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Asrat D, Copas A, Olubukola A. Exploring the association between unintended pregnancies and unmet contraceptive needs among Ugandan women of reproductive age: an analysis of the 2016 Uganda demographic and health survey. BMC Pregnancy Childbirth 2024; 24:117. [PMID: 38326780 PMCID: PMC10851597 DOI: 10.1186/s12884-023-06222-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 12/21/2023] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Unintended pregnancy and unmet contraceptive needs pose significant public health challenges, particularly in developing nations, where they contribute to maternal health risks. While previous research has explored determinants of unintended pregnancies, there remains a gap in understanding the association between unplanned pregnancies and unmet contraceptive needs among Ugandan women of reproductive age. This study aimed to assess unmet contraceptive needs and their correlation with unintended pregnancies and other factors in Uganda, utilizing a nationally representative sample. METHODS Data was extracted from the 2016 Uganda Demographic Health Survey (UDHS), a cross-sectional survey conducted in the latter half of 2016. The study encompassed 18,506 women aged 15-49 with a history of at least one prior pregnancy. The primary outcome variable was the planning status of the most recent pregnancy, while the principal independent variable was unmet contraceptive need. Additional variables were controlled in the analysis. Data analysis was performed using STATA version 17, involving descriptive analysis, cross-tabulation, chi-square testing, and logistic regression. Statistical significance was set at p < 0.05. RESULTS A substantial proportion of women reported unintended pregnancies (44.5%), with approximately 21.09% experiencing an unmet need for contraception. In the adjusted model, women with unmet contraceptive needs had 3.97 times higher odds of unintended pregnancy (95% CI = 3.61-4.37) compared to those with met contraceptive needs. Significant factors linked to unintended pregnancies included women's age, place of residence, household wealth status, decision-making authority regarding contraceptive use, educational attainment, husband's occupation, and educational level. CONCLUSION This study revealed that both the rate of unintended pregnancies and unmet contraceptive needs in Uganda exceeded the global average, warranting urgent policy attention. Addressing unmet contraceptive needs emerges as a potential strategy to curtail unintended pregnancies. Further qualitative research may be necessary to elucidate the sociocultural and behavioral determinants of unwanted pregnancies, facilitating context-specific interventions.
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Affiliation(s)
- Daniel Asrat
- University College of London, London, UK.
- Institute for Life and Earth Sciences Including Health and Agriculture (PAULESI), Pan African University, Oyo, Nigeria.
| | - Andrew Copas
- Institute for Global Health, Faculty of Pop Health Sciences, University College of London, London, UK
| | - Adesina Olubukola
- Department of Obstetrics & Gynaecology College of Medicine and Pan African University Institute for Life and Earth Sciences Including Health and Agriculture (PAULESI), University of Ibadan, Oyo, Nigeria
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Legese MH, Asrat D, Swedberg G, Hasan B, Mekasha A, Getahun T, Worku M, Shimber ET, Getahun S, Ayalew T, Gizachew B, Aseffa A, Mihret A. Sepsis: emerging pathogens and antimicrobial resistance in Ethiopian referral hospitals. Antimicrob Resist Infect Control 2022; 11:83. [PMID: 35698179 PMCID: PMC9195281 DOI: 10.1186/s13756-022-01122-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 05/29/2022] [Indexed: 12/22/2022] Open
Abstract
Background Sepsis due to multidrug resistant (MDR) bacteria is a growing public health problem mainly in low-income countries.
Methods A multicenter study was conducted between October 2019 and September 2020 at four hospitals located in central (Tikur Anbessa and Yekatit 12), southern (Hawassa) and northern (Dessie) parts of Ethiopia. A total of 1416 patients clinically investigated for sepsis were enrolled. The number of patients from Tikur Anbessa, Yekatit 12, Dessie and Hawassa hospital was 501, 298, 301 and 316, respectively. At each study site, blood culture was performed from all patients and positive cultures were characterized by their colony characteristics, gram stain and conventional biochemical tests. Each bacterial species was confirmed using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI TOF). Antimicrobial resistance pattern of bacteria was determined by disc diffusion. Logistic regression analysis was used to assess associations of dependent and independent variables. A p-value < 0.05 was considered as statistically significant. The data was analyzed using SPSS version 25.
Results Among 1416 blood cultures performed, 40.6% yielded growth. Among these, 27.2%, 0.3% and 13.1%, were positive for pathogenic bacteria, yeast cells and possible contaminants respectively. Klebsiella pneumoniae (26.1%), Klebsiella variicola (18.1%) and E. coli (12.4%) were the most frequent. Most K. variicola were detected at Dessie (61%) and Hawassa (36.4%). Almost all Pantoea dispersa (95.2%) were isolated at Dessie. Rare isolates (0.5% or 0.2% each) included Leclercia adecarboxylata, Raoultella ornithinolytica, Stenotrophomonas maltophilia, Achromobacter xylosoxidans, Burkholderia cepacia, Kosakonia cowanii and Lelliottia amnigena. Enterobacteriaceae most often showed resistance to ampicillin (96.2%), ceftriaxone (78.3%), cefotaxime (78%), cefuroxime (78%) and ceftazidime (76.4%). MDR frequency of Enterobacteriaceae at Hawassa, Tikur Anbessa, Yekatit 12 and Dessie hospital was 95.1%, 93.2%, 87.3% and 67.7%, respectively. Carbapenem resistance was detected in 17.1% of K. pneumoniae (n = 111), 27.7% of E. cloacae (n = 22) and 58.8% of Acinetobacter baumannii (n = 34).
Conclusion Diverse and emerging gram-negative bacterial etiologies of sepsis were identified. High multidrug resistance frequency was detected. Both on sepsis etiology types and MDR frequencies, substantial variation between hospitals was determined. Strategies to control MDR should be adapted to specific hospitals. Standard bacteriological services capable of monitoring emerging drug-resistant sepsis etiologies are essential for effective antimicrobial stewardship.
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Yitayew B, Woldeamanuel Y, Asrat D, Rahman A, Mihret A, Aseffa A, Olsson PE, Jass J. Antimicrobial resistance genes in microbiota associated with sediments and water from the Akaki river in Ethiopia. Environ Sci Pollut Res Int 2022; 29:70040-70055. [PMID: 35583762 PMCID: PMC9512891 DOI: 10.1007/s11356-022-20684-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 05/03/2022] [Indexed: 06/15/2023]
Abstract
The spread of antimicrobial-resistant pathogens is a global health concern. Most studies report high levels of antimicrobial resistance genes (ARGs) in the aquatic environment; however, levels associated with sediments are limited. This study aimed to investigate the distribution of ARGs in the sediments and water of the Akaki river in Addis Ababa, Ethiopia. The diversity and abundance of 84 ARGs and 116 clinically important bacteria were evaluated from the sediments and water collected from five sites in the Akaki river. Most of the ARGs were found in the city close to anthropogenic activities. Water samples collected in the middle catchment of the river contained 71-75% of targeted ARGs, with genes encoding aminoglycoside acetyltransferase (aac(6)-Ib-cr), aminoglycoside adenylyl transferase (aadA1), β-lactamase (blaOXA-10), quinolone resistance S (qnrS), macrolide efflux protein A (mefA), and tetracycline resistance (tetA), were detected at all sampling sites. Much fewer ARGs were detected in all sediments, and those near the hospitals had the highest diversity and level. Despite the lower levels and diversity, there were no unique ARGs detected in the sediments that were also not detected in the waters. A wide range of clinically relevant pathogens were also detected in the Akaki river. The findings suggest that the water phase, rather than the sediments in the Akaki river, is a potential conduit for the spread of ARGs and antibiotic-resistant bacteria.
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Affiliation(s)
- Berhanu Yitayew
- College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
- School of Science and Technology, The Life Science Center - Biology, Örebro University, 701 82, Örebro, Sweden
| | | | - Daniel Asrat
- College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Aminur Rahman
- School of Science and Technology, The Life Science Center - Biology, Örebro University, 701 82, Örebro, Sweden
| | - Adane Mihret
- College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Per-Erik Olsson
- School of Science and Technology, The Life Science Center - Biology, Örebro University, 701 82, Örebro, Sweden
| | - Jana Jass
- School of Science and Technology, The Life Science Center - Biology, Örebro University, 701 82, Örebro, Sweden.
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Sewunet T, Asrat D, Woldeamanuel Y, Aseffa A, Giske CG. Molecular epidemiology and antimicrobial susceptibility of Pseudomonas spp. and Acinetobacter spp. from clinical samples at Jimma medical center, Ethiopia. Front Microbiol 2022; 13:951857. [PMID: 36204631 PMCID: PMC9530197 DOI: 10.3389/fmicb.2022.951857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Pseudomonas aeruginosa (P. aeruginosa) and Acinetobacter baumannii (A. baumannii) can cause difficult-to-treat infections. We characterized molecular epidemiology of ceftazidime-resistant P. aeruginosa and carbapenem-resistant A. baumannii at a tertiary hospital in Ethiopia. Materials and methods Non-fermenting gram-negative bacilli (n = 80) isolated from admitted patients were subjected for species identification by MALDI-TOF. Pseudomonas species resistant to ceftazidime or meropenem, and Acinetobacter species resistant to meropenem, or imipenem were selected for whole genome sequencing. DNA extracted with EZ1 Advanced XL instrument (Qiagen, Hilden, Germany) was sequenced on Illumina (HiSeq2500) using libraries prepared by NEXTRA-kits (Illumina). Raw reads were assembled using SPAdes 3.13.0, and assembled genomes were used to query databases for resistome profile and sequence types. Result Among Pseudomonas species isolated, 31.7% (13/41), and 7.3% (3/41) were non-susceptible to ceftazidime, and meropenem, respectively. Carbapenem-resistance was 56.4% (22/39) among Acinetobacter species. Moreover, 92% (12/13) of Pseudomonas species non-susceptible to ceftazidime and/or meropenem, and 89.4% (17/19) of Acinetobacter species encoded multiple resistance genes for at least three classes of antimicrobials. The prevalent β - lactamase genes were blaOXA–486 (53.8%, 7/13), blaCTX–M–15 (23.0%, 3/13) among Pseudomonas, and blaGES–11 (57.8%, 11/19) among Acinetobacter. The blaOXA–51-like β - lactamase, blaOXA–69 (63.1%, 12/19) was the most prevalent carbapenemase gene among Acinetobacter isolates. Single isolates from both P. aeruginosa, and A. baumannii were detected with the blaNDM–1. Sequence type (ST)1 A. baumannii and ST274 P. aeruginosa were the prevalent sequence types. A cgMLST analysis of the ST1 A. baumannii isolates showed that they were closely related and belonged to the international clonal complex one (ICC1). Similarly, ST274 P. aeruginosa isolates were clonally related. Conclusion The prevalence of MDR isolates of Pseudomonas and Acinetobacter spp. was high. A. baumannii isolates were clonally spreading in the admission wards at the hospital. Emergence of blaNDM–1 in the intensive care, and surgical wards of the hospital is a severe threat that requires urgent intervention.
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Affiliation(s)
- Tsegaye Sewunet
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- *Correspondence: Tsegaye Sewunet, ;
| | - Daniel Asrat
- Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Christian G. Giske
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
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Ali MM, Asrat D. Variation of invasive neonatal GBS disease across the regions. The Lancet Global Health 2022; 10:e776-e777. [DOI: 10.1016/s2214-109x(22)00182-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 03/25/2022] [Indexed: 11/26/2022] Open
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Yitayew B, Woldeamanuel Y, Asrat D, Aseffa A, Olsson PE, Mihret A, Jass J. Carbapenemase-producing Aeromonas species isolated from the urban-impacted Akaki river in Ethiopia. J Water Health 2022; 20:903-914. [PMID: 35768966 DOI: 10.2166/wh.2022.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Carbapenemase-producing Aeromonas species are an emerging health threat. This study aimed to determine carbapenemase-mediated resistance among Aeromonas isolates from the Akaki river, Ethiopia during the dry and wet seasons in 2019-2020. Antimicrobial susceptibility to carbapenems and cephalosporins was determined and carbapenemase production was confirmed. Of 163 isolates, the majority were human pathogens Aeromonas caviae (62), Aeromonas hydrophila (33) and Aeromonas veronii (49). These isolates were resistant to carbapenem and cephalosporin antibiotics, with the highest resistance to cefotaxime 86 (59.7%), ertapenem 71 (49.3%) and imipenem 65 (45.1%). Resistance to carbapenem antibiotics varied between species, where most A. veronii 37 (75.5%) and A. hydrophila 28 (84.8%) were resistant to imipenem and all A. caviae were sensitive. A. veronii, A. caviae and A. hydrophila resistance to meropenem was 31 (63.3%), 3 (4.8%) and 19 (57.6%), respectively. Of isolates resistant to carbapenem, 82.1% A. hydrophila and 94.4% A. veronii were carbapenemase producers. Cephalosporin resistance also varied among the different species. The highest resistance to carbapenem antibiotics was in isolates collected during the wet season (p<0.05); however, it was not consistent across all classes of antibiotics tested. The rivers in megacities could be reservoirs of carbapenemase-producing Aeromonas spp.
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Affiliation(s)
- Berhanu Yitayew
- College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia; School of Science and Technology, The Life Science Center - Biology, Örebro University, Örebro, Sweden E-mail:
| | | | - Daniel Asrat
- College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Per-Erik Olsson
- School of Science and Technology, The Life Science Center - Biology, Örebro University, Örebro, Sweden E-mail:
| | - Adane Mihret
- College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia; Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Jana Jass
- School of Science and Technology, The Life Science Center - Biology, Örebro University, Örebro, Sweden E-mail:
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Shenkute D, Legese MH, Yitayew B, Mitiku A, Engidaye G, Gebremichael S, Asrat D, Woldeamanuel Y. High Magnitude of Fecal Carriage of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae at Debre Berhan Comprehensive Specialized Hospital, Ethiopia. Infect Drug Resist 2022; 15:2445-2458. [PMID: 35586558 PMCID: PMC9109895 DOI: 10.2147/idr.s356807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/30/2022] [Indexed: 11/23/2022] Open
Abstract
Background Gastrointestinal colonization rate of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) is the major risk factor for infection and dissemination of resistance clones in healthcare facilities. This study aimed to investigate the magnitude of the fecal carriage of ESBL-PE and associated factors among hospitalized patients at Debre Berhan Comprehensive Specialized Hospital, North Shoa, Amhara Regional State, Ethiopia. Methods A hospital-based cross-sectional study was conducted among 383 hospitalized patients from November 2020 to March 2021. Stool sample or rectal swab was aseptically collected and cultured on different culture media for isolation of Enterobacteriaceae. Identification was done by conventional biochemical tests. Screening of extended-spectrum beta-lactamase (ESBL) production was done by using cefotaxime and ceftazidime and confirmed by the combination disk method. Data analysis was performed by Statistical Package for Social Sciences software version 25 and a P-value ≤0.05 was considered as statistically significant. Results From the total of 383 hospitalized patients, a total of 347 Enterobacteriaceae were isolated. The overall gastrointestinal colonization rate of ESBL-PE was 47.3% (164/347). The predominant ESBL-PE were E. coli 54.9% (90/164) and K. pneumoniae 33.5% (55/164). The overall multi-drug resistance rate (MDR) was 87.8% (305/347). The highest resistance was observed to ampicillin (98.3%), followed by gentamicin (80.7%), and tetracycline (73.3%), respectively. ESBL-PE were highly susceptible to meropenem (90.2%) and imipenem (89.0%). History of antibiotic use in the past 3 months (p<0.001), admission in the neonatal intensive care unit (p=0.023), and presence of chronic disease (p<0.001) were independently associated with fecal carriage of ESBL-PE. Conclusion The magnitude of ESBL-PE and MDR was high in the study area. Meropenem and imipenem were active against ESBL-PE. Therefore, strict infection control measure is needed in the study area to limit the infection and dissemination of ESBL-PE.
