scholarly journals Bacterial Tonsillitis and Antimicrobial Resistance Profiles Among Children Within Five Years of Age At Hargeisa Group of Hospital, Somaliland: A Cross-Sectional Study

Author(s):  
Hamda Hussein Darod ◽  
Addisu Melese ◽  
Mulugeta Kibret ◽  
Wondemagegn Mulu

Abstract Background Tonsillitis is the third most frequently diagnosed infection in the pediatrics age group around the world. It causes significant morbidity and loss of school attendance in children. The emergence of drug resistance in bacterial tonsillitis is getting higher every year. However, data on the drug resistance profiles of bacterial causes of tonsillitis among children within five years of age is not available in Somaliland.Therefore; this study determined the bacterial causes of tonsillitis and their antimicrobial resistance profiles among children within five years of age at Hargeisa Group of Hospital, Somaliland. Methods A cross-sectional study was conducted from March to July 2020. A total of 374 children within five years of age were included using convenient sampling method. Throat swabs were collected from children, processed and bacterial species were identified using standard bacteriological procedures. Antimicrobial susceptibility was done using disc diffusion method. Data on demographic variables and clinical profiles were collected using structured questionnaires. Logistic regression analysis was computed to identify factors associated with bacterial tonsillitis. P-values < 0.05 were taken as statistically significant. Results The median age of children included in the study was 4 years. Overall, 120(32.1%)(95% CI 27.4–36.8%) of children had culture confirmed bacterial tonsillitis. Of them,23(19.2%) had mixed infections.The most frequent bacterial isolates were Streptococcus pyogenes 78(55%), Staphylococcus aureus 42 (29%) and Streptococcus pneumoniae 10(7%). Isolates revealed 83.3–100 % rate of resistance to ampicillin. S. aureus was resistant to clarithromycin (38%) while 60% of S. pneumoniae isolates were resistant to gentamicin. The overall multidrug resistance (MDR) was 50.4% and 52.6% of S.pyogenes and 60% of S.pneumoniae were MDR. History of tonsillitis(AOR = 0.12; 95% CI = 0.06–0.21), difficulty of swallowing(AOR = 6.99; 95% CI = 3.56–13.73), weight loss (AOR = 0.33; 95% CI = 0.186–0.597) and attending school (AOR = 2.98; 95% CI = 1.64–5.42) were found to be associated with tonsillitis among children within five years of age. Conclusions Bacterial tonsillitis with high degree of ampicillin resistance, mixed infections and MDR isolates are major concerns in children within five years of age at Hargeisa, Somaliland. Therefore, treatment of cases should be guided by regular culture and antimicrobial susceptibility testing to prevent disease consequences and critical drug resistance.

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 774
Author(s):  
Dina N. Abdelrahman ◽  
Aya A. Taha ◽  
Mazar M. Dafaallah ◽  
Alaa Abdelgafoor Mohammed ◽  
Abdel Rahim M. El Hussein ◽  
...  

Background: Pseudomonas aeruginosa is a pathogenic bacterium, causing nosocomial infections with intrinsic and acquired resistance mechanisms to a large group of antibiotics, including β-lactams. This study aimed to determine the susceptibility pattern to selected antibiotics and to index the first reported β-lactamases gene (extended spectrum β-lactamases (ESBLs) genes and class C β-lactamases genes) frequency in Ps. aeruginosa in Khartoum State, Sudan. Methods: 121 Ps. aeruginosa clinical isolates from various clinical specimens were used in this cross-sectional study conducted in Khartoum State. A total of 80 isolates were confirmed as Ps. aeruginosa through conventional identification methods and species-specific primers (the remaining 40 isolates were other bacterial species). The susceptibility pattern of the confirmed isolates to selected antibiotics was done following the Kirby Bauer disk diffusion method. Multiplex PCR was used for detection of seven β-lactamase genes (blaTEM, blaSHV, blaCTXM-1, blaVEB, blaOXA-1, blaAmpC and blaDHA). Results: Of the 80 confirmed Ps. aeruginosa isolates, 8 (10%) were resistant to Imipenem while all isolates were resistant to Amoxicillin and Amoxyclav (100%). A total of 43 (54%) Ps. aeruginosa isolates were positive for ESBLs genes, while 27 (34%) were positive for class C β-lactamases, and 20 (25%) were positive for both classes. Frequency of ESBLs genes was as follows: blaTEM, 19 (44.2%); blaSHV, 16 (37.2%); blaCTX-M1, 10 (23.3%); blaVEB, 14 (32.6%); and blaOXA-1, 7 (16.3%). Occurrence of class C β-lactamases genes was blaAmpC 22 (81.5%) and blaDHA 8 (29.6%). In total, 3 (11.1%) isolates were positive for both blaAmpC and blaDHA genes. Conclusion: Ps. aeruginosa isolates showed a high rate of β-lactamases production, with co-resistance to other antibiotic classes. The lowest resistance rate of Ps. aeruginosa was to Imipenem followed by Gentamicin and Ciprofloxacin. No statistically significant relationship between production of β-lactamases in Ps. aeruginosa and resistance to third generation cephalosporins was found.


PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0257272
Author(s):  
Habtamu Mekonnen ◽  
Abdurahaman Seid ◽  
Genet Molla Fenta ◽  
Teklay Gebrecherkos

Introduction Hospital admitted patients are at increased risk of nosocomial infections (NIs) with multi-drug resistant (MDR) pathogens which are prevalent in the hospital environment. Pseudomonas aeruginosa (P. aeruginosa) and Acinetobacter baumannii (A. baumannii) are common causes of NIs worldwide. The objective of this study is to determine antimicrobial resistance profiles and associated factors of Acinetobacter spp and P. aeruginosa NIs among hospitalized patients. Methods A cross-sectional study was conducted at Dessie comprehensive specialized hospital, North-East Ethiopia, from February 1 to April 30, 2020. A total of 254 patients who were suspected of the bloodstream, urinary tract, or surgical site nosocomial infections were enrolled consecutively. Socio-demographic and other variables of interest were collected using a structured questionnaire. Specimens were collected and processed following standard microbiological procedures. Antimicrobial susceptibility was determined using the Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines. Data were analyzed with SPSS version 23 and p-value < 0.05 was considered statistically significant. Results Overall, 13% of patients had nosocomial Acinetobacter spp and/or P. aeruginosa infections. The culture positivity rate was 16(6.3%) for Acinetobacter spp and 18(7.1%) for P. aeruginosa. Patients admitted in the surgical ward (Adjusted odds ratio (AOR):10.66;95% confidence interval (CI):1.22–93.23), pediatric ward (AOR:14.37;95%CI:1.4–148.5), intensive care unit (AOR:41.93;95%CI:4.7–374.7) and orthopedics (AOR:52.21;95%CI:7.5–365) were significantly at risk to develop NIs compared to patients admitted in the medical ward. Patients who took more than two antimicrobial types at admission were 94% (AOR:0.06; 95% CI:0.004–0.84) times more protected from NIs compared to those who did not take any antimicrobial. About 81% of Acinetobacter spp and 83% of P. aeruginosa isolates were MDR. Amikacin and meropenem showed promising activity against Acinetobacter spp and P. aeruginosa isolates. Conclusion The high prevalence of MDR Acinetobacter spp and P. aeruginosa nosocomial isolates enforce treating of patients with NIs based on antimicrobial susceptibility testing results.


F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 774
Author(s):  
Dina N. Abdelrahman ◽  
Aya A. Taha ◽  
Mazar M. Dafaallah ◽  
Alaa Abdelgafoor Mohammed ◽  
Abdel Rahim M. El Hussein ◽  
...  

Background: Pseudomonas aeruginosa is a pathogenic bacterium, causing nosocomial infections with intrinsic and acquired resistance mechanisms to a large group of antibiotics, including β-lactams. This study aimed to determine the susceptibility pattern to selected antibiotics and to index the first reported β-lactamases gene (extended spectrum β-lactamases (ESBLs) genes and class C β-lactamases genes) frequency in Ps. aeruginosa in Khartoum State, Sudan. Methods: 121 Ps. aeruginosa clinical isolates from various clinical specimens were used in this cross-sectional study conducted in Khartoum State. A total of 80 isolates were confirmed as Ps. aeruginosa through conventional identification methods and species-specific primers (the remaining 40 isolates were other bacterial species). The susceptibility pattern of the confirmed isolates to selected antibiotics was done following the Kirby Bauer disk diffusion method. Multiplex PCR was used for detection of seven β-lactamase genes (blaTEM, blaSHV, blaCTXM-1, blaVEB, blaOXA-1, blaAmpC and blaDHA). Results: Of the 80 confirmed Ps. aeruginosa isolates, 8 (10%) were resistant to Imipenem while all isolates were resistant to Amoxicillin and Amoxyclav (100%). A total of 43 (54%) Ps. aeruginosa isolates were positive for ESBLs genes, while 27 (34%) were positive for class C β-lactamases, and 20 (25%) were positive for both classes. Frequency of ESBLs genes was as follows: blaTEM, 19 (44.2%); blaSHV, 16 (37.2%); blaCTX-M1, 10 (23.3%); blaVEB, 14 (32.6%); and blaOXA-1, 7 (16.3%). Occurrence of class C β-lactamases genes was blaAmpC 22 (81.5%) and blaDHA 8 (29.6%). In total, 3 (11.1%) isolates were positive for both blaAmpC and blaDHA genes. Conclusion: Ps. aeruginosa isolates showed a high rate of β-lactamases production, with co-resistance to other antibiotic classes. The lowest resistance rate of Ps. aeruginosa was to Imipenem followed by Gentamicin and Ciprofloxacin. No statistically significant relationship between production of β-lactamases in Ps. aeruginosa and resistance to third generation cephalosporins was found.


