Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Gidan Health Center, Gidan Woreda Health Office, Gidan, Ethiopia.
Front Public Health. 2023 Feb 6;11:1114223. doi: 10.3389/fpubh.2023.1114223. eCollection 2023.
Under five children are at risk of diarrhea-associated morbidity and mortality. and are major causes of diarrhea in under-five children, especially in developing countries. This study aimed to assess the prevalence, antimicrobial resistance pattern, and associated factors of and among under-five diarrheic children in Debre Markos town public health facilities.
A cross-sectional study was conducted at public health facilities in Debre Markos town using a consecutive convenient sampling technique. Data on socio-demographic and associated factors were collected using a structured questionnaire. serovars and species were identified using MacConkey, Xylose Lysine Deoxycholate, agar, and biochemical tests. The antimicrobial resistance pattern was determined by using the modified Kirby-Bauer disk diffusion technique.
The overall prevalence of and was 11.7% (26/222; 95% CI = 7.2-17.5%). Isolated serovars showed a higher rate of resistance (85.7%, 6/7) for both Ampicillin and Amoxicillin/Clavulanic acid while isolates showed a higher resistance rate to Amoxicillin/Clavulanic acid (78.9%, 15/19) and Ampicillin (73.7%, 14/19). The overall multidrug resistance (MDR) rate of and isolates was 88.5% (23/26). Parent/guardian educational status ≤ elementary school (AOR = 3.783; 95% CI = 1.28-11.19; = 0.016), presence of two or more under-five children in the family (AOR = 8.999; 95% CI = 2.93-27.69; < 0.001), unimproved source of drinking water (AOR = 5.010; 95% CI = 1.56-16.10; = 0.007), the habit of storing cooked foods for later use (AOR = 3.199; 95% CI = 1.07-9.54; = 0.037), attendance of the child at social gatherings (AOR = 5.387; 95% CI = 1.78-16.35; = 0.003), and infrequent child fingernail trimming (every ≥ 2 weeks; AOR = 4.693; 95% CI = 1.47-14.94; = 0.009) showed statistically significant association with the prevalence of culture-confirmed and isolates.
The prevalence of culture-confirmed and isolates was significantly high in the study area. and isolates exhibited a high rate of MDR pattern. Parent/guardian education level below the elementary school, the presence of two or more under-five children in the family, using unimproved water source, a habit of storing cooked food, and infrequent fingernail trimming were independent predictors of culture-confirmed and . Therefore, besides public health measures, regular surveillance of the prevalence and antimicrobial resistance pattern of and should be routinely practiced in the study setting.
五岁以下儿童面临腹泻相关发病率和死亡率的风险。志贺菌和沙门氏菌是五岁以下儿童腹泻的主要原因，尤其是在发展中国家。本研究旨在评估德布雷马克洛斯镇公立卫生机构中五岁以下腹泻儿童中志贺菌和沙门氏菌的流行率、抗生素耐药模式和相关因素。
采用连续便利抽样技术，在德布雷马克洛斯镇公立卫生机构进行了一项横断面研究。使用结构化问卷收集社会人口统计学和相关因素的数据。使用麦康凯、木糖赖氨酸去氧胆酸盐、琼脂和生化试验鉴定血清型和菌种。采用改良 Kirby-Bauer 纸片扩散技术测定抗生素耐药模式。
志贺菌和沙门氏菌的总流行率为 11.7%（26/222；95%CI=7.2-17.5%）。分离的志贺菌血清型对氨苄西林和阿莫西林/克拉维酸的耐药率更高（85.7%，6/7），而沙门氏菌分离株对阿莫西林/克拉维酸（78.9%，15/19）和氨苄西林（73.7%，14/19）的耐药率更高。志贺菌和沙门氏菌分离株的总多重耐药（MDR）率为 88.5%（23/26）。父母/监护人受教育程度≤小学（AOR=3.783；95%CI=1.28-11.19；=0.016）、家庭中有两个或更多五岁以下儿童（AOR=8.999；95%CI=2.93-27.69；<0.001）、饮用水源未改善（AOR=5.010；95%CI=1.56-16.10；=0.007）、有储存熟食以备后用的习惯（AOR=3.199；95%CI=1.07-9.54；=0.037）、儿童参加社交聚会（AOR=5.387；95%CI=1.78-16.35；=0.003）和儿童指甲修剪不频繁（每≥2 周；AOR=4.693；95%CI=1.47-14.94；=0.009）与培养证实的志贺菌和沙门氏菌分离株的流行率有统计学显著关联。
在研究区域，培养证实的志贺菌和沙门氏菌分离株的流行率显著较高。志贺菌和沙门氏菌分离株表现出较高的 MDR 模式。父母/监护人受教育程度低于小学、家庭中有两个或更多五岁以下儿童、使用未经改善的水源、有储存熟食的习惯和指甲修剪不频繁是培养证实的志贺菌和沙门氏菌的独立预测因子。因此，除了公共卫生措施外，还应在研究环境中定期监测志贺菌和沙门氏菌的流行率和抗生素耐药模式。
