Bacterial profile, antibacterial susceptibility pattern and associated factors among women attending antenatal and post-natal health services at the University of Gondar Teaching Hospital, Northwest Ethiopia

Background: Bacterial infections are an important cause of maternal morbidity and mortality especially in re-source limited countries such as Ethiopia. The major bacterial infections include urinary tract infections, septice-mia and endometritis. Antibiotic resistant bacterial pathogens have become a growing problem worldwide and pose a serious threat to vulnerable populations, including mothers. However, studies which address the problem in the Ethiopian setting are scarce. Objective: To assess the bacterial profile, antibacterial susceptibility pattern and associated factors among mothers attending antenatal and postnatal care health services. Methods: A cross-sectional study was conducted on 222 study participants at the University of Gondar Teaching Hospital from January 1 to May 31, 2016. Clinical specimens such as urine, blood and cervical discharge specimens were collected from patients and antimicrobial susceptibility tests conducted following standard procedures. Data were entered and analyzed with SPSS version 20. Bivariate and multivariate logistic regression models were applied in data analysis. Results: Out of 222 specimens collected, 57(25.7%) bacterial species were isolated. The predominant bacterial isolates from urine culture were Escherichia coli (24/47; 51.1%) and Staphylococcus aureus (16/47;34%). From blood cultures, Staphylococcus aureus (2/8; 25%), Coagulase negative staphylococci (2/8;25%), Klebsiella pneumoniae (2/8;25%) and Streptococcus pyogenes 2/8(25%) were isolated. Neisseria gonorrheae (2/27;7.4%) was isolated from cervical discharge cultures. The majority of the isolates were resistant to amoxacillin and ampicillin but susceptible to ceftriaxone. Many multidrug resistant bacterial species were isolated. Being in the first trimester of pregnancy and having a history of diabetes mellitus were strongly associated with the presence of bacterial infections. Conclusion: The overall prevalence of bacterial infections was high with many being resistant to commonly pre-scribed antimicrobial agents. This calls for an urgent need to conduct screening of bacterial infectionsin both antenatal as well as postnatal women

Septicemia, bacterial isolates and drug susceptibility among women attending delivery at dilchora hospital, dire dawa, Eastern Ethiopia

Background: Puerperal sepsis is the second most frequent cause of maternal morbidity and mortality in resource limited settings and often occurs within the first 42 days after childbirth. Objective: The aim of the study was to assess the prevalence of septicemia, its bacterial isolates, drug susceptibility patterns and associated factors among sepsis suspected women attending delivery at a referral hospital in Ethiopia. Method: A cross sectional study was conducted with a sample size of 441 women in the age group 15-49 years at Dilchora hospital, Dire Dawa, Eastern Ethiopia from May 1 to July 30, 2016. Sociodemographic and clinical data were collected using structured interview questionnaires. Blood was collected aseptically and inoculated into a broth medium and cultured aerobically for 48 hours. Antimicrobial susceptibility pattern of isolated bacteria was determined by Kirby Bauer disc diffusion method. Data were analyzed using SPSS version 16. Binary logistic regression was used to test for association. Significant variables were further adjusted using multivariate analysis. Result: The prevalence of septicemia was 12.9% of suspected cases and coagulase negative staphylococcus was found to be the most frequent isolate (28.1%) followed by E. coli (22.8%), Pseudomonas aeruginosa (10.5%) and Proteus spp (3.5%). Multiple vaginal examinations and multiple pregnancies were associated with the occurrence of sepsis. Conclusion: The prevalence of septicemia was 12.9%. Coagulase negative staphylococci and E. coli were the predominant bacteria isolated. Most of bacterial isolates were resistant against commonly used antibiotics such as ampicillin, amoxicillin and tetracycline

Multi-drug resistant bacteria and associated factors among reproductive age women with significant bacteriuria

Background: Urinary tract infection (UTI), an infection that disproportionately affects women, is commonly caused by bacteria. Emergence of multi-drug resistant urinary tract infections is a serious health issue with significant maternal morbidity and mortality. Objective: The aim of this study was to assess the prevalence of multi-drug resistant bacteria and associated factors among reproductive age women with significant bacteriuria. Methods: Cross-sectional study was conducted from April to August 2016 on 424 study subjects in Jimma University Specialized Hospital. Data were collected using pretested questionnaire. Morning midstream urine samples were collected and processed following standard operating procedures. Antimicrobial susceptibility testing was done following Clinical Laboratory Standards Institute 2014 guidelines. Samples were tested for cell surface hydrophobicity, biofilm production, extended spectrum betalactamases and carbapenemases production. Results: The prevalence of UTI among suspected reproductive age women was 22.9%. E. coli was the most frequent isolate with a rate of 57% among isolated bacteria followed by Klebsiella species (24.7%). Over 90% of the isolates were multi-drug resistant. Resistance pattern for ampicillin was 100% followed by ticarcillin (92.4%) and colistin (86%) while less resistance rate was found for imipenem(13%). Multivariate analysis revealed that risk factors such as previous history of hospitalization, extended spectrum betalactamase production and strong biofilm production were significantly associated with multidrug resistance (p <0.05). Conclusion: The prevalence of multi-drug resistance (MDR) among isolates of UTI in the study was high and this correlates with the prevalence of virulence phenotypes. Gram-negative organisms were the most common causes of UTIs

High burden of nosocomial infections caused by multi-drug resistant pathogens in pediatric patients at hawassa university comprehensive specialized hospital

