Epidemiology and antibiotic susceptibility of Vibrio cholerae associated with the 2017 outbreak in Kasese district, Uganda

Abstract Background: Uganda is among the 51 countries where cholera outbreaks are common. This report summarizes findings from the epidemiologic investigation, which aimed at identifying the mode of transmission and antibiotic susceptibility patterns of the Vibrio cholerae isolated in Kasese district, Uganda. Methods: A descriptive cross-sectional study was carried out between 2017 and 2018 to describe the epidemiology of the cholera epidemic of in Kasese district, Uganda. Rectal swabs from 69 suspected case-persons were cultured on Thiosulphate-Citrate-Bile-Salts Sucrose (TCBS™; SEIKEN Japan) agar and incubated at 370C for 18-24 hours. The isolates were serotyped with polyvalent 01 antiserum and monovalent serotype Inaba and Ogawa antisera (Denka Seiken, Tokyo, Japan) to determine which serotype was responsible for the outbreak. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method on Mueller-Hinton agar. Questionnaires were administered to a total of 75 participants who were either the cases or relatives to the case. GPS points of the homes of the cases and pictures of potential source infection were also taken and cases were mapped. Results: A total of 222 cases were recorded in the Kasese District outbreak between the month of September 2017 and January 2018 with the case fatality rate (CFR) of 1.4%. Children below the age of 14 years contributed the biggest proportion of the cases (70%) and out of these, 33% were aged below five years. Culture isolated 69 V. cholerae 01 serotype Inaba from the total of 71 samples. Salmonella typhi was Isolated from the other two samples which were negative for V. cholerae. Antibiotic susceptibility testing showed 100% resistance to Ampicillin and over 50% were resistant to trimethoprim/Sulfamethoxazole whereas gentamicin showed 100% susceptibility. Environmental assessment revealed rampant cases of open defecation. Conclusion: Though we did not culture water to confirm contamination with Vibrio cholerae, we hypothesize that the cholera epidemic in Kasese 2017 was sparked off by consumption of contaminated water following the heavy floods that washed away latrines into water sources in Bwera, Isango and Nakiyumbu sub-counties. V. cholerae was also highly resistant to the commonly used antibiotics. Key words: Cholera, antibiotic resistance, epidemiology, environment.

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Epidemiology and Antibiotic Susceptibility of Vibrio cholerae Associated with the 2017 Outbreak in Kasese district

10.21203/rs.2.11224/v5 ◽

2019 ◽

Author(s):

Jacob Stanley Iramiot ◽

Innocent B. Rwego ◽

Catherine Kansiime ◽

Benon B Asiimwe

Keyword(s):

Vibrio Cholerae ◽

Antibiotic Susceptibility ◽

Susceptibility Testing ◽

Case Fatality ◽

Diffusion Method ◽

Suspected Case ◽

Disk Diffusion Method ◽

Cross Sectional ◽

Cholera Epidemic ◽

Two Samples

Abstract Background: Uganda is among the 51 countries where cholera outbreaks are common. This report summarizes findings from the epidemiologic investigation, which aimed at identifying the mode of transmission and antibiotic susceptibility patterns of the Vibrio cholerae isolated in Kasese district, Uganda. Methods: A descriptive cross-sectional study was carried out between 2017 and 2018 to describe the epidemiology of the cholera epidemic of in Kasese district, Uganda. Rectal swabs from 69 suspected case-persons were cultured on Thiosulphate-Citrate-Bile-Salts Sucrose (TCBS™; SEIKEN Japan) agar and incubated at 370C for 18-24 hours. The isolates were serotyped with polyvalent 01 antiserum and monovalent serotype Inaba and Ogawa antisera (Denka Seiken, Tokyo, Japan) to determine which serotype was responsible for the outbreak. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method on Mueller-Hinton agar. Questionnaires were administered to a total of 75 participants who were either the cases or relatives to the case. GPS points of the homes of the cases and pictures of potential source infection were also taken and cases were mapped. Results: A total of 222 cases were recorded in the Kasese District outbreak between the month of September 2017 and January 2018 with the case fatality rate (CFR) of 1.4%. Children below the age of 14 years contributed the biggest proportion of the cases (70%) and out of these, 33% were aged below five years. Culture isolated 69 V. cholerae 01 serotype Inaba from the total of 71 samples. Salmonella typhi was Isolated from the other two samples which were negative for V. cholerae. Antibiotic susceptibility testing showed 100% resistance to Ampicillin and over 50% were resistant to trimethoprim/Sulfamethoxazole whereas gentamicin showed 100% susceptibility. Environmental assessment revealed rampant cases of open defecation. Conclusion: Though we did not culture water to confirm contamination with Vibrio cholerae, we hypothesize that the cholera epidemic in Kasese 2017 was sparked off by consumption of contaminated water following the heavy floods that washed away latrines into water sources in Bwera, Isango and Nakiyumbu sub-counties. V. cholerae was also highly resistant to the commonly used antibiotics. Key words: Cholera, antibiotic resistance, epidemiology, environment.

