bacterial and yeast), risk factors, andantimicrobial susceptibility patterns of urinary tract infections patients admitted in intensive careunit in public Hospitals at Addis Ababa Ethiopia. Methods: A cross-sectional study was conducted from September 2020 to December 2020 inAddis Ababa public Hospitals’ intensive care unit patients. By using convenient sampling method a total of 220 patients included. To assess Socio-demographic status and associated risk factors of participant we used a structured questionnaire. Urine specimens were collected fromstudy participant, sent to Ethiopian public health institution for microbiological investigation andantimicrobial susceptibility testing. The data was analyzed by SPSS software version 23. Results: Out of 220 urine samples 113 (51.4%) were culture positive of which 20.9% wasbacteriuria while 19.1% was candiduria and 11.4% by mixed culture. The most commonorganism isolated was Candida albicans 29 (21.01%) followed by Enterococcus spp andCandida krusei 18 (13.1%) for each. Ampicillin, Ceftriaxone, and Cefotaxime highly resisted bymost Gram-negative bacteria. Amikacin, Meropenem and, Imipenem were the most active drugsagainst Gram-negative bacteria. Penicillin is resisted by Gram-positive bacteria whereasNitrofurantin best drug of choice for Gram-positive bacteria. Number of admission days inIntensive Care Unit, diabetes millets and Injury found to be risk factors for urinary tractinfection. Female sex, and antibiotic use also a predisposing factor for urinary tract infectioncaused by yeast. Conclusion and Recommendation: The overall prevalence of bacteriuria/ candiduria was51.4% with high drug resistance of bacterial isolate. This implies that, UTI is a significantproblem in different public Hospitals’ intensive care unit patients in Addis Ababa. Thus,Hospitals may need revise their infection prevention practices to prevent the transmission ofresistant bacteria in Intensive Care Unit.
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    Multidrug Resistance among Fermentative and non-fermentative Gram-negative Bacilli Isolated from Clinical Specimens at Arsho Advanced Medical Laboratory, Addis Ababa, Ethiopia
    (Addis Ababa University, 2019-10) Desalegn Yasin; Bitew Adane; Fentaw Surafel
    Background: Antimicrobial resistance has recently been identified as one of the three most important problems facing human health by the World Health Organization. Gram negative bacteria are major producers of extended-spectrum beta-lactamase and carbapenemase enzymes which made them multidrug resistant. Objective: This study aimed to determine magnitude of multidrug resistant fermentative and non-fermentative gram-negative bacilli isolated from clinical specimens at Arsho Advanced Medical Laboratory, Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted from January 1 to March 30, 2019. A total of 873 different clinical samples were collected and inoculated to MacConkey agar, Blood Agar and Chocolate agar. Species identification, antimicrobial susceptibility testing and extended spectrum beta-lactamase screening was performed using VITEK®2 automation. Extended spectrum beta-lactamase production was confirmed with combined disc method. Carbapenem resistance was performed on Muller Hinton agar and carbapenemase producers were confirmed by modified carbapenem inactivation method as per Clinical and Laboratory Standards Institute guideline. Data was entered and analyzed using SPSS version 23. Results: From 873 various clinical samples processed, 175 gram negative bacteria were isolated of which 88% (154/175) were fermenters and 12% (21/175) were non-fermenters. Majority of the isolates were from urine (56%) followed by wound (21.7%) specimen. The predominant isolates were Escherichia coli, 58.3% (102/175) from fermenters and Pseudomonas aeruginosa, 5.1% (9/175) from non-fermenters. Highest resistance level was seen in ampicillin (86%) and cefalotin (73.2%), and lowest resistance against meropenem (9.8%) and tobramycin (18.9%). Overall Multidrug resistance was 80.5%, extended spectrum beta-lactamase production was 28% and carbapenemase production was 5.4%. Conclusion: Prevalence of multidrug resistance in gram negative bacteria was high. Meropenem (91.8%) was the most active antibiotic against extended spectrum beta-lactamase producers while gentamicin (55.6%) for carbapenemase producers.