Background: Pediatric patients are at increased risk of nosocomial infections with multi-drug resistant pathogens which are more prevalent in the hospital environment. The aim of this study was to determine the prevalence of nosocomial infections, antibiotic resistance pattern of bacterial isolates and associated factors in pediatric patients. Methods: This was a cross-sectional study conducted from March to August, 2016. Data included sociodemographic and clinical variables in patients clinically suspected of having nosocomial infections and collected using a structured questionnaire. Bacterial identification and antimicrobial susceptibility test was done with standard microbiological methods. Data were analyzed with SPSS version 20 and p value < 0.05 was considered to be statistically significant. Results: Out of 939 children admitted to the hospital, 384 patients (40.9%) were clinically suspected and had 462 nosocomial infections. Blood stream infection was the most common site of nosocomial infections. Culture confirmed nosocomial infections were reported in 82 patients (21.4%; 95% CI, 17.2-25.8%) with 88 isolates. Among the most frequently isolated bacteria, 21 (23.9%) were Klebsiella spp, and 16 (18.2%) were S. aureus, 62.5% of which were methicillin resistant. Among all bacterial pathogens, 88.9% were multi-drug resistant. Extremely high (97.9%) multi-drug resistance was associated with Gram negative bacteria. Among these, all isolates, except E. coli, were 100% multi-drug resistant. Long hospital stay and malnutrition were significantly associated with nosocomial infections. Conclusion: The high prevalence of nosocomial infections with multi-drug resistant bacteria suggests the need for proper implementation of the nosocomial infections prevention and control measures

Enteric pathogens and antimicrobial susceptibility profile among pediatric patients with diarrhea in Addis Ababa, Ethiopia

Background: Diarrheal disease remain a major public health problem in developing countries including Ethiopia. The current study was designed to isolate medically important bacterial enteric pathogens and assess the antimicrobial susceptibility pattern for prescribed drugs. Methods: A cross-sectional study was performed between November 2016 and May 2017 to determine bacterial enteric pathogens that cause diarrhea and assess their antimicrobial susceptibility profile. Stool specimens from pediatric patients aged 0-14 years were collected from two health centers and one specialized hospital to identify bacterial enteric pathogens. Antimicrobial susceptibility tests were performed on bacterial isolates using the Kirby-Bauer disc diffusion method. Results: Out of 290 study patients with diarrhea examined, the majority of bacterial enteropahogens isolated in the study were Shigella species 22(7.6%) followed by enterohemorrgic E.coli O157:H7 13(4.5%) and Salmonella species 7(2.4%). Among the Salmonella species 42.9% showed resistance to trimethoprim-sulphamethoxazole. Among the Shigella species, 77.3% were resistant to ampicillin and 68.2% to trimethoprim-sulphamethoxazole whereas E.coli O157:H7 strains were resistant mostly to ampicillin (69.2%), and trimethoprim-sulphamethoxazole (46.1%). The overall prevalence of multi-drug resistance (MDR) (to ≥3 classes of antibiotics) among the isolates was 26.2%. Conclusion: Salmonella species, enterohemorrhagic E.coli O157:H7and Shigella species were the most frequently isolated pathogens in children with diarrhea. A high proportion of the Salmonella and Shigella isolates identified in the study showed resistance to the most frequently prescribed drugs ampicillin and trimethoprim-sulphamethoxazole. Ciprofloxacin was found to be the best drug of choice for the treatment of diarrhea caused by Salmonella and Shigella. When antibiotics are indicated to treat diarrhea in children, clinicians should rely on stool culture and antimicrobial susceptibility testing before prescribing drugs

Bacterial profile and antimicrobial susceptibility patterns from external ocular infections and associated risk factors at the all Africa leprosy rehabilitation and training center (alert), Addis Ababa, Ethiopia

Background: Bacteria are major causative agents that frequently cause infections of the eyes and loss of vision. Resistance of bacteria isolated from ocular infections to antimicrobial agents is a global concern. Objective: The aim of this study was to determine the prevalence of different bacterial isolates and their antimicrobial susceptibility pattern in patients with external ocular infections and to determine any associated risk factors. Methods: A cross sectional study was conducted from May to August 2015 in ALERT outpatient and inpatient department of Eye Clinic. A total of 288 samples were collected which were processed for bacterial culture according to standard procedures. Presumptive isolates were further identified by a series of biochemical tests. The antimicrobial susceptibility patterns of the isolates were determined by the disk diffusion method. The data were entered and analyzed using SPSS software version 20. Results: A total of 288 patients were enrolled. The overall prevalence of bacterial pathogens among external ocular samples was 171/288 (59.4%). Gram-positive bacteria were the most common isolates accounting for 70.2% (120/171). Staphylococcus aureus was present in 36.8% of the cases (63/171). Most (91.6%) of the bacteria isolated showed high resistance to Penicillin (120/131) and Tetracycline (70.4%; 119/169). Gentamicin was the most effective antibiotic against gram-positive and gram-negative bacteria (94%, 161/171). The overall prevalence of multiple drug resistance was 159/171 (93%): gram-positive 117/120 (97.5%) and gram-negative 42/51 (82%). Most variables did not have a statistically significant association with presence of ocular infection; only repeated infections were observed to have significant association. Conclusion: The prevalence of bacterial pathogens among external ocular samples was high. Most of the isolates were drug resistant to commonly used antibiotics. Gentamicin and Ciprofloxacin were the most effective antim-icrobial agents for both gram-positive and gram-negative bacteria