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Epidemiology and Antibiotic Susceptibility of Vibrio cholerae Associated with the 2017 Outbreak in Kasese district

10.21203/rs.2.11224/v4 ◽

2019 ◽

Author(s):

Jacob Stanley Iramiot ◽

Innocent B. Rwego ◽

Catherine Kansiime ◽

Benon B Asiimwe

Keyword(s):

Vibrio Cholerae ◽

Antibiotic Susceptibility ◽

Case Fatality ◽

Cross Sectional Study ◽

Diffusion Method ◽

Suspected Case ◽

Disk Diffusion Method ◽

Cross Sectional ◽

Mueller Hinton Agar ◽

Global Threat

Abstract Background Cholera has continued to be a global threat to public health and a key indicator of lack of social development in developing countries. This report summarizes findings from the epidemiologic investigation, which aimed at identifying the mode of transmission and antibiotic susceptibility patterns of the Vibrio cholerae isolated in Kasese district, Uganda. Materials and methods This was a descriptive cross-sectional study to describe the epidemiology of the 2017 cholera outbreak in Kasese district. Rectal swabs were collected from 69 suspected case-persons and cultured on Thiosulphate-Citrate-Bile-Salts Sucrose (TCBS™; SEIKEN Japan) agar and incubated at 370C for 18-24 hours. The isolates were serotyped with polyvalent 01 antiserum and monovalent serotype Inaba and Ogawa antisera (Denka Seiken, Tokyo, Japan) to determine which serotype was responsible for the outbreak. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method on Mueller-Hinton agar. Results A total of 222 cases were recorded in the Kasese District outbreak between the month of September 2017 and January 2018 with the case fatality rate (CFR) of 1.4%. Children below the age of 14 years contributed the biggest proportion of the cases (70%) and out of these, 33% were aged below five years. Antibiotic susceptibility using Kirby-Bauer disc diffusion method showed 100% resistance to Ampicillin and over 50% were resistant to trimethoprim/sulfamethoxazole whereas gentamicin showed 100% susceptibility. The general trend also showed increased susceptibility to combination therapy as opposed to mono-therapy.

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Epidemiology and Antibiotic Susceptibility of Vibrio cholerae Associated with the 2017 Outbreak in Kasese district

10.21203/rs.2.11224/v2 ◽

2019 ◽

Author(s):

Jacob Stanley Iramiot ◽

Innocent B. Rwego ◽

Catherine Kansiime ◽

Benon B Asiimwe

Keyword(s):

Vibrio Cholerae ◽

Antibiotic Susceptibility ◽

Case Fatality ◽

Cross Sectional Study ◽

Diffusion Method ◽

Suspected Case ◽

Disk Diffusion Method ◽

Cross Sectional ◽

Mueller Hinton Agar ◽

Global Threat

Abstract Background Cholera has continued to be a global threat to public health and a key indicator of lack of social development in developing countries. This report summarizes findings from the epidemiologic investigation, which aimed at identifying the mode of transmission and antibiotic susceptibility patterns of the Vibrio cholerae isolated in Kasese district, Uganda. Materials and methods This was a descriptive cross-sectional study to describe the epidemiology of the 2017 cholera outbreak in Kasese district. Rectal swabs were collected from 69 suspected case-persons and cultured on Thiosulphate-Citrate-Bile-Salts Sucrose (TCBS™; SEIKEN Japan) agar and incubated at 370C for 18-24 hours. The isolates were serotyped with polyvalent 01 antiserum and monovalent serotype Inaba and Ogawa antisera (Denka Seiken, Tokyo, Japan) to determine which serotype was responsible for the outbreak. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method on Mueller-Hinton agar. Results A total of 222 cases were recorded in the Kasese District outbreak between the month of September 2017 and January 2018 with the case fatality rate (CFR) of 1.4%. Children below the age of 14 years contributed the biggest proportion of the cases (70%) and out of these, 33% were aged below five years. Antibiotic susceptibility using Kirby-Bauer disc diffusion method showed 100% resistance to Ampicillin and over 50% were resistant to trimethoprim/sulfamethoxazole whereas gentamicin showed 100% susceptibility. The general trend also showed increased susceptibility to combination therapy as opposed to mono-therapy.

