1Department of Microbiology, St. Paul's Hospital Millennium Medical College, P.O.Box 1271, Addis Ababa, Ethiopia.
2Department of Microbiology, School of Medical Laboratory Sciences, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia.
Antimicrob Resist Infect Control. 2018 Sep 12;7:110. doi: 10.1186/s13756-018-0402-5. eCollection 2018.
Diarrheal illness remains one of the leading causes of morbidity and mortality among children under 5 years of age worldwide, especially in developing countries. Diarrheagenic (DEC) is the major cause of gastroenteritis in children in the developing world and is associated with high resistance levels to antibiotics. The aims of this study were to isolate and determine susceptibility patterns of DEC among children under 5 years of age with acute diarrhea and to assess maternal knowledge, attitude and practice towards childhood diarrhea.
A cross sectional study was conducted from August-December 2015 at 3 selected health institutions. Stool samples were cultured and isolated species were run for antimicrobial susceptibility testing using disk diffusion method. In addition, children's caretakers were interviewed using structured questionnaires including a Knowledge, Attitude and Practice (KAPs) survey. Bivariate and multivariate logistic regression analysis was used to quantify the effect of different risk factors on bacterial related diarrhea.
A total of 253 children, 115 males and 138 females with acute diarrhea were enrolled. was identified in a total of sixty-one children (24.1%), followed by (9.1%) and (3.95%). Additionally, eighty-six children (34.0%) had parasites identified in stool samples. isolates showed 83.6% resistance to ampicillin and augmentin followed by, trimethoprim-sulfamethoxazole (62.3%). Multiple resistances were observed in 72.1% of isolates; however, more than 90% of the strains were sensitive to ciprofloxacin and ceftriaxone. Caretakers identified the following as causes of infection: contaminated food and water (83.4%), microorganisms (55.3%), inadequate breast milk (54.1%), teething (45.1%), house flies (43.1%) and evil eye (15.8%). No hand washing before meals and low levels of knowledge had a significant association with infection ( < 0.05).
In children with suspected diarrheagenic we observed a high frequency of multidrug resistant . Furthermore, study subjects with low awareness about source, cause and symptoms of the disease were more likely to acquire suspected diarrheagenic infections. Thus, there is a need for more education in addition to continuous surveillance of the prevalence and antibiotic susceptibility pattern of diarrheal bacterial isolates in hospitals and in the community.
腹泻病仍然是全世界 5 岁以下儿童发病率和死亡率的主要原因之一，尤其是在发展中国家。肠致病性（DEC）是发展中国家儿童患胃肠炎的主要原因，并且与抗生素的高耐药水平有关。本研究的目的是分离和确定 5 岁以下急性腹泻儿童中 DEC 的药敏模式，并评估儿童腹泻的母婴知识、态度和实践。
2015 年 8 月至 12 月在 3 家选定的医疗机构进行了一项横断面研究。对粪便样本进行培养和分离，采用纸片扩散法对分离株进行抗菌药物敏感性试验。此外，对儿童护理人员进行了问卷调查，包括知识、态度和实践（KAP）调查。采用二变量和多变量逻辑回归分析来量化不同危险因素对细菌相关腹泻的影响。
共纳入 253 名 115 名男性和 138 名女性急性腹泻儿童。共有 61 名儿童（24.1%）被鉴定为 ，其次为 （9.1%）和 （3.95%）。此外，86 名儿童（34.0%）粪便样本中发现寄生虫。分离株对氨苄西林和氨曲南的耐药率为 83.6%，其次是 （62.3%）。72.1%的分离株存在多重耐药，但超过 90%的菌株对环丙沙星和头孢曲松敏感。护理人员将以下情况确定为感染原因：受污染的食物和水（83.4%）、微生物（55.3%）、母乳不足（54.1%）、出牙（45.1%）、家蝇（43.1%）和邪眼（15.8%）。饭前不洗手和知识水平低与 感染有显著关联（<0.05）。
在疑似腹泻性 感染的儿童中，我们观察到了高度的多重耐药性。此外，对疾病的来源、原因和症状认识较低的研究对象更容易感染疑似腹泻性感染。因此，除了对医院和社区的腹泻性细菌分离株的流行和抗生素药敏模式进行持续监测外，还需要进行更多的教育。
