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在埃塞俄比亚 Hawassa 大学综合专科医院就诊的患者中,伤寒沙门氏菌的流行情况、相关因素和抗菌药物敏感性谱。

Prevalence of Salmonella Typhi, its associated factors and antimicrobial susceptibility profile among patients attending Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia.

机构信息

Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia.

Department of Medical Laboratory Science, College of Health Sciences, Oda Bultum University, Chiro, Ethiopia.

出版信息

BMC Infect Dis. 2024 Oct 31;24(1):1224. doi: 10.1186/s12879-024-10118-4.

Abstract

INTRODUCTION

Salmonella Typhi infections cause significant morbidity and mortality worldwide, especially in developing countries including Ethiopia. This study aimed to determine the prevalence of Salmonella Typhi, its associated factors and antibiotic susceptibility profile among suspected typhoid patients.

METHODS

A cross-sectional study was conducted on 270 typhoid fever suspected patients at Hawassa University Comprehensive Specialized Hospital from June 2022 to September 2022. Data were collected using questionnaires by face-to-face interview. Stool samples for microbiological culture, blood samples for S. Typhi IgM/Entero-check WB rapid test and isolates for antimicrobial susceptibility tests were used through standard procedures and according to the reagents manufactures' instructions. Hygiene implementation of patients was also assessed using interview. Sociodemographic and clinical characteristics of the patient's were considered. Descriptive statistics were used to summarize the data, and logistic regression model analysis was performed to assess associations between S. Typhi infection and the associated sociodemographic and clinical factors.

RESULTS

The prevalence of S. Typhi IgM/Entero-check WB rapid test and stool culture results were 3.3%; (95% CI: 1.5-5.6) and 3.7%; (95% CI: 1.9-6.3) respectively. Not washing hands after latrine [AOR = 0.85, 95% CI (0.15-4.79), p = 0.05] is not significant but, not washing hands before meal [AOR = 0.053, 95% CI (0.08-0.36), p = 0.03], eating raw vegetables [AOR = 0.024, 95% CI (0.001-0.48), p = 0.015] and drinking water from a stream [AOR = 0.12, 95% CI (0.19-0.70), p = 0.001] were significantly associated with S. Typhi infection, but in terms of AOR, all are preventive. Susceptibility of isolates was 9/10 (90%), 8/10 (80%), and 8/10 (80%) to ciprofloxacin, ceftriaxone, and chloramphenicol, respectively. The majorities 100% and 80% of the isolates were resistant to ampicillin and cotrimoxazole, respectively. About 40% of the isolates were MDR.

CONCLUSION

The prevalence of Salmonella Typhi with MDR has been observed. Therefore, health programmers and stakeholders should make efforts to improve the habit of sanitation, strengthen the capacity of laboratory diagnostic methods and increase awareness of the misprescription and misuse of antibiotics to reduce the impact of MDR bacteria.

摘要

简介

伤寒沙门氏菌感染在全球范围内导致了显著的发病率和死亡率,尤其是在包括埃塞俄比亚在内的发展中国家。本研究旨在确定伤寒疑似患者中伤寒沙门氏菌的流行率、相关因素和抗生素敏感性谱。

方法

2022 年 6 月至 2022 年 9 月,在 Hawassa 大学综合专科医院对 270 名伤寒疑似患者进行了横断面研究。通过面对面访谈使用问卷收集数据。使用标准程序和根据试剂制造商的说明,对粪便样本进行微生物培养、血液样本进行伤寒沙门氏菌 IgM/Entero-check WB 快速检测和分离物进行抗生素敏感性测试。还通过访谈评估患者的卫生实施情况。考虑了患者的社会人口统计学和临床特征。使用描述性统计来总结数据,并进行逻辑回归模型分析,以评估 S. Typhi 感染与相关社会人口统计学和临床因素之间的关联。

结果

伤寒沙门氏菌 IgM/Entero-check WB 快速检测和粪便培养结果的流行率分别为 3.3%(95%CI:1.5-5.6)和 3.7%(95%CI:1.9-6.3)。便后不洗手[AOR=0.85,95%CI(0.15-4.79),p=0.05]虽然没有统计学意义,但饭前不洗手[AOR=0.053,95%CI(0.08-0.36),p=0.03]、食用生蔬菜[AOR=0.024,95%CI(0.001-0.48),p=0.015]和饮用溪流水[AOR=0.12,95%CI(0.19-0.70),p=0.001]与 S. Typhi 感染显著相关,但就 AOR 而言,所有这些都是预防措施。分离物对环丙沙星、头孢曲松和氯霉素的敏感性分别为 9/10(90%)、8/10(80%)和 8/10(80%)。分离物对氨苄西林和复方磺胺甲噁唑的耐药率分别约为 100%和 80%。约 40%的分离物为 MDR。

结论

已经观察到具有 MDR 的伤寒沙门氏菌的流行率。因此,卫生规划人员和利益相关者应努力改善卫生习惯,加强实验室诊断方法的能力,并提高对抗生素不合理使用的认识,以减少 MDR 细菌的影响。

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