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Affiliation(s)
- Demissew Shenkute
- Department of Medical Laboratory Science, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
- Correspondence: Demissew Shenkute, Email
| | - Melese Hailu Legese
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Berhanu Yitayew
- Department of Medical Laboratory Science, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Asaye Mitiku
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia
| | - Getabalew Engidaye
- Department of Medical Laboratory Science, Debre Berhan Health Science College, Debre Berhan, Ethiopia
| | - Saba Gebremichael
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Daniel Asrat
- Department of Microbiology, Immunology, and Parasitology, College of Health Sciences Addis Ababa University, Addis Ababa, Ethiopia
| | - Yimtubezinash Woldeamanuel
- Department of Microbiology, Immunology, and Parasitology, College of Health Sciences Addis Ababa University, Addis Ababa, Ethiopia
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Seman A, Mihret A, Sebre S, Awoke T, Yeshitela B, Yitayew B, Aseffa A, Asrat D, Abebe T. Prevalence and Molecular Characterization of Extended Spectrum β-Lactamase and Carbapenemase-Producing Enterobacteriaceae Isolates from Bloodstream Infection Suspected Patients in Addis Ababa, Ethiopia. Infect Drug Resist 2022; 15:1367-1382. [PMID: 35378892 PMCID: PMC8976516 DOI: 10.2147/idr.s349566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/11/2022] [Indexed: 12/30/2022] Open
Abstract
Background Production of Extended spectrum beta-lactamase (ESBL) and Carbapenemase is the most common strategy for drug resistance in clinical isolates of Enterobacteriaceae. This study was conducted to determine the magnitude of ESBL and Carbapenemase production (CPE) among clinical isolates of Enterobacteriaceae causing bloodstream infections (BSI) in Ethiopia. Methods A cross-sectional study was performed from September 2018 to January 2019 in Ethiopia. A total of 2397 BSI suspected patients were enrolled and blood culture was performed using a BacT/Alert instrument in combination with conventional methods for identification. After antimicrobial susceptibility test, phenotypic confirmation of ESBLs was done by combined disc-diffusion. Meanwhile carbapenemase production was done by modified carbapenem inactivation method. Multiplex PCR was conducted to detect the presence of blaCTX-M,blaSHV,blaTEM, blaKPC and blaNDM genes. Results A total of 104 (4.3%) Enterobacteriaceae were isolated from 2397 BSI suspected patients. Klebsiella pneumoniae (55/104, 52%) was the predominant isolate followed by E. coli, (19.2%, 20/104) and K.oxytoca (17.3%, 18/104). ESBL and carbapenemase production were observed from 70 (67.3%, 57.4 −76.2% at 95% CI) and 8 (7.7%, 3.4–14.6% at 95% CI) isolates respectively. The highest frequency of ESBL and carbapenemase production was observed in K. pneumoniae 78.2% (43/55) and 9.1% (5/55), respectively. All the 70 isolates confirmed as ESBL producers harbored at least one of the ESBL genes and the majority of them carried multiple beta-lactamase genes (84.3%), where blaCTX-M, type was the most predominant (67.3%). Similarly, the entire eight isolates positive for carbapenemase carried blaNDM but none of them carried blaKPC. Conclusion In our study, the rate of ESBL production among BSI-causing Enterobacteriaceae was alarming and most of the isolates carried multiple types of ESBL genes. A significant magnitude of CPE isolates causing BSI was recorded.
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Affiliation(s)
- Aminu Seman
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Bacterial and Viral Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
- Correspondence: Aminu Seman, Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, P.O. Box: 9086, Addis Ababa, Ethiopia, Tel +251 920 747 176, Email ;
| | - Adane Mihret
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Bacterial and Viral Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Shemse Sebre
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Bacterial and Viral Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Tewachew Awoke
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Biruk Yeshitela
- Bacterial and Viral Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Berhanu Yitayew
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Abraham Aseffa
- Bacterial and Viral Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Daniel Asrat
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tamrat Abebe
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Chala G, Eguale T, Abunna F, Asrat D, Stringer A. Identification and Characterization of Campylobacter Species in Livestock, Humans, and Water in Livestock Owning Households of Peri-urban Addis Ababa, Ethiopia: A One Health Approach. Front Public Health 2021; 9:750551. [PMID: 34926375 PMCID: PMC8677049 DOI: 10.3389/fpubh.2021.750551] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/27/2021] [Indexed: 12/22/2022] Open
Abstract
Campylobacter is the most common cause of bacterial infectious diarrhea and acute gastroenteritis globally, and is recognized as a significant zoonotic pathogen. Antimicrobial resistance amongst Campylobacter isolates is a significant global concern. A cross-sectional study was conducted to identify and characterize Campylobacter species in humans, animals and water sources in livestock owning households of peri-urban Addis Ababa, Ethiopia; and to characterize antimicrobial resistance. A total of 519 fecal samples from humans (n = 99), livestock (n = 179), poultry (n = 69), and water (n = 172) were collected. Samples were cultured for viable Campylobacter spp. and multiplex PCR utilized for the identification and confirmation. Antimicrobial susceptibility of the isolates was assessed using the Kirby-Bauer disc diffusion method. Campylobacter spp. was detected in 67/519 (13.0%) of the total tested samples, and the household level prevalence of Campylobacter was 42.4%. The prevalence of Campylobacter spp. was: humans (10.1%), cattle (18.5%), poultry (13.0%), sheep (13.3%), goats (7.1%), and water (10.5%). Campylobacter jejuni and C. fetus were the most frequently isolated species, followed by C. coli. The majority of isolates obtained from human samples had co-occurrence with isolates from cattle, poultry or water samples from the same household. The use of stored water, the practice of indoor and outdoor manure collecting, and animal species Campylobacter positivity were significantly associated with greater odds of human Campylobacter spp. positivity. All Campylobacter isolates from humans, poultry, sheep, goats and water, and 96.0% of isolates from cattle were resistant to at least one or more of the tested antimicrobials, with 95.5% of isolates resistant to three or more classes of antimicrobials. A One Health approach is recommended to further investigate Campylobacter species infections, and other zoonotic infectious diseases, in the livestock owning populations in Ethiopia, where there is close interaction between humans, animals and the environment.
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Affiliation(s)
- Gemechu Chala
- College of Veterinary Medicine, Hawassa University, Hawassa, Ethiopia
| | - Tadesse Eguale
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Fufa Abunna
- College of Veterinary Medicine and Agriculture, Addis Ababa University, Addis Ababa, Ethiopia
| | - Daniel Asrat
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Andrew Stringer
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
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Sewunet T, Asrat D, Woldeamanuel Y, Ny S, Westerlund F, Aseffa A, Giske CG. Polyclonal spread of bla CTX-M-15 through high-risk clones of Escherichia coli at a tertiary hospital in Ethiopia. J Glob Antimicrob Resist 2021; 29:405-412. [PMID: 34775133 DOI: 10.1016/j.jgar.2021.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 09/18/2021] [Accepted: 09/28/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The burden of antimicrobial resistance and spread of epidemic clones are rarely reported from low-income countries. We aimed to investigate genome-based epidemiology of extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-EC) at a tertiary hospital in Jimma, Ethiopia. METHODS Bacteria were isolated from clinical specimens obtained from Jimma Medical Center and subjected to species identification (MALDI-TOF), antibiotic susceptibility testing (disk diffusion), and whole genome sequencing (Illumina HiSeq2500). Genomic data analysis was performed using the Enterobase and Center for Genomic Epidemiology bioinformatics pipelines. A maximum likelihood tree was generated using FastTree/2.1.8 based on SNPs in shared genomic regions to identify transmission clusters. RESULT E. coli isolates (n=261) were collected from 1,087 single non-repeat clinical specimens over a period of five months in 2016. The prevalence of ESBL-EC was (54.7%, 143/261), and 96% of these isolates were resistant to multiple classes of antibiotics. ESBL-gene blaCTX-M-15 was present in 88.4.% of the isolates (122/138). Genes conferring resistance to aminoglycosides and ciprofloxacin - aac(6')-Ib-cr (62.3%, 86/138), phenicols - catB3 (56.5%, 78/138), sulfonamides - sul1 (68.1%, 94/138), trimethoprim - dfrA17 (57.9%, 80/138) and macrolides - mph(A) (67.3%, 93/138) were detected. The most prevalent sequence types were ST410 (23%), ST648 (17%), ST131 (10%), and ST167 (7%). Isolates of same sequence type collected from different units of the hospital were highly similar in SNP-analysis. CONCLUSION A high prevalence of ESBL, and dissemination of blaCTX-M-15 through multiple high-risk clones of E. coli, was detected. The nosocomial spread of multidrug-resistant ESBL-EC within the hospital puts vulnerable patients at risk for difficult-to-treat infections.
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Affiliation(s)
- Tsegaye Sewunet
- Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Ethiopia; School of Laboratory Sciences, Jimma University, Jimma, Ethiopia; Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Sweden.
| | - Daniel Asrat
- Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Ethiopia
| | | | - Sofia Ny
- Public Health Agency of Sweden, Sweden
| | - Fredrik Westerlund
- Department of Biology and Biological Engineering, Chalmers University of Technology, Sweden
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Christian G Giske
- Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Sweden; Karolinska University Hospital, Clinical Microbiology, Sweden
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Cavalerie L, Wardeh M, Lebrasseur O, Nanyingi M, McIntyre KM, Kaba M, Asrat D, Christley R, Pinchbeck G, Baylis M, Mor SM. One hundred years of zoonoses research in the Horn of Africa: A scoping review. PLoS Negl Trop Dis 2021; 15:e0009607. [PMID: 34270551 PMCID: PMC8318308 DOI: 10.1371/journal.pntd.0009607] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 07/28/2021] [Accepted: 06/29/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND One Health is particularly relevant to the Horn of Africa where many people's livelihoods are highly dependent on livestock and their shared environment. In this context, zoonoses may have a dramatic impact on both human and animal health, but also on country economies. This scoping review aimed to characterise and evaluate the nature of zoonotic disease research in the Horn region. Specifically, it addressed the following questions: (i) what specific zoonotic diseases have been prioritised for research, (ii) what data have been reported (human, animal or environment), (iii) what methods have been applied, and (iv) who has been doing the research? METHODOLOGY/PRINCIPAL FINDINGS We used keyword combinations to search online databases for peer-reviewed papers and theses. Screening and data extraction (disease, country, domain and method) was performed using DistillerSR. A total of 2055 studies focusing on seven countries and over 60 zoonoses were included. Brucellosis attracted the highest attention in terms of research while anthrax, Q fever and leptospirosis have been comparatively under-studied. Research efforts did not always align with zoonoses priorities identified at national levels. Despite zoonoses being a clear target for 'One Health' research, a very limited proportion of studies report data on the three domains of human, animal and environment. Descriptive and observational epidemiological studies were dominant and only a low proportion of publications were multidisciplinary. Finally, we found that a minority of international collaborations were between Global South countries with a high proportion of authors having affiliations from outside the Horn of Africa. CONCLUSIONS/SIGNIFICANCE There is a growing interest in zoonoses research in the Horn of Africa. Recommendations arising from this scoping review include: (i) ensuring zoonoses research aligns with national and global research agendas; (ii) encouraging researchers to adopt a holistic, transdisciplinary One Health approach following high quality reporting standards (COHERE, PRISMA, etc.); and (iii) empowering local researchers supported by regional and international partnerships to engage in zoonoses research.
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Affiliation(s)
- Lisa Cavalerie
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Brownlow Hill, Liverpool, United Kingdom
- International Livestock Research Institute, Addis Ababa, Ethiopia
- * E-mail:
| | - Maya Wardeh
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Brownlow Hill, Liverpool, United Kingdom
- Department of Mathematical Sciences, University of Liverpool, Peach Street, Liverpool, United Kingdom
| | - Ophélie Lebrasseur
- International Livestock Research Institute, Addis Ababa, Ethiopia
- Department of Archaeology, Classics and Egyptology; School of Histories, Language and Cultures, University of Liverpool, Liverpool, United Kingdom
| | - Mark Nanyingi
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Brownlow Hill, Liverpool, United Kingdom
- Department of Epidemiology and Public Health, School of Public Health, University of Nairobi, Nairobi, Kenya
| | - K. Marie McIntyre
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Brownlow Hill, Liverpool, United Kingdom
- Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom
| | - Mirgissa Kaba
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Daniel Asrat
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences Addis Ababa University, Addis Ababa, Ethiopia
| | - Robert Christley
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Brownlow Hill, Liverpool, United Kingdom
- Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom
| | - Gina Pinchbeck
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Brownlow Hill, Liverpool, United Kingdom
| | - Matthew Baylis
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Brownlow Hill, Liverpool, United Kingdom
- Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom
| | - Siobhan M. Mor
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Brownlow Hill, Liverpool, United Kingdom
- International Livestock Research Institute, Addis Ababa, Ethiopia
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Negash AA, Asrat D, Abebe W, Aseffa A, Vaneechoutte M. Phenotypic and Molecular Characterization of Penicillin and Macrolide-Resistant Streptococcus pneumoniae Serotypes Among Pediatric Patients in Addis Ababa, Ethiopia. Infect Drug Resist 2021; 14:1765-1772. [PMID: 34012275 PMCID: PMC8126871 DOI: 10.2147/idr.s309876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 04/15/2021] [Indexed: 11/23/2022] Open
Abstract
Background In several countries, introduction of the pneumococcal conjugate vaccine (PCV) has led to a decline in antimicrobial-resistant pneumococcal disease but has also resulted in a concomitant increase in antimicrobial-resistant, non-vaccine serotypes of Streptococcus pneumoniae. We sought to determine the magnitude of penicillin and macrolide resistance among pneumococcal serotypes and the mechanisms of macrolide resistance in Ethiopia, 5 years after the introduction of PCV10 in the country. Methods Susceptibility to penicillin and erythromycin of 119 pneumococcal isolates collected from pediatric patients aged 0-15 years in Addis Ababa, Ethiopia, was tested using disc diffusion, and minimum inhibitory concentration (MIC) was also determined by Etest. Pneumococcal serotypes were determined by sequencing the cpsB gene and using Quellung reaction. Polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism analysis were used to detect and differentiate the macrolide resistance genes erm(B), mef(A), and mef(B). Results Among the 119 isolates, 2.5% (3/119) were resistant to penicillin, while 58% (69/119) were intermediate. Resistance to erythromycin was observed in 33.6% (40/119) of the isolates with the highest level of resistance among isolates from middle ear discharge, i.e., 53.3% (8/15). Half (19/40) of the erythromycin resistant isolates were serotype 19A and among serotype 19A isolates, the majority i.e., 54.3% (19/35) were resistant to erythromycin. The most common macrolide resistance determinant was mef(E) with a prevalence of 50% (20/40). Conclusion Five years after introduction of PCV10 in Ethiopia, we observed that the prevalence of penicillin-resistant S. pneumoniae was low. However, there was a high level of macrolide resistance which was mostly in serotype 19A, and the resistance was mainly mediated by efflux pumps. Introduction of PCV13 (which covers serotype 19A) would significantly improve coverage of the macrolide-resistant serotypes. Continued surveillance of pneumococcal serotype distribution and their antibiotic resistance pattern in Ethiopia is warranted.