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Epidemiology and Antibiotic Susceptibility of Vibrio cholerae Associated with the 2017 Outbreak in Kasese district

10.21203/rs.2.11224/v3 ◽

2019 ◽

Author(s):

Jacob Stanley Iramiot ◽

Innocent B. Rwego ◽

Catherine Kansiime ◽

Benon B Asiimwe

Keyword(s):

Vibrio Cholerae ◽

Antibiotic Susceptibility ◽

Case Fatality ◽

Cross Sectional Study ◽

Diffusion Method ◽

Suspected Case ◽

Disk Diffusion Method ◽

Cross Sectional ◽

Mueller Hinton Agar ◽

Global Threat

Abstract Background Cholera has continued to be a global threat to public health and a key indicator of lack of social development in developing countries. This report summarizes findings from the epidemiologic investigation, which aimed at identifying the mode of transmission and antibiotic susceptibility patterns of the Vibrio cholerae isolated in Kasese district, Uganda. Materials and methods This was a descriptive cross-sectional study to describe the epidemiology of the 2017 cholera outbreak in Kasese district. Rectal swabs were collected from 69 suspected case-persons and cultured on Thiosulphate-Citrate-Bile-Salts Sucrose (TCBS™; SEIKEN Japan) agar and incubated at 370C for 18-24 hours. The isolates were serotyped with polyvalent 01 antiserum and monovalent serotype Inaba and Ogawa antisera (Denka Seiken, Tokyo, Japan) to determine which serotype was responsible for the outbreak. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method on Mueller-Hinton agar. Results A total of 222 cases were recorded in the Kasese District outbreak between the month of September 2017 and January 2018 with the case fatality rate (CFR) of 1.4%. Children below the age of 14 years contributed the biggest proportion of the cases (70%) and out of these, 33% were aged below five years. Antibiotic susceptibility using Kirby-Bauer disc diffusion method showed 100% resistance to Ampicillin and over 50% were resistant to trimethoprim/sulfamethoxazole whereas gentamicin showed 100% susceptibility. The general trend also showed increased susceptibility to combination therapy as opposed to mono-therapy.

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Epidemiology and Antibiotic Susceptibility of Vibrio cholerae Associated with the 2017 Outbreak in Kasese district

10.21203/rs.2.11224/v1 ◽

2019 ◽

Author(s):

Jacob Stanley Iramiot ◽

Innocent B. Rwego ◽

Catherine Kansiime ◽

Benon B Asiimwe

Keyword(s):

Vibrio Cholerae ◽

Antibiotic Susceptibility ◽

Case Fatality ◽

Cross Sectional Study ◽

Diffusion Method ◽

Suspected Case ◽

Disk Diffusion Method ◽

Cross Sectional ◽

Mueller Hinton Agar ◽

Global Threat

Abstract Background Cholera has continued to be a global threat to public health and a key indicator of lack of social development in developing countries. This report summarizes findings from the epidemiologic investigation, which aimed at identifying the mode of transmission and antibiotic susceptibility patterns of the Vibrio cholerae isolated in Kasese district, Uganda. Materials and methods This was a descriptive cross-sectional study to describe the epidemiology of the 2017 cholera outbreak in Kasese district. Rectal swabs were collected from 69 suspected case-persons and cultured on Thiosulphate-Citrate-Bile-Salts Sucrose (TCBS™; SEIKEN Japan) agar and incubated at 370C for 18-24 hours. The isolates were serotyped with polyvalent 01 antiserum and monovalent serotype Inaba and Ogawa antisera (Denka Seiken, Tokyo, Japan) to determine which serotype was responsible for the outbreak. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method on Mueller-Hinton agar. Results A total of 222 cases were recorded in the Kasese District outbreak between the month of September 2017 and January 2018 with the case fatality rate (CFR) of 1.4%. Children below the age of 14 years contributed the biggest proportion of the cases (70%) and out of these, 33% were aged below five years. Antibiotic susceptibility using Kirby-Bauer disc diffusion method showed 100% resistance to Ampicillin and over 50% were resistant to trimethoprim/sulfamethoxazole whereas gentamicin showed 100% susceptibility. The general trend also showed increased susceptibility to combination therapy as opposed to mono-therapy.

