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
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2014-05
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Addis Ababa University
Abstract
Background: Blood stream and urinary tract infections are a major cause of mortality and morbidity ofthe pediatric population. Extended spectrum beta-lactamase (ESBL) producing and carbapenemresistant enterobacteriaceae is the challenge for controlling now days. Assessing the prevalent bacteriaand their antibiotic resistance helps to provide effective therapies, develop rational prescriptionprograms and make policy decisions.
Objective: To determine the prevalence and antimicrobial resistance of bacterial isolates with specialemphasis on enterobacteriaceae among children suspected for septicemia and urinary tract infection inTikur Anbessa University Hospital, Addis Ababa, Ethiopia.
Method: A cross sectional study was conducted from January 10 to March 30/2014 at Tikur AnbessaUniversity Hospital, Addis Ababa, Ethiopia. A total of 322 study participants who were suspected forsepticemia and/or UTI were recruited. All blood and urine samples were cultured on Blood andMacConkey agar. All culture positives were characterized by colony morphology, biochemical tests using the standard procedure. Significant bacteriuria was determined for all culturepositive urine samples. Antimicrobial susceptibility test was performed for all bacterial isolates usingKirby-Bauer method. ESBL was detected using combination disk & double disk synergy methods onMuller Hinton agar. Carbapenemase were detected by Modified Hodge method using Meropenem. Alldemographic & 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 177blood 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 inblood 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% ofGram 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 quitenarrow today due to the wide scale resistance to common antibiotics. The emergence of MDR calls forcontinuous monitoring & reviewing of antimicrobial policy in hospitals and the country at large.
Key terms: Septicemia, UTI, Bacterial isolates, antimicrobial resistance pattern, ESBL, Carbapenemresistance, Tikur Anbessa University Hospital, Addis Ababa, Ethiopia
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Septicemia UTI Bacterial isolates Antimicrobial resistance pattern ESBL