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Affiliation(s)
- Abel Abera Negash
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia.,Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Daniel Asrat
- Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Workeabeba Abebe
- Department of Pediatrics and Child Health, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abraham Aseffa
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
| | - Mario Vaneechoutte
- Laboratory Bacteriology Research, Department of Diagnostic Sciences, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
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Sewunet T, Asrat D, Woldeamanuel Y, Ny S, Westerlund F, Aseffa A, Giske CG. High prevalence of bla CTX-M-15 and nosocomial transmission of hypervirulent epidemic clones of Klebsiella pneumoniae at a tertiary hospital in Ethiopia. JAC Antimicrob Resist 2021; 3:dlab001. [PMID: 34223080 PMCID: PMC8210115 DOI: 10.1093/jacamr/dlab001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/28/2020] [Indexed: 12/21/2022] Open
Abstract
Background Genomic epidemiology of antibiotic resistance is not sufficiently studied in low-income countries. Objectives To determine prevalence of ESBL production, and resistome and virulome profiles, of Klebsiella pneumoniae isolated at Jimma Medical Center, Ethiopia. Methods Strains isolated from patients with suspected infections between June and November 2016 were characterized by MALDI-TOF for species identification and disc diffusion for antimicrobial susceptibility testing. All K. pneumoniae isolates were characterized by double disc diffusion for ESBL production and all ESBL-producing strains (ESBL-KP) were subjected to WGS on the Illumina (HiSeq 2500) platform. DNA was extracted by automated systems (MagNA Pure 96). Genome assembly was performed using SPAdes (v. 3.9) and draft genomes were used for analysing molecular features of the strains. Maximum likelihood trees were generated using FastTree/2.1.8 based on SNPs in shared genomic regions to identify transmission clusters. Results Of the 146 K. pneumoniae strains isolated, 76% were ESBL-KP; 93% of the ESBL-KP strains showed resistance to multiple antimicrobial classes. blaCTX-M-15 (84.4%) was the most prevalent ESBL gene. Resistance genes for aminoglycosides and/or fluoroquinolones [aac(6′)-Ib-cr (65.1%)], phenicols [catB3 (28.4%)], sulphonamides [sul1 (61.2%) and sul2 (60.5%)], trimethoprim [dfrA27 (32.1%)], macrolides [mph(A) (12.8%)] and rifampicin [arr2/arr3 (39.4%)] were prevalent. Plasmids of the IncF and IncR families were prevalent among ST218, ST147, ST15 and ST39. KL64 and KL57 capsular types and O1 and O2 LPSs were prevalent. A high-risk clone, ST218-KL57 encoding rmpA1/rmpA2 and iutA, was detected. Phylogenetic analysis showed a cluster of clonally related strains from different units of the hospital. Conclusions Prevalence of ESBL-KP was high and blaCTX-M-15 was the predominant ESBL gene. ESBL genes had spread through both clonal and polyclonal expansion of high-risk and hypervirulent clones. Nosocomial transmission of MDR strains between different units of the hospital was observed.
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Affiliation(s)
- Tsegaye Sewunet
- Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia.,Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Stockholm, Sweden
| | - Daniel Asrat
- Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Sofia Ny
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Fredrik Westerlund
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Christian G Giske
- Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Clinical Microbiology, Stockholm, Sweden
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Negash AA, Asrat D, Abebe W, Hailemariam T, Wubete A, Aseffa A, Vaneechoutte M. Etiology, antibiotic susceptibility and prognostic factors of pediatric community-acquired sepsis in Addis Ababa, Ethiopia. J Infect Dev Ctries 2021; 15:113-122. [PMID: 33571153 DOI: 10.3855/jidc.12674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 09/15/2020] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION There is a scarcity of data on pediatric community-acquired sepsis (CAS) in Ethiopia. We sought to determine the etiology, role of Streptococcus pneumoniae, antibiotic susceptibility pattern, and prognostic factors in children with CAS in Addis Ababa, Ethiopia. METHODOLOGY A prospective cross-sectional study of 101 children aged 0-15 years with suspected CAS was performed at two major hospitals in Addis Ababa, Ethiopia. Blood culture, antibiotic susceptibility testing, amplification of the autolysin (lytA) gene and typing S. pneumoniae by sequencing and Quellung reaction were performed. Data were analyzed using descriptive statistics and logistic regression. RESULTS The prevalence of culture-positive CAS was 18.81% (19/101). S. pneumoniae (21.1%) (Serotypes 19A (n = 2), 33C and 12F) and Klebsiella pneumoniae (21.1%) were the most common causes of CAS. Half of K. pneumoniae isolates were resistant to gentamicin and ceftriaxone. The most common antibiotics used for treatment were a combination of ampicillin with gentamicin (47.5%). The presence of lower respiratory tract infections (LRTIs) in the preceding 3 months was an independent predictor associated with culture-proven sepsis (adjusted odds ratio (AOR), 7.02; 95% confidence interval (CI), 1.42 - 34.64; P = 0.02). The case-fatality rate was 11.9% (12/101). Presence of underlying comorbidity (AOR, 6.8; 95% CI, 1.59-28.7; P = 0.009) was an independent predictor of mortality. CONCLUSIONS S. pneumoniae and K. pneumoniae were the major causes of CAS and there was a substantial level of antibiotic resistance. Presence of LRTIs in the preceding 3 months was a predictor of culture-proven CAS whereas underlying comorbidity was a predictor of mortality.
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Affiliation(s)
| | - Daniel Asrat
- Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Workeabeba Abebe
- Department of Pediatrics and Child Health, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tewodros Hailemariam
- Department of Pediatrics and Child Health, Yekatit 12 Medical College, Addis Ababa, Ethiopia
| | - Andualem Wubete
- Department of Emergency Medicine and Critical Care, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abraham Aseffa
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
| | - Mario Vaneechoutte
- Laboratory Bacteriology Research, Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Ali MM, Woldeamanuel Y, Asrat D, Fenta DA, Beall B, Schrag S, McGee L. Features of Streptococcus agalactiae strains recovered from pregnant women and newborns attending different hospitals in Ethiopia. BMC Infect Dis 2020; 20:848. [PMID: 33198686 PMCID: PMC7668015 DOI: 10.1186/s12879-020-05581-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 11/03/2020] [Indexed: 12/14/2022] Open
Abstract
Background Streptococcus agalactiae (Group B Streptococcus, GBS) serotypes, sequence types, and antimicrobial resistance profile vary across different geographic locations affecting disease patterns in newborns. These differences are important considerations for vaccine development efforts and data from large countries in Africa is limited. The aim of this study was to determine serotypes and genotypes of GBS isolates from pregnant women and their newborns in Ethiopia. Methods A hospital based cross-sectional study was conducted at three hospitals in Ethiopia from June 2014 to September 2015. Out of 225 GBS isolates, 121 GBS were recovered, confirmed and characterized at CDC’s Streptococcus Laboratory using conventional microbiology methods and whole genome sequencing. Results Of the 121 isolates, 87 were from rectovaginal samples of pregnant women, 32 from different body parts of their newborns and 2 from blood of newborns with suspected sepsis. There were 25 mother-infant pairs and 24 pairs had concordant strains. The most prevalent serotypes among mothers and/or their babies were II, Ia and V (41.5, 20.6, 19.5 and 40.6%, 25 and 15.6%, respectively). Multilocus sequence typing (MLST) on 83 isolates showed ST10 (24; 28.9%) and ST2 (12; 14.5%) as most predominant sequence types. All GBS strains were susceptible to penicillin, cefotaxime and vancomycin, which correlated to the presence of wildtype PBP2x types and the lack of known vancomycin-resistance genes. Tetracycline resistance was high (73; 88%, associated primarily with tetM, but also tetO and tetL). Five isolates (6%) were resistant to erythromycin and clindamycin and 3 isolates were fluoroquinolone-resistant, containing associated mutations in gyrA and parC genes. All isolates were positive for one of four homologous Alpha/Rib family determinants and 1–2 of the three main pilus types. Conclusions Predominant serotypes were II, Ia, and V. A limited number of clonal types were identified with two STs accounting for about half of the isolates. All strains collected in this study were susceptible to beta-lactam antibiotics and vancomycin. Typical of most GBS, these isolates were positive for single alpha-like family protein, serine-rich repeat gene, as well as 1–2 pilus determinants. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-020-05581-8.
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Affiliation(s)
- Musa Mohammed Ali
- Hawassa University College of Medicine and Health Sciences, School of Medical laboratory Science, Hawassa, Ethiopia.
| | - Yimtubezinash Woldeamanuel
- Department of Microbiology, Immunology and Parasitology, Addis Ababa University College of Health Science, Addis Ababa, Ethiopia
| | - Daniel Asrat
- Department of Microbiology, Immunology and Parasitology, Addis Ababa University College of Health Science, Addis Ababa, Ethiopia
| | - Demissie Assegu Fenta
- Hawassa University College of Medicine and Health Sciences, School of Medical laboratory Science, Hawassa, Ethiopia
| | - Bernard Beall
- Respiratory Diseases Branch, Centers of Disease Control and Prevention (CDC), Atlanta, USA
| | - Stephanie Schrag
- Respiratory Diseases Branch, Centers of Disease Control and Prevention (CDC), Atlanta, USA
| | - Lesley McGee
- Respiratory Diseases Branch, Centers of Disease Control and Prevention (CDC), Atlanta, USA
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Weldesenbet H, Asrat D, Weldeamanuel Y. The prevalence and associated factors of Treponema pallidum among HIV-positive and HIV-negative individuals who attended voluntary counseling and testing center of St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia: A cross-sectional study design. SAGE Open Med 2020; 8:2050312120904604. [PMID: 32110402 PMCID: PMC7026812 DOI: 10.1177/2050312120904604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 12/23/2019] [Indexed: 11/30/2022] Open
Abstract
Background: Treponema pallidum and HIV are among the most common public health problems in Ethiopia. These infections are interrelated. Treponema pallidum causes genital ulcer which enhances HIV transmission and complicates HIV by causing severe ulcer among HIV-positive individuals. Although Treponema pallidum and HIV have a similar route of transmission, screening services for Treponema pallidum are not available in most of the voluntary counseling and testing centers. Objectives: This study aimed to assess the seroprevalence of Treponema pallidum and sociodemographic factors among HIV-positive and HIV-negative individuals from the voluntary counseling and testing center of St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods: In this research, a cross-sectional study was conducted and a total of 292 consecutive samples were collected from the voluntary counseling and testing center of St. Paul’s Hospital Millennium Medical College. Data were collected using an interviewer-administered questionnaire. A blood specimen was tested for the presence of Treponema pallidum using rapid plasma reagin and a rapid test kit for HIV. The data were entered and analyzed using SPSS version 20. Results: The overall prevalence of Treponema pallidum was 5/292 (1.7%). All HIV-positive clients were negative for Treponema pallidum. None of the risk factors were significantly associated with Treponema pallidum. Conclusion: In this study, the prevalence of Treponema pallidum was 5/292 (1.7%). None of the study participants were co-infected with Treponema pallidum and HIV. Recommendation: There was a lack of association between syphilis and HIV in this study, but still the prevalence of Treponema pallidum among voluntary counseling and testing center clients is a public health problem. Therefore, Treponema pallidum infection control strategies should be designed in parallel with HIV control strategy and actions should be taken to avert the problem, including the provision of better health education and screening services at voluntary counseling and testing centers parallel with HIV.
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Affiliation(s)
- Habtamu Weldesenbet
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Daniel Asrat
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yimtubezinash Weldeamanuel
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Belete Y, Asrat D, Woldeamanuel Y, Yihenew G, Gize A. Bacterial Profile And Antibiotic Susceptibility Pattern Of Urinary Tract Infection Among Children Attending Felege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia. Infect Drug Resist 2019; 12:3575-3583. [PMID: 31819542 PMCID: PMC6874112 DOI: 10.2147/idr.s217574] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 10/28/2019] [Indexed: 11/28/2022] Open
Abstract
Background Urinary tract infection (UTI) is a common and important clinical problem in pediatrics. Recurrent UTIs may lead to renal scarring, hypertension, and end-stage renal dysfunction later in life. The objective of the study was to determine bacterial profile and antimicrobial susceptibility pattern of urinary tract infections (UTIs) among children attending Felege Hiwot Referral Hospital (FHRH). Methods A cross-sectional study was conducted from February 2013 to May 2013 among children 5–15 years of age with symptoms of UTI. Samples were processed for culture and identification. Antimicrobial susceptibility was done for positive urine cultures by the Kirby-Bauer’s disk diffusion method based on standards of the Clinical Laboratory Standard Institute (CLSI). Data were entered into Epi-data version 3.2.1 and exported to the Statistical Package for the Social Science (SPSS) version 20 statistical software. Fisher’s exact test and binary logistic regression test results were used. Results A total of 259 urine samples were collected from children with UTI. The result revealed 41 (15.8%) samples had significant bacteriuria, among which the most prevalent pathogen was E. coli 14 (34.1%) followed by Pseudomonas species. Gram-negative bacteria showed high level of sensitivity to ciprofloxacin (70), norfloxacin (63.4%) and ceftriaxone (60%), whereas the level of resistance was high to ampicillin (80%) and nitrofurantoin (70%). Gram-positive isolates showed high sensitivity to ciprofloxacin (77.8%), penicillin (72.8%) and erythromycin (72.7%). Multiple drug resistance (MDR) for Gram-positive and Gram-negative bacteria was 100% and 83.1%, respectively. Conclusion E. coli is the predominant bacteria isolated in the present study. The results showed that the prevalence of resistance to at least one antibiotic to commonly prescribed antimicrobials was high. Hence, the guidelines for empiric treatment of UTI should be re-evaluated periodically based on local studies.
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Affiliation(s)
- Yerega Belete
- Department of Microbiology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Daniel Asrat
- Department of Microbiology, Immunology And Parasitology, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yimtubezinash Woldeamanuel
- Department of Microbiology, Immunology And Parasitology, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gebeyehu Yihenew
- Department of Microbiology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Addisu Gize
- Department of Microbiology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Negash AA, Asrat D, Abebe W, Hailemariam T, Gebre M, Aseffa A, Vaneechoutte M. Pneumococcal serotype 19A is the major cause of pediatric acute otitis media with ruptured tympanic membrane in Addis Ababa, Ethiopia, 5 years after the introduction of the ten-valent pneumococcal conjugate vaccine. Int J Pediatr Otorhinolaryngol 2019; 126:109638. [PMID: 31442868 DOI: 10.1016/j.ijporl.2019.109638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 08/08/2019] [Accepted: 08/09/2019] [Indexed: 12/11/2022]
Abstract
INTRODUCTION In Ethiopia, there is a lack of data on pneumococcal serotypes causing acute otitis media (AOM) in children. We aimed to study the etiology, pneumococcal serotypes and antimicrobial resistance patterns of isolates from children with AOM with spontaneous perforation of the tympanic membrane (SPTM). METHODS We carried out a prospective observational study in children with AOM with SPTM, aged 0-15 years in Addis Ababa, Ethiopia. Middle ear fluid was collected using sterile swabs, cultured and antibiotic susceptibility testing was performed. Serotypes of Streptococcus pneumoniae were determined by sequencing the cpsB gene and by the Quellung reaction. RESULTS A total of 55 children were enrolled. Out of 55 samples that were cultured, 52 (94.5%) were culture positive for a total of 66 bacterial species, and 56.4% (31/55) samples were positive for 41 (62.1%) known pathogenic bacterial species. The most common pathogenic bacterial isolates were S. pneumoniae (36.6%), Staphylococcus aureus (19.5%), Streptococcus pyogenes (14.6%) and Haemophilus influenzae (12.2%). Serotype 19A (73.3%) was the predominant pneumococcal serotype. There was a high rate of non-susceptibility to penicillin (86.6%) and trimethoprim/sulfamethoxazole (80%) among pneumococcal isolates. Out of 21 different isolates tested for amoxicillin susceptibility, 15 (71.4%) were resistant. CONCLUSIONS Pneumococcal serotype 19A was the predominant cause of AOM with SPTM in children in Addis Ababa, Ethiopia, 5 years after introduction of PCV10. There was a high rate of resistance to commonly prescribed antibiotics. The study highlights the need for wide scale surveillance of the etiology and antimicrobial susceptibility of AOM in Ethiopian children.