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Urinary tract infections and antibiotic susceptibility among the patients attending B & D hospital of Lalitpur, Nepal

Asian Journal of Medical Sciences ◽

10.3126/ajms.v7i5.14908 ◽

2016 ◽

Vol 7 (5) ◽

pp. 47-51 ◽

Cited By ~ 1

Author(s):

Yadav Prasad Joshi ◽

Shreejeet Shrestha ◽

Russell Kabir ◽

Anita Thapa ◽

Parbati Upreti ◽

...

Keyword(s):

Urinary Tract ◽

Tract Infection ◽

Antibiotic Susceptibility ◽

Bacterial Infections ◽

Antimicrobial Agents ◽

Cross Sectional Study ◽

Diffusion Method ◽

Disk Diffusion Method ◽

Cross Sectional ◽

Tract Infections

Background:Urinary tract infection is the most common bacterial infections in humans and serious health problem in many parts of the world. It has become more complicated in treatment due to different pathogens and increasing resistant to antimicrobial agents. This study aims to investigate the prevalence of urinary tract infection and antibiotic susceptibility patterns of pathogens among the patients attending in B & B hospital Nepal.Materials and Methods:A hospital based cross sectional study was conducted in between April 2010 to March 2011. Urine samples were collected from clinically suspected patients and tested bacteriologically using standard procedures. Antimicrobial susceptibility test was performed for isolated pathogen using the Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute guidelines.Results:Out of 1260 examined specimens 25.24 % were positive and majority 61.64% were females. The most common pathogens isolated were Escherichia coli (66.67%), Enterococcus (7.55%) and Staphylococcus (6.60 %). The drug resistant among the positive cases were reported. The highest resistant of positive cases was found with Cefexime (87.88%) and Enterococcus with Ampicillin (66.67%) and Staphyllococcus with Cloxacillin (66.67%). The highest susceptibility was for Vancomycin and Ampicillin i.e. 33.33% in each.Conclusion:The findings showed that E. coli isolates were the predominant pathogen and the presence of bacterial isolates with very high resistance to the commonly prescribed drugs. As drug resistance among bacterial pathogens is an evolving process and serious issue. Therefore, routine surveillance and monitoring studies should be conducted to provide physicians knowledge on the updated and most effective empirical treatment of UTIs. Asian Journal of Medical Sciences Vol.7(5) 2016 47-51

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Antibiotic Susceptibility Pattern of Salmonella Enterica serovars Typhi and Paratyphi A Isolated From Patients Suspected of Enteric Fever

Tribhuvan University Journal of Microbiology ◽

10.3126/tujm.v7i0.33791 ◽

2020 ◽

Vol 7 ◽

pp. 31-36

Author(s):

Dhirendra Niroula ◽

Jyotsna Shrestha ◽

Supriya Sharma ◽

Anjana Singh

Keyword(s):

Salmonella Enterica ◽

Antibiotic Susceptibility ◽

Enteric Fever ◽

Multidrug Resistant ◽

Diffusion Method ◽

Biochemical Tests ◽

Salmonella Spp ◽

Disk Diffusion Method ◽

Cross Sectional ◽

Microbiological Techniques

Objectives: The study aimed to assess the antibiotic susceptibility profile of Salmonella spp isolated from patients suspected of enteric fever. Methods: This cross-sectional prospective study was carried out from April to June, 2014among 484 patients clinically suspected of enteric fever visiting Bir Hospital, Kathmandu, Nepal. Blood sample collected from each patient was processed for culture in bile broth. Identification of Salmonella spp was done by conventional microbiological techniques including colony characteristics, Gram's staining and biochemical tests. Antibiotic susceptibility testing of identified isolates was done by Kirby-Bauer disk diffusion method following the 2014 CLS I guideline. Results: Out of 484 blood samples, 36 (7.43%) cases showed the growth of Salmonella spp; of which 27 (75%) were Salmonella enterica serovar Typhi (ST) and 9 (25%) were Salmonella enterica Paratyphi A (SPA). Among the Salmonella isolates, 5.55% were multidrug resistant and 41.66% were fluoroquinolone resistant. More than 80% of isolates were sensitive to chloramphenicol, amoxicillin, and cotrimoxazole whereas 58%, 50% and 6% of isolates were sensitive to fluoroquinolone antibiotics i.e. ciprofloxacin, ofloxacin and nalidixic acid respectively. All the isolates were susceptible to ceftazidime. All SPA and 89% of ST were sensitive to azithromycin. Conclusion: Higher percentage of susceptible isolates to chloramphenicol, cotrimoxazole, and amoxicillin suggests the reconsideration of these antibiotics for the treatment of enteric fever. Azithromycin can be considered as drug of choice for the treatment of enteric fever.

