Assefa Addisu, Girma Mengistu
Department of Biology, Madda Walabu University, P.O.B.247, Bale Robe, Ethiopia.
Robe Teachers College, Bale Robe, Ethiopia.
Trop Dis Travel Med Vaccines. 2019 Nov 20;5:19. doi: 10.1186/s40794-019-0096-6. eCollection 2019.
Diarrheal diseases are responsible for high level of morbidity and mortality, particularly in children below 5 years. and spp. are pathogenic microbes responsible for the major diarrheal associated mortality. The purpose of this study was to determine the prevalence, factors associated with and isolates infections and their antimicrobial susceptibility patterns among diarrheic children aged below 5 years attending BRGH and GRH, Ethiopia.
A health institution based cross-sectional study was conducted from April to July 2016. One stool samples was collected from 422 diarrheic children under the ages of five and were cultured on to Hektoen Enteric (HE) and Salmonella-Shigella agar. Isolation identification of the and isolates were conducted using standard bacteriological methods. Antibiotic susceptibility was done by Kirby-Bauer disk diffusion method. The isolates were defined as multidrug resistant if it was resistant to two or more antimicrobial agents. Descriptive statistics were employed and logistic regression models were constructed to determine factors associated with prevalence.
The prevalence of and isolates were 6.9 and 4.3%, respectively. Children aged between 1 to 3 years were significantly associated with infection [AOR = 19.08, 95% CI (2.68-135.86)]. The odd of prevalence of isolates was significantly associated with absence of latrine, absence of hand washing after latrine, and in unimmunized children in adjusted odd ratio. Unimproved water sources and hand washing before meal had also higher odd of prevalence although the difference was not significant. All and isolates were resistant to amoxicillin (100%). In addition, all isolates were completely resistant to chloramphenicol, and tetracycline, and were multidrug resistant. However, all and a isolates were susceptible to ciprofloxacin and ceftriaxone.
There was a relatively low prevalence of and species in the study areas and were significantly associated with lack of personal hygiene and environmental sanitation. There were also higher drug resistance and multidrug resistant pattern. Personal hygiene and environmental sanitation, including access to latrine and supply of safe drinking water are suggested. Checking susceptibilities of and isolates causing diarrhea is also suggested.
腹泻病导致了高发病率和高死亡率，尤其是在5岁以下儿童中。志贺菌属和沙门菌属是导致腹泻相关主要死亡的致病微生物。本研究的目的是确定在埃塞俄比亚布雷达沃转诊医院（BRGH）和贡德尔转诊医院（GRH）就诊的5岁以下腹泻儿童中志贺菌属和沙门菌属的流行情况、与感染相关的因素及其抗菌药物敏感性模式。
2016年4月至7月进行了一项基于卫生机构的横断面研究。从422名5岁以下腹泻儿童中采集一份粪便样本，接种于赫氏肠道菌（HE）琼脂和沙门菌-志贺菌琼脂上。采用标准细菌学方法进行志贺菌属和沙门菌属分离株的鉴定。通过 Kirby-Bauer 纸片扩散法进行抗生素敏感性试验。如果分离株对两种或更多种抗菌药物耐药，则定义为多重耐药。采用描述性统计方法，并构建逻辑回归模型以确定与志贺菌属流行相关的因素。
志贺菌属和沙门菌属分离株的流行率分别为6.9%和4.3%。1至3岁儿童与志贺菌属感染显著相关[AOR = 19.08，95%CI（2.68 - 135.86）]。在调整后的比值比中，沙门菌属分离株的流行几率与没有厕所、便后不洗手以及未接种疫苗的儿童显著相关。水源未改善和饭前洗手也有较高的流行几率，尽管差异不显著。所有志贺菌属和沙门菌属分离株均对阿莫西林耐药（100%）。此外，所有沙门菌属分离株对氯霉素和四环素完全耐药，且为多重耐药。然而，所有志贺菌属和部分沙门菌属分离株对环丙沙星和头孢曲松敏感。
研究地区志贺菌属和沙门菌属的流行率相对较低，且与缺乏个人卫生和环境卫生显著相关。同时也存在较高的耐药性和多重耐药模式。建议改善个人卫生和环境卫生，包括提供厕所和安全饮用水。还建议检测引起腹泻的志贺菌属和沙门菌属分离株的药敏情况。