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Affiliation(s)
- Abel Abera Negash
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia; Laboratory Bacteriology Research, Department of Diagnostic Sciences, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium.
| | - Daniel Asrat
- Department of Microbiology, Immunology and Parasitology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Workeabeba Abebe
- Department of Pediatrics and Child Health, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tewodros Hailemariam
- Department of Pediatrics and Child Health, Yekatit 12 Medical College, Addis Ababa, Ethiopia
| | - Meseret Gebre
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
| | - Abraham Aseffa
- Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia
| | - Mario Vaneechoutte
- Laboratory Bacteriology Research, Department of Diagnostic Sciences, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
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Kiros T, Asrat D, Ayenew Z, Tsige E. Bacterial urinary tract infection among adult renal transplant recipients at St. Paul's hospital millennium medical college, Addis Ababa, Ethiopia. BMC Nephrol 2019; 20:289. [PMID: 31366333 PMCID: PMC6668100 DOI: 10.1186/s12882-019-1485-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 07/23/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Despite significant advances in surgical techniques, immunosuppression protocols, follow up periods and antimicrobial stewardship in modern medicine; post-renal transplantation urinary tract infection remained a major public health problem globally. This multiple serious squeals includes asymptomatic bacteriuria, cystitis and pyelonephritis. Among these, the bacterial origin of infection complications accounts for the most significant clinical, socio-economic impacts in many countries of the world. Therefore, the aim of the study was to investigate the prevalence of bacterial isolates that cause urinary tract infections, assess antibiotic susceptibility pattern among symptomatic and asymptomatic renal transplant recipients attending at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. METHODS A hospital-based cross-sectional study was conducted from December 2017 to August 2018 among 74 renal transplant recipients St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. A first morning voided clean-catch mid-stream urine specimens were collected and 0.001 ml inoculated onto blood and MacConkey agar plates following the standard bacteriological protocols. It was incubated aerobically at 35-37 °C for 24-48 h. Cultural characteristics and series of biochemical tests were used for the identification of isolates to species level based on the standard bacteriological protocols. RESULTS A hospital-based cross-sectional study has shown that significant bacteriuria was found in 11/74 (14.9, 95% CI =8.2-24.7) patients. The prevalence among females 6/32 (18.75%) was higher among males 5/42 (11.9%) without significant association (COR = 2.09, 95% CI = 1.04-8.45, P = 0.253). Urinary tract infection was higher in the age group of 35-49 years old (19.3%). Age was statistically significant and stronger independent associated risk factor with crude odds ratio = 3.67, 95% CI = 2.89-20.07 and P = 0.003, respectively. The most prevalent bacteria isolates were Escherichia coli 2(18.2%), Staphylococcus aureus 2(18.2%), Acinetobacter spp. 2(18.2%), Enterococcus spp. 2(18.2%), Coagulase-negative Staphylococci 2(18.2%) followed by Porteus mirabilis 1(9.1%). The majority (80%) of Gram-negative bacteria were resistant to ciprofloxacin, chloramphenicol, and trimethoprim/sulfamethoxazole. Simultaneously, the multidrug-resistant bacterial isolates accounts for 82% among tested kidney allograft recipients. CONCLUSIONS In conclusion, the overall prevalence of urinary tract infection in the study participants was relatively low with a prevalence of 14.9%. Majority of the study participants were asymptomatic and a higher percentage of females were involved. The multidrug-resistant bacterial isolates in the present study account for 82%.
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Affiliation(s)
- Teklehaimanot Kiros
- Department of Medical Microbiology, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Daniel Asrat
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zeleke Ayenew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Negash AA, Asrat D, Abebe W, Hailemariam T, Gebre M, Verhaegen J, Aseffa A, Vaneechoutte M. Pneumococcal Carriage, Serotype Distribution, and Risk Factors in Children With Community-Acquired Pneumonia, 5 Years After Introduction of the 10-Valent Pneumococcal Conjugate Vaccine in Ethiopia. Open Forum Infect Dis 2019; 6:ofz259. [PMID: 31263735 PMCID: PMC6592415 DOI: 10.1093/ofid/ofz259] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 05/30/2019] [Indexed: 12/18/2022] Open
Abstract
Background There is a scarcity of data on pneumococcal serotypes carried by children in Ethiopia. We studied pneumococcal nasopharyngeal carriage rate, serotypes, and risk factors among children with community acquired pneumonia (CAP). Methods A prospective observational cohort study was performed in children with CAP, aged 0–15 years, in 2 pediatric emergency departments in Addis Ababa, Ethiopia. Nasopharyngeal swabs were cultured, and serotypes of Streptococcus pneumoniae were determined by sequencing the cpsB gene and by the Quellung reaction. Risk factors were analyzed by using binary logistic regression. Results Nasopharyngeal swabs were collected from 362 children with CAP. Pneumococcal carriage rate was 21.5% (78 of 362). The most common serotypes were 19A (27%), 16F (8.5%), and 6A (4.9%). In addition, 8.5% of the pneumococcal isolates were nontypeable. In bivariate analysis, children with a parent that smokes were more likely to carry pneumococci (crude odds ratio, 3.9; 95% confidence interval [CI], 1.2–12.3; P = .023) than those with parents that do not smoke. In multivariable analysis, living in a house with ≥2 rooms (adjusted odds ratio [AOR], 0.48; 95% CI, 0.28–0.82; P = .007) and vaccination with ≥2 doses of 10-valent pneumococcal conjugate vaccine (PCV10) (AOR, 0.37; 95% CI, 0.15–0.92; P = .033) were protective of pneumococcal carriage. Conclusions Five years after introduction of PCV10 in Ethiopia, the vaccine-related serotype 19A was predominant in the nasopharynx of children with CAP. Continued evaluation of the direct and indirect impact of PCV10 on pneumococcal serotype distribution in Ethiopia is warranted.
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Affiliation(s)
- Abel Abera Negash
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia.,Laboratory Bacteriology Research, Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - Daniel Asrat
- Department of Microbiology and Immunology, School of Medicine, Addis Ababa University, Ethiopia
| | - Workeabeba Abebe
- Department of Pediatrics and Child Health, School of Medicine, Addis Ababa University, Ethiopia
| | - Tewodros Hailemariam
- Department of Pediatrics and Child Health, Yekatit 12 Medical College, Addis Ababa, Ethiopia
| | - Meseret Gebre
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Jan Verhaegen
- Pneumococcal Reference Laboratory, Universitair Ziekenhuis, Katholieke Universiteit Leuven, Belgium
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Mario Vaneechoutte
- Laboratory Bacteriology Research, Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium
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Negash AA, Asrat D, Abebe W, Hailemariam T, Hailu T, Aseffa A, Vaneechoutte M. Bacteremic Community-Acquired Pneumonia in Ethiopian Children: Etiology, Antibiotic Resistance, Risk Factors, and Clinical Outcome. Open Forum Infect Dis 2019; 6:ofz029. [PMID: 30838226 PMCID: PMC6396085 DOI: 10.1093/ofid/ofz029] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 01/16/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Community-acquired pneumonia (CAP) remains a leading cause of morbidity and mortality. We sought to determine the magnitude, etiology, and risk factors of CAP in children 5 years after introduction of pneumococcal conjugate vaccine (PCV) 10 in Ethiopia. METHODS We conducted a prospective observational study on the bacterial etiology and risk factors of CAP among children aged 0-15 years in 2 pediatric emergency departments in Addis Ababa, Ethiopia. Blood culture, antibiotic susceptibility testing, and amplification of pneumococcal lytA and cpsB genes were performed. Serotypes of Streptococcus pneumoniae were determined by Quellung reaction and sequencing the cpsB gene. RESULTS Out of 643 eligible children, 549 were enrolled. The prevalence of bacteremic pneumonia was 5.6%. Staphylococcus aureus (26.5%) was the predominant pathogenic species, followed by Enterococcus faecium (11.8%), Escherichia coli (11.8%), and Klebsiella pneumoniae (11.8%). In univariate analysis, parental smoking and nonvaccination with PCV10 were associated with bacteremic CAP. In multivariable analysis, female sex (adjusted odds ratio [aOR], 2.3; 95% confidence interval [CI], 1.1-4.9), weight-for-age z-score (WAZ) <-2 SDs (aOR, 2.2; 95% CI, 1.1-4.8), and lower chest indrawing (aOR, 0.44; 95% CI, 0.2-0.95) were independently associated with bacteremic CAP. The overall in-hospital case fatality rate was 2.37% (13/549), and WAZ <-3 SDs (OR, 13.5; 95% CI, 3.95-46.12) was associated with mortality. CONCLUSIONS Five years after the introduction of PCV10 in Ethiopia, S. aureus was the main cause of bacteremic CAP in children, the contribution of S. pneumoniae was low, and there was a high level of antibiotic resistance among isolates.
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Affiliation(s)
- Abel Abera Negash
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
- Laboratory Bacteriology Research, Department of Diagnostic Sciences, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
| | - Daniel Asrat
- Department of Microbiology and Immunology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Workeabeba Abebe
- Department of Pediatrics and Child Health, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tewodros Hailemariam
- Department of Pediatrics and Child Health, Yekatit 12 Medical College, Addis Ababa, Ethiopia
| | - Tsegaye Hailu
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Mario Vaneechoutte
- Laboratory Bacteriology Research, Department of Diagnostic Sciences, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
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Gebreegziabher G, Asrat D, W/Amanuel Y, Hagos T. Isolation and Antimicrobial Susceptibility Profile of Shigella and Salmonella Species from Children with Acute Diarrhoea in Mekelle Hospital and Semen Health Center, Ethiopia. Ethiop J Health Sci 2018; 28:197-206. [PMID: 29983517 PMCID: PMC6016337 DOI: 10.4314/ejhs.v28i2.11] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Salmonella and Shigella remain the major contributors to acute enteric infections and diarrhoea. Hence, the objective of this study was to isolate and determine the antimicrobial susceptibility pattern of Shigella and Salmonella species from children with acute diarrhoea in Mekelle Hospital and Semen Health Center. Methods A cross sectional study was conducted among 260 children with acute diarrhoea from November 2011 to March 2012 in Mekelle, Ethiopia. Stool specimen was collected from all study participants who presented with acute diarrhoea. Microscopy, culture and confirmatory identification were done by the pattern of biochemical reactions using a standard bacterial identification system (API 20E, BioMerieux, Marcy-l'Etoile, France) and polyvalent (Poly O and H) antiseras for Salmonella species and Vi for S.typhi. Isolated colonies were assessed for antimicrobial susceptibility profile using disk diffusion method. Data was entered and analyzed using SPSS version 16.0 software. Results Out of the 260 study participants, 145(55.8%) were males while 115(44.2%) were females. The majority of the patients (44.2%) were of children under five years old. A total of 120 enteropathogens were isolated. The frequency of isolation was 19(7.3%), 18(6.9%) and 83(31.9%) for Salmonella species, Shigella species and intestinal parasites respectively. Most of the Shigella isolates were resistant to ampicillin (88.9%), Tetracycline (77.8), cotrimoxazole (55.6%) and chloramphenicol (55.6%). Among the Salmonella isolates, the highest resistance was observed to ampicillin (89.5%), Tetracycline (89.5%), chloramphenicol (78.9%) and cotrimoxazole (57.9%). Multi-drug resistance was noted in 19(100%) and 16(88.9%) of Salmonella and Shigella species respectively. Conclusions Shigella and Salmonella are still challenging pathogens in children < 5 years of age. High antibiotic resistance was observed among both isolates to ampicillin, tetracycline, chloramphenicol and cotrimoxazole.
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Affiliation(s)
- Gebremichael Gebreegziabher
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University
| | - Daniel Asrat
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University
| | - Yimtubezinash W/Amanuel
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University
| | - Tesfalem Hagos
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University
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Feleke H, Medhin G, Kloos H, Gangathulasi J, Asrat D. Household-stored drinking water quality among households of under-five children with and without acute diarrhea in towns of Wegera District, in North Gondar, Northwest Ethiopia. Environ Monit Assess 2018; 190:669. [PMID: 30353421 PMCID: PMC6208974 DOI: 10.1007/s10661-018-7033-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 10/08/2018] [Indexed: 05/28/2023]
Abstract
Contamination of drinking water in household water storage containers and inadequate water supplies are common public burdens in low- and middle-income countries, including towns in Wegera District, Ethiopia. Our study aimed to assess the quality of drinking water and identify factors associated with diarrhea in households with under-five (U5) children with and without diarrhea in Ambagiorgis and Gedebge towns in Wegera District. Stored drinking water samples from households with U5 children with and without diarrhea had fecal coliform (FC) counts of 59 (86.8%) and 55 (82.1%) (p > 0.05) and fecal streptococci (FS) counts of 29 (42.7%) and 24 (35.8%) (p > 0.05), respectively. The very high sanitary risk scores were 32 (47.1%) and 21 (31.3%) for FC (p > 0.05); 25 (36.8%) and 3 (4.5%) for FS (p < 0.001), respectively. Contamination of the stored drinking water samples with FS was significantly higher in households with diarrhetic U5 children in the low- and medium-risk ranges (p < 0.05). Water turbidity of 47 (69.1%) and 23 (34.3%) in households with U5 children with and without diarrhea, respectively, was above the permissible level (p < 0.001). The residual free chlorine (RFC) in all the household-stored drinking water samples was below the World Health Organization (WHO) permissible level and temperatures of all the household-stored drinking water samples were permissible. Promotion and advocacy of good stored drinking water handling practices are essential for decreasing the high risk of microbial contamination in both study areas. We recommend education interventions targeting personal hygiene and drinking water handling at the household level.
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Affiliation(s)
- Hailemariam Feleke
- Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Helmut Kloos
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | | | - Daniel Asrat
- Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
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Arega B, Woldeamanuel Y, Adane K, Sherif AA, Asrat D. Microbial spectrum and drug-resistance profile of isolates causing bloodstream infections in febrile cancer patients at a referral hospital in Addis Ababa, Ethiopia. Infect Drug Resist 2018; 11:1511-1519. [PMID: 30271184 PMCID: PMC6149984 DOI: 10.2147/idr.s168867] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background The spectrum of pathogens causing bloodstream infections (BSIs) in cancer patients has shown significant fluctuations in different geographical areas and time. We studied the microbial spectrum and drug-resistance profile of pathogens causing BSIs in febrile cancer patients at a referral hospital in Ethiopia. Methods This cross-sectional study was conducted between December 2011 and June 2012 at Tikur Anbessa Hospital in Addis Ababa. Blood cultures from febrile cancer patients (n=107) were performed. Bacterial and fungal pathogens were identified and antimicrobial susceptibility testing done for the bacterial isolates using the Kirby-Bauer disk diffusion method. Results A total of 82 pathogens were isolated from 112 blood culture tests of the 76 patients: 71 (86.6%) of the isolates were bacteria and 11 (13.4%) were fungi. The majority (60.5% [43 of 71]) of the isolates were Gram-positive bacteria, where Staphylococcus aureus was predominant (72% [31 of 43]), and 68% of S. aureus isolates were resistant to ceftriaxone and oxacillin. Gram-negative bacteria accounted for 39.5% (28 of 71) of the isolates. Stenotrophomonas maltophilia (17.9% [five of 28]) was the most frequent Gram-negative isolate. In Gram-negative bacteria, the highest rates of resistance were observed in amoxicillin-clavulanic acid (80% [12 of 15]), followed by ceftriaxone (73.3%) and trimethoprim-sulfamethoxazole (73.3%). Multidrug resistance (resistance to three or more types of antibiotics, in this case to ceftriaxone, tetracycline, and trimethoprim-sulfamethoxazole) was observed in 26.3% (13 of 43) of Gram-positive and 40% (six of 16) of Gram-negative bacteria. Neutropenia was an independent risk factor for BSIs (P=0.02). Conclusion Gram-positive bacteria were the predominant etiologic agents of BSIs in Ethiopian patients with cancer. Both Gram-positive and Gram-negative bacteria showed an increasing level of resistance for most of the antibiotics used for empiric therapy. Routine bacterial surveillance and study of their resistance patterns must be an essential component of cancer-related infection control and care in our setting.