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Antibiotic Susceptibility Evaluation of Bacterial Agents Causing Infection in Children with Acute Tonsillopharyngitis

Infectious Disorders - Drug Targets ◽

10.2174/1871526520666201116102441 ◽

2020 ◽

Vol 20 ◽

Author(s):

Hamidreza Sherkatolabbasieh ◽

Majid Firouzi ◽

Shiva Shafizadeh ◽

Iman Amiri

Keyword(s):

Sore Throat ◽

Predictive Value ◽

Positive Culture ◽

Clinical Score ◽

Streptococcal Pharyngitis ◽

Diffusion Method ◽

Disk Diffusion Method ◽

Cross Sectional ◽

Clinical Sensitivity ◽

Group A

Background: The aim of this study is to evaluate the prevalence of group A beta-hemolytic pharyngitis by assessing the outcome of the culture and the resistance and sensitivity of group A beta hemolytic streptococcus to antibiotics. Methods: This cross-sectional study was conducted on 170 patients, aged 3-15 years, referred to the clinic with complaints of sore throat. Patients’ history was collected and physical examination was performed and were score based on clinical findings. Patients with other underlying pathologies and those taking antibiotics prior to the study were excluded from our study. Antimicrobial susceptibility test was performed by disk diffusion method against cephalexin, cefazolin, erythromycin and amoxicillin. Results: A total of 170 patients were reported with sore throat. Patients with positive culture results were 60% male and 40% female. Amoxicillin resistance was the greatest (5%) in the culture. All isolated bacteria were sensitive to amoxicillin, cephalexin, cefazolin and erythromycin. Patients with McIssac score ≥ 6 showed clinical sensitivity 75% specificity 61% negative predictive value 94.8% and positive predictive value 20.3% for Group A beta-hemolytic streptococcal pharyngitis. Conclusion: The results showed the higher the clinical score, the greater the chance of positive throat culture.

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Streptococcal Throat Carriage among Primary School Children Living in Uyo, Southern Nigeria

Journal of Child Science ◽

10.1055/s-0040-1722274 ◽

2021 ◽

Vol 11 (01) ◽

pp. e28-e34

Author(s):

Kevin B. Edem ◽

Enobong E. Ikpeme ◽

Mkpouto U. Akpan

Keyword(s):

Primary School ◽

School Children ◽

Antimicrobial Susceptibility ◽

Group A Streptococcus ◽

Latex Agglutination ◽

Sub Saharan Africa ◽

Primary School Children ◽

Diffusion Method ◽

Disk Diffusion Method ◽

Cross Sectional

AbstractSurveillance of the carrier state for β-hemolytic streptococcal (BHS) throat infections remains essential for disease control. Recent published works from Sub-Saharan Africa have suggested a changing epidemiology in the burden of BHS throat infections. The objective of the present study was therefore to determine the prevalence and pattern of BHS throat carriage in school-aged children in Uyo, Akwa Ibom State. This was a prospective cross-sectional study of 276 primary school children in Uyo. Subjects were recruited by multistage random sampling. Obtained throat swabs were cultured on 5% sheep blood agar. Lancefield grouping on positive cultures was done by using the Oxoid Streptococcal Grouping Latex Agglutination Kit, United Kingdom. Antimicrobial susceptibility testing was done with the disk diffusion method. Associations were tested with Fischer's exact test. The prevalence of BHS carriage was 3.3%. Group C Streptococcus was identified in 89% of isolates and Group G Streptococcus in 11%. Younger age and larger household size were associated with asymptomatic streptococcal throat infections. Antimicrobial susceptibility was highest with cefuroxime and clindamycin (89% of isolates each), while 78% of isolates were susceptible to penicillin. None of the tested isolates was susceptible to co-trimoxazole. The prevalence of streptococcal throat carriage in the study area was low. There were no Group A Streptococcus isolates suggesting an evolving epidemiology of BHS disease in the study area.

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