Darod Hamda Hussein, Melese Addisu, Kibret Mulugeta, Mulu Wondemagegn
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Department of Biology, Science College, Bahir Dar University, Bahir Dar, Ethiopia.
Int J Microbiol. 2023 Apr 5;2023:6474952. doi: 10.1155/2023/6474952. eCollection 2023.
Tonsillitis is the third most frequently diagnosed infection in the pediatric age and is associated with significant morbidity and loss of school attendance. Throat swab cultures are useful for the confirmation of children with a clinically suspected tonsillitis. However, Somaliland is one of the underdeveloped countries with a low standard of sanitation and poor health seeking culture. Treatment of tonsillitis with antibiotics is irrational and not empirical. This study determined the bacterial throat swab culture positivity and antibiotic resistance profiles of the bacterial isolates among children 2-5 years of age with suspicion of tonsillitis at Hargeisa Group of Hospital, Somaliland.
A cross-sectional study was conducted from March to July 2020. A total of 374 children from 2 to 5 years of age suspicion of tonsillitis was included using a convenient sampling method. Throat swabs were collected, and bacterial isolation and identification were done using standard bacteriological procedures. Antimicrobial susceptibility testing was done using the disk diffusion method. Data on demographic variables and clinical profiles were collected using structured questionnaires. Logistic regression analysis was computed to identify factors associated with bacterial tonsillitis.
Overall, 120 (32.1%) (95% CI 27.4-36.8%) of children were positive for bacterial throat cultures. Of these, 23 (19.2%) were mixed bacterial isolates. The most frequent bacterial isolates were beta-hemolytic streptococci 78 (55%), 42 (29%), and 10 (7%). Isolates revealed 83.3-100% rate of resistance to ampicillin. Beta-hemolytic streptococci isolates were 94.9% resistant to ampicillin. . was resistant to clarithromycin (38%) while . isolates were 100% resistant to ampicillin. History of tonsillitis (AOR = 0.12; 95% CI = 0.06-0.21), difficulty in swallowing (AOR = 6.99; 95% CI = 3.56-13.73), and attending schools (AOR = 2.98; 95% CI = 1.64-5.42) were found to be associated with positive throat culture.
Resistance to ampicillin and MDR among beta-hemolytic streptococci and other isolates of throat colonizers in children with clinically suspected of bacterial tonsillitis are major concerns in Hargeisa, Somaliland. Therefore, treatments of cases are recommended to be guided by regular culture and antimicrobial susceptibility testing to prevent complications of tonsillitis and associated antibiotic resistance.
扁桃体炎是儿童期第三常见的确诊感染疾病，会导致显著的发病率并使儿童缺课。咽拭子培养对于确诊临床疑似扁桃体炎的儿童很有用。然而，索马里兰是一个不发达国家，卫生标准低且就医文化差。用抗生素治疗扁桃体炎是不合理且缺乏经验依据的。本研究确定了索马里兰哈尔格萨医院集团中2至5岁疑似扁桃体炎儿童的咽拭子细菌培养阳性率及分离出细菌的抗生素耐药谱。
于2020年3月至7月进行了一项横断面研究。采用方便抽样法纳入了总共374名2至5岁疑似扁桃体炎的儿童。采集咽拭子，使用标准细菌学程序进行细菌分离和鉴定。采用纸片扩散法进行药敏试验。使用结构化问卷收集人口统计学变量和临床特征数据。进行逻辑回归分析以确定与细菌性扁桃体炎相关的因素。
总体而言，120名（32.1%）（95%可信区间27.4 - 36.8%）儿童咽拭子细菌培养呈阳性。其中，23名（19.2%）为混合细菌分离株。最常见的细菌分离株是β溶血性链球菌，共78株（55%），其他细菌分别为42株（29%）和10株（7%）。分离株对氨苄西林的耐药率为83.3% - 100%。β溶血性链球菌分离株对氨苄西林的耐药率为94.9%。……对克拉霉素耐药（38%），而……分离株对氨苄西林100%耐药。扁桃体炎病史（比值比=0.12；95%可信区间=0.06 - 0.21）、吞咽困难（比值比=6.99；95%可信区间=3.56 - 13.73）和上学（比值比=2.98；95%可信区间=1.64 - 5.42）被发现与咽拭子培养阳性有关。
在索马里兰哈尔格萨，临床疑似细菌性扁桃体炎儿童中，β溶血性链球菌和其他咽部定植菌分离株对氨苄西林的耐药性及多重耐药是主要问题。因此，建议根据定期培养和药敏试验指导病例治疗，以预防扁桃体炎并发症及相关抗生素耐药性。