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Affiliation(s)
- Balew Arega
- College of Health Sciences, Debre Markos University, Debre Markos, .,Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa,
| | - Yimtubezinash Woldeamanuel
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa,
| | - Kelemework Adane
- Department of Microbiology and Immunology, College of Health Sciences, Mekelle University, Mekelle
| | - Abdulaziz A Sherif
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Daniel Asrat
- Department of Microbiology, Immunology, and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa,
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Negash A, Asrat D, Abebe W, Hailemariam T, Hailu T, Aseffa A, Vaneechoutte M. Community acquired pediatric pneumonia due to methicillin resistant and methicillin susceptible Staphylococcus aureus in Ethiopia during 2016-2017. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.4165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Eguale T, Asrat D, Alemayehu H, Nana I, Gebreyes WA, Gunn JS, Engidawork E. Phenotypic and genotypic characterization of temporally related nontyphoidal Salmonella strains isolated from humans and food animals in central Ethiopia. Zoonoses Public Health 2018; 65:766-776. [PMID: 29984468 DOI: 10.1111/zph.12490] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 05/12/2018] [Accepted: 05/27/2018] [Indexed: 11/28/2022]
Abstract
Salmonella is one of the common causes of food-borne bacterial illnesses. The primary sources of human nontyphoidal Salmonella (NTS) infection are food animals. This study characterized temporally and spatially related Salmonella isolated during April 2013 to March 2014 from faeces of diarrhoeic human patients in Addis Ababa (n = 68) and food animals (n = 84) in Addis Ababa and surrounding districts (dairy cattle, n = 30; slaughtered cattle, n = 20; poultry, n = 26; swine n = 8). Isolates were serotyped, page typed and tested for antimicrobial susceptibility using Kirby-Bauer disc diffusion method, and genotyped by pulsed-field gel electrophoresis (PFGE). The dominant Salmonella serovars isolated from food animals were S. Saintpaul (38.1%), S. Typhimurium (17.9%) and S. Kentucky (9.5%), whereas in humans, S. Typhimurium (39.7%), S. Virchow (30.9%) and S. Kottbus (10.3%) were frequently isolated. Resistance to streptomycin, sulfisoxazole, tetracycline, ampicillin and cephalothin was higher in animal isolates than human isolates, and mean number of antimicrobials to which isolates were resistant was significantly higher in isolates from cattle and poultry compared to those from humans (p < 0.05). All S. Kentucky isolated from animals and humans were multidrug resistant (MDR) with shared resistance phenotype (AmpCfCipTeSuSNa). Although this study involved small sample size and was not able to show clear epidemiological linkage among isolates from various sources, genotyping by PFGE analysis demonstrated circulation of closely related genotypes of S. Virchow, S. Typhimurium and S. Kentucky among humans and food animals. Detection of related Salmonella isolates from humans and animals, the high MDR status of isolates from animals and close proximity of farms and human residential areas in the absence of appropriate biosecurity present major public health problem. Integrated surveillance of Salmonella serovars in humans and animals and implementation of appropriate hazard analysis and pathogen control strategies along critical points of the food chain from farm to table is recommended.
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Affiliation(s)
- Tadesse Eguale
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Daniel Asrat
- Department of Microbiology, Immunology & Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Haile Alemayehu
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ismael Nana
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, Ohio
| | - Wondwossen A Gebreyes
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, Ohio
| | - John S Gunn
- Department of Microbial Infection and Immunity, Infectious Diseases Institute, The Ohio State University, Columbus, Ohio
| | - Ephrem Engidawork
- Department of Pharmacology and Clinical Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Feleke H, Medhin G, Abebe A, Beyene B, Kloos H, Asrat D. Enteric pathogens and associated risk factors among under-five children with and without diarrhea in Wegera District, Northwestern Ethiopia. Pan Afr Med J 2018; 29:72. [PMID: 29875953 PMCID: PMC5987073 DOI: 10.11604/pamj.2018.29.72.13973] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 01/12/2018] [Indexed: 11/30/2022] Open
Abstract
Introduction Childhood diarrhea is highly prevalent in slums in developing countries, but it remains understudied. The objectives of this study were to explore the prevalence of Giardia, rotavirus and bacterial enteropathogens among diarrheic and non-diarrheic children and investigate socio-environmental determinants of diarrhea in two Ethiopian towns. Methods A cross-sectional study was conducted from June to October 2016. Prevalence of childhood diarrhea was established using information gathered during interviews with mothers/guardians. Saline wet mounts of fresh stool samples were used to test for the presence of Giardia. Stool samples were cultured on MacConkey agar and suspected colonies were characterized using biochemical tests. Susceptibility testing was done by the disk diffusion method. ELISA was used to screen for rotavirus. Results A total of 225 children were included in this study. Four enteropathogens (Giardia, rotavirus, Shigella and Salmonella) were identified from 31% (35/112) diarrheic and 12% (14/113) from non-diarrheic children (p < 0.001). The prevalence of rotavirus infection was 18.0% among diarrheic children and 3.3% among non-diarrheic children unvaccinated against rotavirus (p < 0.01). The prevalence of Giardia was 21.0% among diarrheic and 8.0% among non-diarrheic children (p < 0.01). Diarrheic children had significantly higher rates of bloody stool (p < 0.02), vomiting, fever and breastfeeding for children beyond 23 months of age (p < 0.001). Giardia and rotavirus were identified in more diarrheic than non-diarrheic children. Conclusion The high prevalence of Giardia and rotavirus in the study area indicates the need for coordinated healthcare activities in the two communities. Vaccination against rotavirus infections and educational interventions are recommended.
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Affiliation(s)
- Hailemariam Feleke
- Ethiopian Institute of Water Resources, Addis Ababa University, Ethiopia.,Department of Biology, Assosa University, Ethiopia
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Ethiopia
| | | | | | - Helmut Kloos
- Medical Center, University of California, San Francisco, USA
| | - Daniel Asrat
- Faculty of Medicine, Addis Ababa University, Ethiopia
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Arega B, Wolde-Amanuel Y, Adane K, Belay E, Abubeker A, Asrat D. Rare bacterial isolates causing bloodstream infections in Ethiopian patients with cancer. Infect Agent Cancer 2017; 12:40. [PMID: 28702079 PMCID: PMC5504797 DOI: 10.1186/s13027-017-0150-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 07/05/2017] [Indexed: 01/04/2023] Open
Abstract
Background In recent years, saprophytic bacteria have been emerging as potential human pathogens causing life-threatening infections in patients with malignancies. However, evidence is lacking concerning such bacteria, particularly in sub-Saharan countries. This study was designed to determine the spectrum and drug resistance profile of the rare bacterial pathogens causing bloodstream infections (BSIs) in febrile cancer patients at a referral hospital in Ethiopia. Methods Between December 2011 and June 2012, blood samples were collected from 107 patients with cancer in Tikur Anbessa hospital. Culturing was performed using the blood culture bottles and solid media and the microorganisms were identified using the gram staining and APINE identification kits (Biomerieux, France). The disk diffusion method was used for the antimicrobial susceptibility testing. Results Overall, 13 (12.2%) rare human pathogens were isolated from 107 adult febrile cancer patients investigated. Aeromonas hydrophilia species (a fermentative gram-negative rod) was the predominant isolate, 30.8% (4/13), followed by Chryseomonas luteola 15.4% (2/13), Sphignomonas poucimobilis 15.4% (2/13), and Pseudomonas fluorescens 15.4% (2/13). Of the nine isolates tested for a nine set of antibiotics, 89% were resistant to amoxicillin-clavulanic acid, ampicillin, and trimethoprim-sulphamethoxazole. Conclusions This study revealed the emergence of saprophytic bacteria as potential drug-resistant nosocomial pathogens in Ethiopian patients with cancer. As these pathogens are ubiquitous in the environment, infection prevention actions should be strengthened in the hospital and early diagnosis and treatment with appropriate antibiotics are warranted for those already infected.
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Affiliation(s)
- Balew Arega
- College of Health Sciences, Debremarkos University, P.O.Box 269, Debremarkos, Ethiopia.,Department of Microbiology, Immunology & Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Churchill Avenue, P.O. Box 9086, Addis Ababa, Ethiopia
| | - Yimtubezinash Wolde-Amanuel
- Department of Microbiology, Immunology & Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Churchill Avenue, P.O. Box 9086, Addis Ababa, Ethiopia
| | - Kelemework Adane
- Department of Microbiology and Immunology, College of Health Sciences, Mekelle University, P.O.Box 1872, Mekelle, Ethiopia
| | - Ezra Belay
- Department Medical Biochemistry, College of Health Sciences, Mekelle University, P.O.Box 1872, Mekelle, Ethiopia
| | - Abdulaziz Abubeker
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Churchill Avenue, P.O. Box 9086, Addis Ababa, Ethiopia
| | - Daniel Asrat
- Department of Microbiology, Immunology & Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Churchill Avenue, P.O. Box 9086, Addis Ababa, Ethiopia
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Legese MH, Weldearegay GM, Asrat D. Extended-spectrum beta-lactamase- and carbapenemase-producing Enterobacteriaceae among Ethiopian children. Infect Drug Resist 2017; 10:27-34. [PMID: 28182124 PMCID: PMC5279835 DOI: 10.2147/idr.s127177] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Infections by extended-spectrum beta-lactamase- (ESBL) and carbapenem-resistant Enterobacteriaceae (CRE) are an emerging problem in children nowadays. Hence, the aim of this study was to determine the prevalence of ESBL- and carbapenemase-producing Enterobacteriaceae among children suspected of septicemia and urinary tract infections (UTIs). METHODS A cross-sectional study was conducted from January to March 2014. A total of 322 study participants suspected of septicemia and UTIs were recruited. All blood and urine samples were cultured on blood and MacConkey agar. All positive cultures were characterized by colony morphology, Gram stain, and standard biochemical tests. Antimicrobial susceptibility test was performed on Muller-Hinton agar using disk diffusion. ESBL was detected using combination disk and double-disk synergy methods, and the results were compared. Carbapenemase was detected by modified Hodge method using meropenem. Data were analyzed using SPSS version 20. RESULTS The overall prevalence of ESBL- and carbapenemase-producing Enterobacteriaceae was 78.57% (n=22/28) and 12.12%, respectively. Among the Enterobacteriaceae tested, Klebsiella pneumoniae (84.2%, n=16/19), Escherichia coli (100%, n=5/5), and Klebsiella oxytoca (100%, n=1/1) were positive for ESBL. Double-disk synergy method showed 90.9% sensitivity, 66.7% specificity, 95.2% positive predictive value, and 50% negative predictive value. Carbapenemase-producing Enterobacteriaceae were K. pneumoniae (9.09%, n=3/33) and Morganella morganii (3.03%, n=1/33). CONCLUSION Screening Enterobacteriaceae for ESBL production is essential for better antibiotics selection and preventing its further emergence and spread. In resource-limited settings, double-disk synergy method can be implemented for screening and confirming ESBL production. Moreover, occurrence of CRE in countries where no carbapenems are sold is worrying microbiologists as well as clinicians. Hence, identifying factors that induce carbapenemase production in the absence of carbapenems prescription is essential for control of CRE dissemination within the community.
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Affiliation(s)
- Melese Hailu Legese
- Department of Clinical Laboratory Sciences, School of Allied Health Sciences
| | | | - Daniel Asrat
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Eguale T, Birungi J, Asrat D, Njahira MN, Njuguna J, Gebreyes WA, Gunn JS, Djikeng A, Engidawork E. Genetic markers associated with resistance to beta-lactam and quinolone antimicrobials in non-typhoidal Salmonella isolates from humans and animals in central Ethiopia. Antimicrob Resist Infect Control 2017; 6:13. [PMID: 28105330 PMCID: PMC5240271 DOI: 10.1186/s13756-017-0171-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 01/05/2017] [Indexed: 11/21/2022] Open
Abstract
Background Beta-lactam and quinolone antimicrobials are commonly used for treatment of infections caused by non-typhoidal Salmonella (NTS) and other pathogens. Resistance to these classes of antimicrobials has increased significantly in the recent years. However, little is known on the genetic basis of resistance to these drugs in Salmonella isolates from Ethiopia. Methods Salmonella isolates with reduced susceptibility to beta-lactams (n = 43) were tested for genes encoding for beta-lactamase enzymes, and those resistant to quinolones (n = 29) for mutations in the quinolone resistance determining region (QRDR) as well as plasmid mediated quinolone resistance (PMQR) genes using PCR and sequencing. Results Beta-lactamase genes (bla) were detected in 34 (79.1%) of the isolates. The dominant bla gene was blaTEM, recovered from 33 (76.7%) of the isolates, majority being TEM-1 (24, 72.7%) followed by TEM-57, (10, 30.3%). The blaOXA-10 and blaCTX-M-15 were detected only in a single S. Concord human isolate. Double substitutions in gyrA (Ser83-Phe + Asp87-Gly) as well as parC (Thr57-Ser + Ser80-Ile) subunits of the quinolone resistance determining region (QRDR) were detected in all S. Kentucky isolates with high level resistance to both nalidixic acid and ciprofloxacin. Single amino acid substitutions, Ser83-Phe (n = 4) and Ser83-Tyr (n = 1) were also detected in the gyrA gene. An isolate of S. Miami susceptible to nalidixic acid but intermediately resistant to ciprofloxacin had Thr57-Ser and an additional novel mutation (Tyr83-Phe) in the parC gene. Plasmid mediated quinolone resistance (PMQR) genes investigated were not detected in any of the isolates. In some isolates with decreased susceptibility to ciprofloxacin and/or nalidixic acid, no mutations in QRDR or PMQR genes were detected. Over half of the quinolone resistant isolates in the current study 17 (58.6%) were also resistant to at least one of the beta-lactam antimicrobials. Conclusion Acquisition of blaTEM was the principal beta-lactamase resistance mechanism and mutations within QRDR of gyrA and parC were the primary mechanism for resistance to quinolones. Further study on extended spectrum beta-lactamase and quinolone resistance mechanisms in other gram negative pathogens is recommended.
