Studies on Enteric Pathogens Associated With Adult Diarrhoeal Out-Patients in Some Hospitals and Clinics of Addis Ababa: Antibiotic Resistance and Plasmid Profile Analysis
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Date
1996-06
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Addis Ababa University
Abstract
700 diarrhoeal samples from adult out-patients, 335 from males
and 365 from females, were collected from 4 hospitals (Tikur
Anbesa, Zeuditu, Yekatit 12 and Menelik II) and Arada Clinic in
Addia Abapa. Of the total samples, 394 (56.3%) yielded one or
more etiologic agents. Of the positive samples, 191 (57%) were
from males and 203 (55.6%) from females. Among 304 single
infections, Salmonella was encountered in 13.2%, Shigella in
13.5%, Entamoeba histolytica in 33.5%, Giardia Lamblia in 28%,
strongyloides stercoralis in 7.6% and Trichuris trichiura in
4.3%. In addition 75 double and 15 triple infections were
found. No Cryptosporidium were identified in any of the
samples. Differences in infection status among age groups and
between sex were insignificant (p>O.Ol).
Among 45 Salmonella isolates, serogroup C comprised 31.1%,
B 24.4%, D 13.3%, S.typhi 15.6%, A 8.9% and E 6.7%.
Susceptibility of Salmonella28.9%, to ampicillin 31.1%,
isolates to tetracyclineto cephalothin 33.3%,wasto
trimethoprim-sulfamethoxazole 42.2%, to chloramphnicol 53.3%,
to kanamycin 46.1%, to carbenicillin 62.2%, to gentamicin 91.1%
and to polymyxin B was 100%. Susceptibility of individual
serogroups ranged from 0% to ampicillin and tetracycline up to
100% susceptibility to polymyxin B in serogroup A. Of the
Salmonella isolates, 93% were resistant to one or more drugs
with a total of 31 distinct resistance patterns (antibiograms).
Frequently encountered antibiograms were those combinations
11hich contained ampicillin, tetracycline, cephalothin,
kanamycin and trimethoprim-sulfamethoxazole. From 2 to 4 drug
resistant strains from each serogroups of Salmonella were
selected for plasmid profile analysis. All strains contained
multiple plasmids which were larger than 21.2 kilobases (Kb)
and several others ranging in sizes from 21.2 Kb to 1.8 Kb.
Among 50 Shigella isolates, serogroup A comprised 28%, B
44%, C 18% and 0 10%. Susceptibility of Shigella isolates to
tetracycline was 26%, to ampicillin 30%, to cephalothin 36%, to
trimethprim-sulfamethoxazole 48%, to chloramphenicol 50%,
carbencillin 72%, to kanamycin 80%, to nalidixic acid 86%,
polymyxin B 90% and to gentamicin '-las 100%. Among all Shigella
serogroups, least susceptibility was encountered to
tetracycline and ampicillin while greatest susceptibility was
observed to gentamicin, pOlymyxin B and nalidixic acid. Of all
Shigella isolates, 98% were resistant to one or more drugs with
a total of 32 distinct antibiograms. Frequently encountered
antibiograms were those combinations which contained
tetracycline, ampicillin, cephalothin and trimethoprimsulfamethoxazole.
From 2 to 6 drug resistant isolates from
each serogroups of Shigella, '-Iere selected for plasmid profile
analysis. As in Salmonella, these also contained multiple
plasmids which were larger than 21.2 Kb and others ranging in
sizes from 21 Kb to 1.4 Kb.
The importance of environmental sanitation, upgrading the
knowledge of personal hygiene among the public and the use of
prescribed antibiotics from proper pharmacies during
necessities is recommended. The need for further research
especially on plasmid profile analysis is stressed.
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Biology