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Affiliation(s)
- Tadesse Eguale
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Josephine Birungi
- Biosciences Eastern and Central Africa-International Livestock Research Institute (BecA-ILRI) Hub, P O Box 30709, Nairobi, Kenya
| | - Daniel Asrat
- Department of Microbiology, Immunology & Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Churchill Avenue, P.O. Box 9086, Addis Ababa, Ethiopia
| | - Moses N Njahira
- ICIPE-African Insect Science for Food and Health, P.O. Box 30772-00100, Nairobi, Kenya
| | - Joyce Njuguna
- Biosciences Eastern and Central Africa-International Livestock Research Institute (BecA-ILRI) Hub, P O Box 30709, Nairobi, Kenya
| | - Wondwossen A Gebreyes
- Department of Veterinary Preventive Medicine, The Ohio State University, 1920 Coffey Rd., Columbus, OH 43210 USA
| | - John S Gunn
- Department of Microbial Infection and Immunity, Center for Microbial Interface Biology, The Ohio State University, Biomedical Research Tower, 460 West 12th, Columbus, OH 432101214 USA
| | - Appolinaire Djikeng
- Biosciences Eastern and Central Africa-International Livestock Research Institute (BecA-ILRI) Hub, P O Box 30709, Nairobi, Kenya
| | - Ephrem Engidawork
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Churchill Avenue, P.O. Box 1176, Addis Ababa, Ethiopia
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Zegeye N, Asrat D, Woldeamanuel Y, Habte A, Gedlu E, Tønjum T, Aseffa A. Throat culture positivity rate and antibiotic susceptibility pattern of beta-hemolytic streptococci in children on secondary prophylaxis for rheumatic heart disease. BMC Infect Dis 2016; 16:510. [PMID: 27663649 PMCID: PMC5035452 DOI: 10.1186/s12879-016-1841-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 09/17/2016] [Indexed: 11/10/2022] Open
Abstract
Background Among children diagnosed to have chronic rheumatic valvular heart disease (RHD) in Ethiopia, many have been observed to develop recurrence of rheumatic fever (RF) despite secondary prophylaxis. This study determined the throat culture positivity rate and drug susceptibility pattern of beta hemolytic streptococci (BHS) isolated from children attending a specialized cardiac clinic in Ethiopia. Methods Throat swabs were collected from 233 children receiving benzathine penicillin injection as secondary prophylaxis for RHD and cultured. The bacterial isolates were characterized using Matrix Assisted Laser Desorption/Ionization-Time of Flight (MALDI-TOF) mass spectrometry. Drug susceptibility was tested with the Kirby Bauer disc diffusion method. Anti-streptolysin O (ASO) titers were determined using ASO latex reagents. Results The throat culture positivity rate for BHS was 24 % (56/233). Among the BHS bacterial strains isolated, four were characterized as S. pyogenes and another four as S. dysgalactiae subsp. equisimilis (Lancefield group A, C and G). All BHS were susceptible to penicillin except one isolate of S. agalactiae. Among 233 children enrolled, 46(19.7 %) showed increased ASO titer. Children who received antibiotic prophylaxis within 2-weeks of last injection had significantly lower BHS throat culture positivity rate than those injected every 4-weeks (p = 0.02). Children who missed at least one prophylaxis within the last 6 months had a higher BHS culture positivity rate than those who did not miss any (p = 0.0003). Conclusions The presence of groups A, C and G streptococci in the throat of children under secondary prophylaxis for RHD and increased ASO titer suggests failure of the regimen. This calls for further investigation into the causes of inadequate prophylaxis (including bioavailability of drugs used, optimal duration and patient compliance) and intervention.
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Affiliation(s)
- Nigus Zegeye
- Department of Medicine, DebreBerhan University, P. O. Box: 445, DebreBerhan, Ethiopia. .,Armauer Hansen Research Institute, Jimma Road, PO Box 1005, Addis Ababa, Ethiopia. .,Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Daniel Asrat
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yimtubezinash Woldeamanuel
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebe Habte
- Armauer Hansen Research Institute, Jimma Road, PO Box 1005, Addis Ababa, Ethiopia
| | - Etsegenet Gedlu
- Department of Pediatrics and Child Health, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tone Tønjum
- Department of Microbiology, Oslo University Hospital, Oslo, Norway.,Department of Microbiology, University of Oslo, Oslo, Norway
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Jimma Road, PO Box 1005, Addis Ababa, Ethiopia
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Eguale T, Engidawork E, Gebreyes WA, Asrat D, Alemayehu H, Medhin G, Johnson RP, Gunn JS. Fecal prevalence, serotype distribution and antimicrobial resistance of Salmonellae in dairy cattle in central Ethiopia. BMC Microbiol 2016; 16:20. [PMID: 26879347 PMCID: PMC4754838 DOI: 10.1186/s12866-016-0638-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 02/09/2016] [Indexed: 11/10/2022] Open
Abstract
Background Salmonellae are major worldwide zoonotic pathogens infecting a wide range of vertebrate species including humans. Consumption of contaminated dairy products and contact with dairy cattle represent a common source of non-typhoidal Salmonella infection in humans. Despite a large number of small-scale dairy farms in Addis Ababa and its surrounding districts, little is known about the status of Salmonella in these farms. Results Salmonella was recovered from the feces of at least one animal in 7.6 % (10/132) of the dairy farms. Out of 1203 fecal samples examined, 30 were positive for Salmonella resulting in a weighted animal level prevalence of 2.3 %. Detection of diarrhea in an animal and in a farm was significantly associated with animal level (p = 0.012) and herd level (p < 0.001) prevalence of Salmonella. Animal level prevalence of Salmonella was significantly associated with age (p = 0.023) and study location; it was highest among those under 6 months of age and in farms from Adaa district and Addis Ababa (p < 0.001). Nine different serotypes were identified using standard serological agglutination tests. The most frequently recovered serotypes were Salmonella Typhimurium (23.3 %), S. Saintpaul (20 %), S. Kentucky (16.7 %) and S. Virchow (16.7 %). All isolates were resistant or intermediately resistant to at least one of the 18 drugs tested. Twenty-six (86.7 %), 19 (63.3 %), 18 (60 %), 16 (53.3 %) of the isolates were resistant to streptomycin, nitrofurantoin, sulfisoxazole and tetracycline , respectively. Resistance to 2 drugs was detected in 27 (90 %) of the isolates. Resistance to 3 or more drugs was detected in 21 (70 %) of the isolates, while resistance to 7 or more drugs was detected in 11 (36.7 %) of the isolates. The rate of occurrence of multi-drug resistance (MDR) in Salmonella strains isolated from dairy farms in Addis Ababa was significantly higher than those isolated from farms outside of Addis Ababa (p = 0.009). MDR was more common in S. Kentucky, S. Virchow and S. Saintpaul. Conclusion Isolation of Salmonella serotypes commonly known for causing human salmonellosis that are associated with an MDR phenotype in dairy farms in close proximity with human population is a major public health concern. These findings imply the need for a strict pathogen reduction strategy.
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Affiliation(s)
- Tadesse Eguale
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.
| | - Ephrem Engidawork
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Churchill Avenue, P.O. Box 1176, Addis Ababa, Ethiopia.
| | - Wondwossen A Gebreyes
- Department of Veterinary Preventive Medicine, The Ohio State University, 1920 Coffey Rd., Columbus, OH, 43210, USA.
| | - Daniel Asrat
- Department of Microbiology, Immunology & Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Churchill Avenue, P.O. Box 9086, Addis Ababa, Ethiopia.
| | - Haile Alemayehu
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.
| | - Roger P Johnson
- Laboratory for Foodborne Zoonoses, 110 Stone Road West, Guelph, ON, N1G 3W4, Canada.
| | - John S Gunn
- Department of Microbial Infection and Immunity, Center for Microbial Interface Biology, The Ohio State University, Biomedical Research Tower, 460 West 12th, Columbus, OH, 43210-1214, USA.
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Eguale T, Gebreyes WA, Asrat D, Alemayehu H, Gunn JS, Engidawork E. Non-typhoidal Salmonella serotypes, antimicrobial resistance and co-infection with parasites among patients with diarrhea and other gastrointestinal complaints in Addis Ababa, Ethiopia. BMC Infect Dis 2015; 15:497. [PMID: 26537951 PMCID: PMC4634906 DOI: 10.1186/s12879-015-1235-y] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Accepted: 10/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-typhoidal Salmonella (NTS) is an important public health problem worldwide. Consumption of animal-derived food products and direct and/or indirect contact with animals are the major routes of acquiring infection with NTS. Published information, particularly on the serotype distribution of NTS among human patients with gastroenteritis and associated risk factors, is scarce in Ethiopia. This study investigated the prevalence, risk factors, serotype distribution and antimicrobial susceptibility of Salmonella species among diarrheic out-patients attending health centers in Addis Ababa and patients with various gastrointestinal complaints at Tikur Anbessa Specialized Hospital (TASH). METHODS Stool samples were cultured for Salmonella species according to the WHO Global Foodborne Infections Network laboratory protocol. Salmonella serotyping was conducted using slide agglutination and microplate agglutination techniques. Antibiotic susceptibility testing was performed using the disk diffusion method according to Clinical and Laboratory Standards Institute guidelines. RESULTS A total of 59 (6.2 %) stool samples, out of 957 were culture positive for Salmonella species. Fifty-five (7.2 %) of 765 diarrheic patients from health centers and 4 (2.1 %) of 192 patients from TASH were culture positive for Salmonella species. Multivariable logistic regression analysis after adjusting for all other variables revealed statistically significant association of Salmonella infection with consumption of raw vegetables (OR = 1.91, 95 % CI = 1.29-2.83, χ(2) = 4.74, p = 0.025) and symptom of watery diarrhea (OR = 3.3, 95 % CI = 1.23-8.88, χ(2) = 10.54, p = 0.005). Eleven serotypes were detected, and the most prominent were S. Typhimurium (37.3 %), S. Virchow (34 %), and S. Kottbus (10.2 %). Other serotypes were S. Miami, S. Kentucky, S. Newport, S. Enteritidis, S. Braenderup, S. Saintpaul, S. Concord and S. V:ROUGH-O. Resistance to three or more antimicrobials was detected in 27 (40.3 %) of the isolates. Resistance to five or more antimicrobials was detected in 17 (25.4 %). Resistance to individual antimicrobials was found at varying proportions: streptomycin (50; 74.6 %), nitrofurantoin (27; 40.3 %), sulfisoxazole (26; 38.8 %), kanamycin (23; 34.3 %), cephalothin (12; 17.9 %), and ampicillin (11; 16.4 %) respectively. Two S. Kentucky, one S. Typhimurium and one S. Concord isolates were multi-drug resistant to more than 10 antimicrobials. CONCLUSIONS The study demonstrated significant association of Salmonella infection with consumption of raw vegetables. There was no significant association of Salmonella infection with co-occurring parasites. The study also showed the dominance of S. Typhimurium and S. Virchow in primary health care units. Overall, prevalence of MDR was low compared to previous studies. Although their proportion was low, S. Kentucky and S. Concord demonstrated wider spectrum of MDR. Continuous monitoring of circulating serotypes, antimicrobial resistance profile and characterization on molecular resistance determinants is essential for proper treatment of patients and for identifying potential environmental origins of antimicrobial resistance.
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Affiliation(s)
- Tadesse Eguale
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.
| | - Wondwossen A Gebreyes
- Department of Veterinary Preventive Medicine, The Ohio State University, 1920 Coffey Rd., Columbus, Ohio, 43210, USA.
| | - Daniel Asrat
- Department of Microbiology, Immunology & Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Churchill Avenue, P.O. Box 9086, Addis Ababa, Ethiopia.
| | - Haile Alemayehu
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.
| | - John S Gunn
- Department of Microbial Infection and Immunity, Center for Microbial Interface Biology, The Ohio State University, Biomedical Research Tower, 460 West 12th, Columbus, OH, 43210-1214, USA.
| | - Ephrem Engidawork
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Churchill Avenue, P.O. Box 1176, Addis Ababa, Ethiopia.
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Tigabu E, Asrat D, Kassa T, Sinmegn T, Molla B, Gebreyes W. Assessment of Risk Factors in Milk Contamination with Staphylococcus aureus in Urban and Peri-Urban Small-Holder Dairy Farming in Central Ethiopia. Zoonoses Public Health 2015; 62:637-43. [PMID: 25916167 DOI: 10.1111/zph.12199] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Indexed: 11/30/2022]
Abstract
Assessment of risk factors associated with milk production systems is central to ensuring quality and safety of milk and milk products. This study was aimed at identifying possible risk factors in milk contamination in urban and peri-urban areas of the central high lands of Ethiopia. A total of 477 on-farm pooled milk (n = 433) and combined bulk milk samples (n = 44) were collected and processed using standard microbiological techniques to isolate and characterize Staphylococcus aureus. In addition, 433 individual farm owners and 22 collection centre owners were interviewed using a structured and pre-tested questionnaire. Multivariate logistic regression was used to determine risk factors. Of the total individual on-farm pooled milk samples analysed (n = 433), it was found that 103 of the individual milk samples (24%) and 17 of the combined bulk milk (39%) were positive for S. aureus. This difference in prevalence was statistically significant. Even though there were a number of potential variables associated with the recovery of S. aureus in bovine milk, four variables including cleaning milk container with hot water and detergent [Adjusted OR: 0.342, 95% CI, (0.166, 0.701)], mastitis check [Adjusted OR: 3.019, 95% CI (1.542, 5.913)], travel time to collection centres [Adjusted OR: 4.932, 95% CI, (2.265, 10.739)] and amount of milk delivered by farmers to collection centres per day [Adjusted OR: 1.059 (1.032, 1.087 β = 0.057)] were found to be statistically significantly associated with isolation of S. aureus. We recommend a targeted educational intervention on defined risk factors to reduce the post-harvest S. aureus contamination of raw milk in urban and peri-urban milk shed areas of central Ethiopia.
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Affiliation(s)
- E Tigabu
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - D Asrat
- Department of Microbiology, Immunology & Parasitology, Black lion school of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - T Kassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - T Sinmegn
- Central Statistical Agency, Addis Ababa, Ethiopia
| | - B Molla
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - W Gebreyes
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
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Guarner J, Amukele T, Mehari M, Gemechu T, Woldeamanuel Y, Winkler AM, Asrat D, Wilson ML, Rio CD. Building capacity in laboratory medicine in Africa by increasing physician involvement: a laboratory medicine course for clinicians. Am J Clin Pathol 2015; 143:405-11. [PMID: 25696799 DOI: 10.1309/ajcpnyt1wpsrclc6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES To describe a 4-day laboratory medicine course for clinicians given at Addis Ababa University, Ethiopia, designed to improve the use of laboratory-based diagnoses. METHODS Each day was dedicated to one of the following topics: hematology, blood bank/transfusion medicine and coagulation, chemistry, and microbiology. The course included lectures, case-based learning, laboratory tours, and interactive computer case-based homework. The same 12-question knowledge quiz was given before and after the course. RESULTS Twenty-eight participants took the quiz before and 21 after completing the course. The average score was 5.28 (range, 2-10) for the initial quiz and 8.09 (range, 4-11) for the second quiz (P = .0001). Two of 12 and 8 of 12 questions were answered correctly by more than 60% of trainees on the initial and second quiz, respectively. CONCLUSIONS Knowledge and awareness of the role of the laboratory increased after participation in the course. Understanding of laboratory medicine principles by clinicians will likely improve use of laboratory services and build capacity in Africa.
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Affiliation(s)
- Jeannette Guarner
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA
| | - Timothy Amukele
- Department of Pathology and Laboratory Medicine, Johns Hopkins University, Baltimore, MD
| | - Meheretu Mehari
- Clinical Laboratory, Black Lion Hospital, Addis Ababa, Ethiopia
| | - Tufa Gemechu
- College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Anne M. Winkler
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA
| | - Daniel Asrat
- College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Michael L. Wilson
- Department of Pathology and Laboratory Medicine, University of Colorado, Denver
| | - Carlos del Rio
- Hubert Department of Global Health, Rollins School of Public Health of Emory University, Atlanta, GA
- Department of Medicine, Emory University School of Medicine, Atlanta, GA
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Mengistie Z, Woldeamanuel Y, Asrat D, Adera A. Prevalence of bacterial vaginosis among pregnant women attending antenatal care in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia. BMC Res Notes 2014; 7:822. [PMID: 25409756 PMCID: PMC4247656 DOI: 10.1186/1756-0500-7-822] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 10/16/2014] [Indexed: 11/10/2022] Open
Abstract
Background Bacterial vaginosis is one of the most common genital tract infections among reproductive age group. The prevalence of bacterial vaginosis varies from country to country even in the same country it varies among populations of interest. Different social and sexual factors can contribute to the development of bacterial vaginosis. The aim of this study was to determine the prevalence of bacterial vaginosis and to identify the possible risk factors associated among pregnant women attending antenatal care in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia. Methods Randomly selected 57 symptomatic and 195 asymptomatic pregnant women aged between 18 and 40 years visiting obstetric and gynecological clinic from November 2011 to April 2012 screenedusing Gram stain Nugent scoring system. Statistical analysis like univariate analysis to calculate frequencies and proportions, bivariate analysis to see association of selected exposure variables with the outcome variable, and multivariate analysis to check the association of possible factors with bacterial vaginosis by adjusting potential confounding factors was calculated using SPSS (Version 16.0). Results The prevalence of bacterial vaginosis is 19.4% using Gram stain Nugent scoring system. In addition, prevalence of bacterial vaginosis is 31.6% and 15.9% among symptomatic and asymptomatic pregnant women respectively. A high percentage of bacterial vaginosis positive pregnant women were asymptomatic (63.3%). 36.7% bacterial vaginosis positive pregnant women reported abnormal vaginal discharge with or without unpleasant smell. Multiple lifetime sexual partner (OR: 8.6; 95% CI: 2.5, 29) and previous history of spontaneous abortion (OR: 5.9; 95% CI: 1.5, 23) had remained significantly associated with prevalence of bacterial vaginosis. Conclusion The prevalence of bacterial vaginosis is higher among asymptomatic pregnant women and associated with the factors previous history of multiple lifetime sexual partner and spontaneous abortion.
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Affiliation(s)
- Zemenu Mengistie
- Department of Medical Microbiology, Mizan Tepi University, P,O, Box 260, Mizan, Ethiopia.
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Gemeda N, Woldeamanuel Y, Asrat D, Debella A. Effect of essential oils on Aspergillus spore germination, growth and mycotoxin production: a potential source of botanical food preservative. Asian Pac J Trop Biomed 2014; 4:S373-81. [PMID: 25183114 DOI: 10.12980/apjtb.4.2014c857] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Accepted: 03/01/2014] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE To investigate effect of essential oils on Aspergillus spore germination, growth and mycotoxin production. METHOD In vitro antifungal and antiaflatoxigenic activity of essential oils was carried out using poisoned food techniques, spore germination assay, agar dilution assay, and aflatoxin arresting assay on toxigenic strains of Aspergillus species. RESULTS Cymbopogon martinii, Foeniculum vulgare and Trachyspermum ammi (T. ammi) essential oils were tested against toxicogenic isolates of Aspergillus species. T. ammi oil showed highest antifungal activity. Absolute mycelial inhibition was recorded at 1 µl/mL by essential oils of T. ammi. The oil also showed, complete inhibition of spore germination at a concentration of 2 µl/mL. In addition, T. ammi oil showed significant antiaflatoxigenic potency by totally inhibiting aflatoxin production from Aspergillus niger and Aspergillus flavus at 0.5 and 0.75 µl/mL, respectively. Cymbopogon martinii, Foeniculum vulgare and T. ammi oils as antifungal were found superior over synthetic preservative. Moreover, a concentration of 5 336.297 µl/kg body weight was recorded for LC50 on mice indicating the low mammalian toxicity and strengthening its traditional reputations. CONCLUSIONS In conclusion, the essential oils from T. ammi can be a potential source of safe natural food preservative for food commodities contamination by storage fungi.
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Affiliation(s)
- Negero Gemeda
- Traditional & Modern Medicine Research Directorate, Ethiopian Health & Nutrition Research Institute, Addis Ababa, Ethiopia
| | | | - Daniel Asrat
- Dipartment of Microbiology Immunology & Parasitology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Asfaw Debella
- Traditional & Modern Medicine Research Directorate, Ethiopian Health & Nutrition Research Institute, Addis Ababa, Ethiopia
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Eguale T, Marshall J, Molla B, Bhatiya A, Gebreyes WA, Engidawork E, Asrat D, Gunn JS. Association of multicellular behaviour and drug resistance in Salmonella enterica serovars isolated from animals and humans in Ethiopia. J Appl Microbiol 2014; 117:961-971. [PMID: 24934091 DOI: 10.1111/jam.12579] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 05/21/2014] [Accepted: 06/12/2014] [Indexed: 11/29/2022]
Abstract
AIMS To determine the association between multicellular behaviour, integron status and antibiotic resistance among 87 Ethiopian Salmonella enterica isolates of animal and human origin. METHODS AND RESULTS Isolates were characterized for their biofilm forming ability, antimicrobial susceptibility and the presence and characteristics of a class 1 integron and Salmonella genomic island 1 (SGI1). The majority of isolates grown at environmental temperatures (20°C) exhibited robust biofilm formation (72·4%) and displayed RDAR colony morphology on Congo red agar plates. The presence of a class 1 integron correlated with the extent of drug resistance and ability to exhibit multicellular behaviour. CONCLUSIONS Although cellulose production and RDAR morphology correlated with increased multicellular behaviour, neither was required for biofilm formation. Contrary to previous reports, colony morphology was generally consistent within a serovar. No integrons were detected in isolates deficient for multicellular behaviour, indicating a potential role of bacterial community formation in transfer of genetic elements among environmental isolates. SIGNIFICANCE AND IMPACT OF STUDY Infection by Salm. enterica is a major public health problem worldwide. The dominance of multidrug resistance and multicellular behaviour in Salmonella isolates of Ethiopian origin highlights a need for integrated surveillance and further detailed phenotypic and molecular studies of isolates from this region.
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Affiliation(s)
- Tadesse Eguale
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Joanna Marshall
- Department of Microbial Infection and Immunity, Center for Microbial Interface Biology, The Ohio State University, Biomedical Research Tower, 460 West 12th, Columbus, OH 43210-1214
| | - Bayleyegn Molla
- Department of Veterinary Preventive Medicine, The Ohio State University, 1920 Coffey Rd., Columbus, Ohio 43210
| | - Aditi Bhatiya
- Department of Microbial Infection and Immunity, Center for Microbial Interface Biology, The Ohio State University, Biomedical Research Tower, 460 West 12th, Columbus, OH 43210-1214
| | - Wondwossen A Gebreyes
- Department of Veterinary Preventive Medicine, The Ohio State University, 1920 Coffey Rd., Columbus, Ohio 43210
| | - Ephrem Engidawork
- Department of Pharmacology School of Pharmacy, College of Health Sciences, Addis Ababa University, Churchill Avenue, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Daniel Asrat
- Department of Microbiology, Immunology & Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Churchill Avenue, P.O. Box 9086, Addis Ababa, Ethiopia
| | - John S Gunn
- Department of Microbial Infection and Immunity, Center for Microbial Interface Biology, The Ohio State University, Biomedical Research Tower, 460 West 12th, Columbus, OH 43210-1214
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Tafa B, Sewunet T, Tassew H, Asrat D. Isolation and Antimicrobial Susceptibility Patterns of Campylobacter Species among Diarrheic Children at Jimma, Ethiopia. Int J Bacteriol 2014; 2014:560617. [PMID: 26904735 PMCID: PMC4745446 DOI: 10.1155/2014/560617] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 11/22/2013] [Accepted: 12/11/2013] [Indexed: 11/17/2022]
Abstract
Introduction. Campylobacter is one of the leading bacterial causes of food-borne disease. The prevalence of Campylobacter species resistant to antimicrobial agents is increasing. This study is intended to determine prevalence and antimicrobial susceptibility patterns of Campylobacter species among under-five children with diarrhea. Methodology. A cross-sectional study was conducted among 227 under-five children with diarrhea from July to October 2012 at Jimma town. Isolation and identification of Campylobacter species were performed using standard bacteriological techniques. Antimicrobial susceptibility test was performed following standard protocol. Chi-square and Fisher's exact tests were used for analysis. Results. From 227 under-five children, 16.7% were positive for Campylobacter spp.; isolates, C. jejuni, C. coli, and C. lari, accounted for 71.1%, 21.1%, and 7.9%, respectively. Higher rate of resistance was observed to ampicillin 76.3%, trimethoprim-sulfamethoxazole (68.4%), tetracycline (39.5%), chloramphenicol (31.6%), clindamycin (26.3%), and doxycycline (23.7%). Erythromycin, ciprofloxacin, gentamicin, norfloxacin, and nalidixic acid were effective for more than 80% of the isolates. Multiple drug resistance was observed among 78.9% of all the three spp. Conclusions. Isolation rate of Campylobacter spp. was high. C. lari was reported for the first time at this study area. Higher rate of resistance was observed to the commonly used drugs.
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Affiliation(s)
- Belay Tafa
- School of Medicine, Dire Dawa University, Dire Dawa, Ethiopia
| | - Tsegaye Sewunet
- Department of Medical Laboratory Sciences and Pathology, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Haimanot Tassew
- Department of Medical Laboratory Sciences and Pathology, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Daniel Asrat
- Department of Medical Microbiology, Immunology & Parasitology, College of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Mengistie Z, Woldeamanuel Y, Asrat D, Yigeremu M. Comparison of clinical and gram stain diagnosis methods of bacterial vaginosis among pregnant women in ethiopia. J Clin Diagn Res 2013; 7:2701-3. [PMID: 24551617 PMCID: PMC3919279 DOI: 10.7860/jcdr/2013/5872.3736] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 05/14/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Bacterial Vaginosis (BV) is characterized by an increased thin homogenous white vaginal discharge accompanied by fishy odour and increased vaginal pH. It is associated with different gynecologic and poor obstetric outcome. Bacterial vaginosis can be easily diagnosed by combination of two Amsel's criteria. OBJECTIVE The aim of this study was to evaluate the accuracy of Amsel's criteria individually or in combination of two for the clinical diagnosis of bacterial vaginosis among pregnant women in Ethiopia. MATERIAL AND METHODS In this crosssectional study 252 pregnant women were screened for bacterial vaginosis. Vaginal swabs were collected for pH determination, saline wet mount microscopic examination to detect clue cells, KOH preparation for whiff test and Gram-stain evaluation of vaginal flora for diagnosis of bacterial vaginosis by Nugent scoring system. Accuracy of clinical diagnosis using individual and two of Amsel's criteria was evaluated. RESULTS The prevalence of BV was 18.3% by Amsel's two of three criteria and 19.4% Gram by Nugent's methods. Comparing with Nugent scoring methods, the clinical diagnosis by Amsel's criteria had sensitivity of 85.7%, specificity of 98%. The most sensitive and specific individual Amsel's criterion was clue cells. Amsel's criteria with the lowest sensitivity and specificity were whiff test and vaginal pH respectively. Combination of clue cells with vaginal pH test were the highest in sensitive while whiff test with clue cells were the highest in specificity than the other combined two Amsel's criteria. CONCLUSION Amsel's criteria diagnosis of bacterial vaginosis can be simplified by using a combination of the two criteria, vaginal pH and clue cells, in settings where time or Gram staining is not available.
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Affiliation(s)
- Zemenu Mengistie
- Faculty, Department of Biomedical Science, College of Health Sciences, Mizan Tepi University, P.O. Box 260, Mizan, Ethiopia
| | - Yimtubezinash Woldeamanuel
- Faculty, Department of Medical Microbiology, Immunology and Parasitology, Faculty of Medicine, Addis Ababa University, P.O. Box 9086, Addis Ababa, Ethiopia
| | - Daniel Asrat
- Faculty, Department of Medical Microbiology, Immunology and Parasitology, Faculty of Medicine, Addis Ababa University, P.O. Box 9086, Addis Ababa, Ethiopia
| | - Mahlet Yigeremu
- Faculty of Medicine, Department of Obstetrics and Gynecology, Addis Ababa University, P.O. Box 9086, Addis Ababa, Ethiopia
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Beyene T, Woldeamanuel Y, Asrat D, Ayana G, Boulware DR. Comparison of cryptococcal antigenemia between antiretroviral naïve and antiretroviral experienced HIV positive patients at two hospitals in Ethiopia. PLoS One 2013; 8:e75585. [PMID: 24124498 PMCID: PMC3790840 DOI: 10.1371/journal.pone.0075585] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 08/15/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Cryptococcal meningitis is a major cause of HIV/AIDS-related deaths in Africa. Cryptococcosis is a neglected killer. However, meningitis can be prevented by early cryptococcal antigen (CrAg) screening and preemptive antifungal treatment during a prolonged period of detectable, subclinical infection. We determined the prevalence of cryptococcal antigenemia in comparison to CD4 count and clinical symptoms. METHODS We surveyed 254 consenting HIV-infected participants to obtain demographic information and clinical history. Serum CrAg was measured by latex agglutination at two sites in the Oromia region of Ethiopia among all persons receiving a CD4 count. RESULTS Of the 254 participants, 127(50.0%) were ART-naïve, 121(47.6%) were ART-experienced, and 6(2.4%) were ART-defaulters. The prevalence of cryptococcal antigenemia was 10.2% overall being 14.2% among ART-naive, 4.1% among ART-experienced, and 50% (3/6) among ART-defaulters, irrespective of CD4 count. Cryptococcal antigenemia was more frequently detected from ART-naïve patients (p = 0.012) and ART-defaulters (p = 0.001) compared with ART-experienced. Serum CrAg positivity was 20.9% in persons with CD4≤150 cells/µL, 12.2% in 151-200 cells/µL, 5.8% among 201-350 CD4/µL, and none above 350 cells/µL. Potential meningitis symptoms were common in the outpatient cohort irrespective of CrAg-status, with only fever and altered mental status statistically more common in CrAg-positive compared to CrAg-negative persons (P<0.05), yet no symptom had a positive predictive value >33%. CONCLUSION We report a 20.9% cryptococcal antigenemia prevalence among those with CD4+ T cells count ≤150 cells/µL, irrespective of ART status, with even higher CrAg prevalence in ART-naïves and ART-defaulters. These groups are target populations for CrAg screening at entry into HIV care.
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Affiliation(s)
- Tafese Beyene
- Department of Biomedical Sciences; Asella School of Health Sciences, Adama Science and Technology University, Asella, Ethiopia
- * E-mail:
| | - Yimtubezinash Woldeamanuel
- Department of Microbiology, Immunology and Parasitology; College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Daniel Asrat
- Department of Microbiology, Immunology and Parasitology; College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gonfa Ayana
- Regional Laboratories Capacity Building Directorate, Ethiopian Health and Nutrition Research Institution (EHNRI), Addis Ababa, Ethiopia
| | - David R. Boulware
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, United States of America
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Weldu Y, Asrat D, Woldeamanuel Y, Hailesilasie A. Comparative evaluation of a two-reagent cold stain method with Ziehl-Nelseen method for pulmonary tuberculosis diagnosis. BMC Res Notes 2013; 6:323. [PMID: 23941444 PMCID: PMC3847439 DOI: 10.1186/1756-0500-6-323] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Accepted: 07/31/2013] [Indexed: 12/05/2022] Open
Abstract
Background Bacteriological examination of sputum is the cornerstone in diagnosis of pulmonary tuberculosis in developing world, which is usually done using a Ziehl-Nelseen (ZN) method. However, due to limited laboratory facilities that can satisfy the procedure, applicability of this procedure appears to be adversely affected in field conditions and at peripheral health institutions. Hence, it has become necessary to look for a procedure which can be used as alternative in such conditions. In a cross-sectional study, using convenient sampling technique 362 pulmonary tuberculosis suspected patients who attended at Mekelle University Hospital (MUH) between November 2011 and February 2012 were included. After obtaining an informed consent, spot- morning-spot sputum samples were collected from suspected patients. Then a set of duplicate slides, of which one was allocated to a two-reagent cold method (a method of staining which requires carbol fuchsine as a primary stain and Gabbet’s methylene blue both as a decolorizer and counter stain) and the other to the Zeihl-Nelseen method were smeared evenly from representative portion of each specimen using the protocol for duplicate smear preparation. Stained smears were read blindly by two technologists at different occasions. Finally to assure quality, all positive smears and 25% of the negative smears were cross checked by senior experienced examiner. Findings Overall concordance between the two methods was 99.7% (kappa (κ) = 0.98; 95%, confidence interval 0.93-1.00), and the observed agreement was statistically significant (p<0.001). When evaluated against Ziehl-Nelseen method, sensitivity and specificity of the two-reagent cold staining method were 95.8% (95% confidence interval 93.7-97.9) and 100% respectively. Positive and negative predictive values of the two-reagent cold staining method were respectively 100% and 99.7%. Positive and negative agreements between the two techniques were respectively 97.9% and 99.9%. Conclusion The two-reagent cold staining method was found to be a suitable alternative to the conventional Ziehl-Nelseen method; it was at least as specific as Ziehl-Neelsen method although somewhat less sensitive. However, large scale multicentric studies need to be performed for further evaluation of this cold staining method.
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Affiliation(s)
- Yemane Weldu
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
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Yismaw G, Asrat D, Woldeamanuel Y, Unakal C. Prevalence of candiduria in diabetic patients attending Gondar University Hospital, Gondar, Ethiopia. Iran J Kidney Dis 2013; 7:102-107. [PMID: 23485533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Accepted: 10/10/2012] [Indexed: 06/01/2023]
Abstract
INTRODUCTION About 10% to 15% of in-hospital urinary tract infections (UTIs) are due to Candida species, and the prevalence is still increasing. A cross-sectional study was conducted to determine fungal causative agents of UTI in asymptomatic and symptomatic diabetic patients and associated risk factors. MATERIALS AND METHODS Between May and June 2010, a total of 422 diabetic patients with asymptomatic UTI (n = 387) and symptomatic UTI (n = 35) were investigated for UTI at Gondar University Hospital. Clean-catch midstream urine specimens were collected from each participant. Fungal urine culture and identification were done using standard microbiologic procedure. RESULTS The age range of the participants was 20 to 84 years (mean, 42.3 years). Significant candiduria was detected in 7.5% and 17.1% of asymptomatic and symptomatic diabetic patients, respectively. The overall prevalence of significant candiduria in both groups was 8.3%. Candida species were isolated in 38 urine samples. Of these, 84.2% were from the asymptomatic diabetic patients and the remaining 15.8% were from the symptomatic patients. The most common species were C albicans (42.0%), C glabrata (34.2%), and C tropicalis (15.8%). Significant candiduria was strongly associated with being female. CONCLUSIONS The presence of candiduria in diabetic patients should not be neglected. Although C albicans is the organism most often associated with serious fungal infection, other Candida species are also isolated as clinically important opportunistic pathogens in type 2 diabetic patients.
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Affiliation(s)
- Gizachew Yismaw
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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Lema T, Woldeamanuel Y, Asrat D, Hunegnaw M, Baraki A, Kebede Y, Yamuah L, Aseffa A. The pattern of bacterial isolates and drug sensitivities of infected ulcers in patients with leprosy in ALERT, Kuyera and Gambo Hospitals, Ethiopia. LEPROSY REV 2012. [DOI: 10.47276/lr.83.1.40] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lema T, Woldeamanuel Y, Asrat D, Hunegnaw M, Baraki A, Kebede Y, Yamuah L, Aseffa A. The pattern of bacterial isolates and drug sensitivities of infected ulcers in patients with leprosy in ALERT, Kuyera and Gambo hospitals, Ethiopia. LEPROSY REV 2012; 83:40-51. [PMID: 22655469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Leprosy remains a public health problem, mainly in Africa, Asia and Latin America. Leprosy has many complications that include leprosy reactions, development of plantar and hand ulcerations, lagophthalomus and corneal anesthesia. OBJECTIVES In Ethiopia there is scarce information on the pattern of bacterial isolates and drug sensitivities of infected ulcers in patients with leprosy. This study was undertaken to identify the bacteriology of infected ulcers and to determine their antimicrobial susceptibility pattern. STUDY DESIGN A descriptive cross-sectional study was conducted in 245 informed and consented leprosy patients with infected ulcers visiting ALERT, Kuyera and Gambo hospitals during the period August 2006 to May 2007. MATERIAL AND METHODS Wound aspirate specimens were collected from ulcers of each patient aseptically and inoculated into standard bacteriological media. Antimicrobial susceptibility testing was performed for all isolates according to the criteria of the National Committee for Clinical Laboratory Standards (NCCLS) by disk diffusion method. RESULTS Of the 245 patients investigated, 64.1% were males and 35.9% females (P < 0.05). The average age of the patients was 50 years (age range 13 to 92 years). According to Ridley-Jopling classifications, patients presented with TT (3.7%), BT, (31.4%), BL (44.5%) and LL (15.9%) types of leprosy. Plantar and hand ulcers were observed in 92.2% and 7.8% of patients, respectively. According the patients, the commonest cause of their ulcers was 'spontaneous' (56.7%). There were 44% Gram-positive and 56% Gram negative bacteria (P > 0.05). Proteus spp. accounted for 29.5% of the total isolates followed by Staphylococcus spp. (28.8%), beta-hemolytic streptococci (15.1%) and different types of Gram-negative bacteria (26.2%). Multiple organisms (two or three) were isolated from 19.6% patients. Of the 212 wound samples cultured anaerobically, 5.2% were positive for anaerobic culture. In this study both Gram-positive and Gram negative bacteria showed decreased sensitivity to most antimicrobial agents tested. CONCLUSION Proteus spp. was the most common isolate from infected ulcers. Ciprofloxacin, norfloxacin and gentamicin were the most effective drugs against the tested bacteria mainly for Gram-negative bacteria. This refers to the in vitro-sensitivity during the study period. The results of this study may help inform clinicians about the selection of an antibiotic in situations where use of an antibiotic may be indicated.
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Affiliation(s)
- Tsehaynesh Lema
- Armauer Hansen Research Institute (AHRI), Addis Ababa University, Medical Faculty, African Leprosy, Tuberculosis, Rehabilitation, and Training Center, P.O. Box. 1005, Ethiopia.
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Mengistu M, Asrat D, Woldeamanuel Y, Mengistu G. Bacterial and fungal meningitis and antimicrobial susceptibility pattern in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia. Ethiop Med J 2011; 49:349-359. [PMID: 23409400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Meningitis is usually caused by viral, bacterial or fungal pathogens. Bacterial meningitis is a medical emergency and if untreated has a high mortality rate. Even among those who survive the infection, some may develop permanent neurological disorders. OBJECTIVES This study was undertaken to isolate and identify the bacterial and fungal etiologic agents of meningitis and to access the susceptibility pattern of bacterial isolates. METHODS During the period of November 2007 to June 2008, 340 cerebrospinal fluid (CSF) specimens were obtained from suspected cases of meningitis admitted to Tikur Anbessa University Hospital, Addis Ababa, Ethiopia. Microbiological analysis was performed on CSF specimens using standard procedures. RESULTS Of the 340 patients investigated, 53.5% were males and 46.5% were females. Over half of the patients (51.2%) were children (1 month to 16 years) and the remaining 32.6% and 16.2% were neonates (below 1 month of age) and adults (above 16 yrs of age), respectively. Fever was the commonest clinical feature observed in all age groups. Of the 340 CSF specimens, 26 (7.6%) had a positive bacterial or fungal culture. Bacterial isolates accounted for 84.6% of the total isolates. Among the bacteria, Streptococcus pneumoniae accounted for 36.4% followed by Haemophilus influenzae type b (Hib) and Nessieria meningitidis (serogroup A and C) (13.6%) each. Cryptococcus neoformans was the only fungal isolate. All gram positive bacteria were sensitive to ceftriaxone, ciprofloxacin, chloramphenicol, erythromycin and rifampicin and showed low level of resistance (< 60%) to penicillin, tetracycline and trimethoprim-sulphamethoxazole. The gram-negative bacteria showed high level of resistance (> 80%) to tetracycline and trimethoprim-sulphamethoxazole, intermediate level of resistance (60-80%) to ampicilin and low level of resistance (< 60%) to ceftriaxone, ciprofloxacin, gentamicin, chloramphenicol and rifampicin. Multiple resistance (resistance to two or more drugs) was observed in 18.2% and 100% gram positive and gram-negative bacteria, respectively. CONCLUSION This study showed that the predominant pathogens of meningitis were S. pneumoniae, H. influenzae and N. meningitidis. Ceftriaxone and ciprofloxacin were the most effective drugs against these organisms. Continuous periodic surveillance is required to form a comprehensive and updated understanding of the etiologies and antimicrobial resistance pattern for appropriate management of meningitis cases in the country.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Anti-Bacterial Agents/pharmacology
- Anti-Bacterial Agents/therapeutic use
- Antiviral Agents/pharmacology
- Antiviral Agents/therapeutic use
- Child
- Child, Preschool
- Cross-Sectional Studies
- Drug Resistance, Multiple, Bacterial
- Drug Resistance, Multiple, Viral
- Ethiopia/epidemiology
- Female
- Gram-Negative Bacteria/drug effects
- Gram-Negative Bacteria/isolation & purification
- Gram-Positive Bacteria/drug effects
- Gram-Positive Bacteria/isolation & purification
- Hospitals, University
- Humans
- Male
- Meningitis, Bacterial/cerebrospinal fluid
- Meningitis, Bacterial/drug therapy
- Meningitis, Bacterial/epidemiology
- Meningitis, Bacterial/microbiology
- Meningitis, Fungal/cerebrospinal fluid
- Meningitis, Fungal/drug therapy
- Meningitis, Fungal/epidemiology
- Meningitis, Fungal/microbiology
- Microbial Sensitivity Tests
- Middle Aged
- Prevalence
- Young Adult
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Affiliation(s)
- Mebratenesh Mengistu
- Department of Microbiology & Parasitology, Addis Ababa University, Faculty of Medicine, Addis Ababa
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Tedla Y, Shibre T, Ali O, Tadele G, Woldeamanuel Y, Asrat D, Aseffa A, Mihret W, Abebe M, Alem A, Medhin G, Habte A. Serum antibodies to Toxoplasma gondii and Herpesvidae family viruses in individuals with schizophrenia and bipolar disorder: a case-control study. Ethiop Med J 2011; 49:211-220. [PMID: 21991754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Recent etiological studies for schizophrenia and bipolar disorder have focused on the protozoan Toxoplasma gondii and Herpesvirdae family viruses. OBJECTIVE To determine the magnitude of T. gondii, cytomegalovirus (CMV), herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) infection in individuals with schizophrenia, bipolar disorder and healthy controls by using serologic diagnostic methods. MATERIAL AND METHODS Serologic diagnostic method was used to determine the prevalence and level of antibodies to T gondii, CMV HSV-1 and HSV-2 in individuals with schizophrenia, bipolar disorder, and unaffected controls recruited from Butajira, Ethiopia. The study was conducted from March to May 2009. A total of 495 serum samples were analysed for the presence and level of immunoglobulin G (IgG) to T. gondii, CMV HSV-1, and HSV-2. RESULTS The seroprevalence of T gondii infection was higher in individuals with schizophrenia [adjusted odds ratio = 4.7; 95% CI (1.5, 15.1)] and bipolar disorder [adjusted odds ratio = 3.0; 95% CI (1.1, 8.6)] than in unaffected controls. The level of IgG to CMV was also significantly higher in individuals with schizophrenia and bipoar disorder than in unaffected controls. Younger individuals with schizophrenia (< 25 years old) also had a significantly higher level of IgG to CMV than matched unaffected controls. CONCLUSION This study provides additional evidence that infection with 7T gondii and CMV may be associated with some cases of schizophrenia and bipolar disorder. Additional studies should focus on antibodies to these agents in the sera and CSF of individuals with recent-onset psychosis.
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Affiliation(s)
- Yared Tedla
- Department of Microbiology, Immunology and Parasitology, Faculty of Medicine, Addis Ababa University, Ethiopia, P.O. Box 9086
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Abdissa A, Asrat D, Kronvall G, Shitu B, Achiko D, Zeidan M, Yamuah LK, Aseffa A. Throat carriage rate and antimicrobial susceptibility pattern of group A Streptococci (GAS) in healthy Ethiopian school children. Ethiop Med J 2011; 49:125-130. [PMID: 21796912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Group A Streptococci (GAS) or Streptococcus pyogenes are the most frequent cause of pharyngitis and skin infection in children and lead to post infection complications including acute rheumatic fever and glomerulonephritis. Pharyngeal carriage rates of GAS among healthy school children vary with geographical location and seasons. There is not much information on the screening of children for carriage of GAS in Ethiopia. OBJECTIVES The study aimed at assessing the carriage rate of Group A Streptococci and antimicrobial susceptibility of the isolates in healthy Ethiopian school children. METHODS A total of 937 children residing in Addis Ababa (n=491), Gondar (n=265) and Dire-Dawa (n=181) were investigated during a period between November 2004 and January 2005. Throat specimens were collected and cultured using standard procedure. Beta haemolytic streptococci were serogrouped by agglutination tests using specific antisera. Antimicrobial susceptibility testing of the isolates was performed by diffusion method. RESULTS The median and the mean ages of the study participants were 11 (range 6-14) years. Girls constituted 52% (486/937) of the study participants. A total of 167 (17.8%) beta haemolytic streptococci were recovered from 937 children investigated GAS accounted for 91/167 (54.5%) of beta hemolytic streptococcal isolates. The carrier rate for GAS was 9.7% (91/937) of the screened children followed by group G with 3.2% (30/937) and group C streptococci with 2.2% (21/937). All GAS isolates were sensitive to oxacillin, penicillin, erythromycin, clindamycin and trimethoprim-sulphamethoxazole. Lower frequency of resistance was observed against tetracycline and vanocmycin. CONCLUSION The present study revealed that GAS was the most predominant beta-haemolytic streptococcus among healthy Ethiopian school children. Our results showed that pharyngeal carriage of GAS in school children should not be underestimated. Therefore it is recommended to conduct regular screening and GAS surveillance in schools, and maintain rational use of antibiotics to minimize GAS resistance.
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Abreha T, Woldeamanuel Y, Pietsch C, Maier M, Asrat D, Abebe A, Hailegiorgis B, Aseffa A, Liebert UG. Genotypes and viral load of hepatitis C virus among persons attending a voluntary counseling and testing center in Ethiopia. J Med Virol 2011; 83:776-82. [DOI: 10.1002/jmv.21788] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2010] [Indexed: 12/28/2022]
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Beyene G, Nair S, Asrat D, Mengistu Y, Engers H, Wain J. Multidrug resistant Salmonella Concord is a major cause of salmonellosis in children in Ethiopia. J Infect Dev Ctries 2011; 5:23-33. [PMID: 21330737 DOI: 10.3855/jidc.906] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2010] [Revised: 04/22/2010] [Accepted: 05/17/2010] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION S. Concord in Ethiopia. The objective of this study was to determine the aetiology of febrile and diarrhoeic illness in Ethiopian children focussing on Salmonella. METHODOLOGY Paediatric patients (n = 1,225) presenting with diarrhoea or fever from the paediatric outpatient department of Tikur Anbessa University Hospital, Addis Ababa (n = 825), and Jimma University Hospital, South West Ethiopia (n = 400), were investigated for pathogens from January to August 2006. RESULTS Parasites were detected in 337 cases, Salmonella in 65, and Shigella in 61. Serotyping of Salmonella (including 48 stored isolates) demonstrated the dominance of S. Concord: S. Concord (85), S. Typhimurium (7), S. Paratyphi B (2), S. Haifa (1), S. Typhi (2), S. Enteritidis (4), S. Butantan (2), S. Infantis (1), S. Pomona (1), Salmonella group M (28:y:-) (1), and S. Oskarshamn (1). Six isolates in serogroups B and D were untypeable. Of 81 S. Concord isolates, 30% were invasive, most (86.5%) were positive for ESBL production by E-test and 70% were multiply resistant to trimethoprim-sulphamethaxole, ceftriaxone, chloramphenicol and gentamicin, of which over one quarter (27%) also showed reduced susceptibility to ciprofloxacin. CONCLUSION Multi-drug resistant S. Concord was the major cause of salmonellosis in two regions of Ethiopia. The strain isolated was highly invasive, highly antibiotic-resistant, and represents a threat to heath care globally.
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Affiliation(s)
- Getenet Beyene
- Department of Medical Microbiology, Immunology and Parasitology, Jimma, University, Ethiopia.
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