2021 ◽  
Author(s):  
Habtamu Mekonnen ◽  
Abdurahaman Seid ◽  
Genet Molla ◽  
Teklay Gebrecherkos

Abstract Background:- Hospital admitted patients are at increased risk of nosocomial infections (NIs) with multi-drug resistant (MDR) pathogens which are prevalent in the hospital environment. P. aeruginosa and A. baumannii are common causes of NIs worldwide. The objective of this study is to determine the magnitude, antimicrobial resistance profiles, and associated factors of Acinetobacter and P. aeruginosa NIs among patients hospitalized at Dessie Comprehensive Specialized Hospital (DCSH), North-East Ethiopia.Methods:- A cross-sectional study was conducted at DCSH from February 1 to April 30, 2020. A total of 254 patients who were suspected of either bloodstream, urinary tract, or surgical site nosocomial infection were enrolled consecutively. Sociodemographic and other variables of interest were collected using a structured questionnaire. The specimens were collected and processed following standard microbiological procedures. Antibacterial susceptibility was determined by the Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines. Data were analyzed with SPSS version 23 and p-value < 0.05 was considered to be statistically significant.Results: Overall, 13% of patients had nosocomial Acinetobacter and/or P. aeruginosa infections. The culture positivity rate was 16(6.3%) for Acinetobacter spp and 18(7.1%) for P. aeruginosa. All isolates of Acinetobacter spp. were from patients with intravenous catheterization. Patients admitted in the surgical ward (Adjusted odds ratio (AOR): 10.66; 95% confidence interval (CI): 1.22-93.23), pediatric ward (AOR: 14.37; 95% CI: 1.4-148.5), intensive care unit (AOR: 41.93; 95% CI:4.7-374.7) and orthopedics (AOR: 52.21;95%CI:7.5-365) were significantly at risk to develop NIs compared to patients admitted in the medical ward. Patients who took more than two antimicrobial types were 94% (AOR: 0.06; 95% CI: 0.004-0.84) times more protected from NIs compared to those who did not take any antimicrobial. About 81% of Acinetobacter spp. and 83% of P. aeruginosa isolates were MDR. Amikacin and meropenem showed promising activity against Acinetobacter and P. aeruginosa isolates.Conclusion: The high prevalence of MDR Acinetobacter and P. aeruginosa nosocomial isolates highlighted the need of improving and implementing infection control programs in the hospitals. Treatment of NIs should be guided by antimicrobial susceptibility testing.


2019 ◽  
Vol 39 (3) ◽  
pp. 180-195
Author(s):  
Ismulat Rahmawati ◽  
Fathiyah Isbaniah ◽  
Heidy Agustin ◽  
Raden Ena Sarikencana

Background: The treatment of drug resistance tuberculosis needs second line injection antituberculosis drug that associated with irreversible ototoxic. The aim of this study is to know the prevalence of ototoxicity in tuberculosis drug resistance patients and the contributing factors. Methods: This is a cross sectional study among drug resistance TB patients who receive kanamysin or capreomycin as a part of drug regimen during intensive phase in January to September 2017 at Persahabatan hospital. Ototoxic defined according to American Speech Language and Hearing Association (ASHA) 1994 criteria by comparing baseline audiometric examination before treatment with current result. Results: Seventy-two patients were included in this study. The prevalence of ototoxicity was found in 34 patients (47,2%). Ototoxic found in 5 subjects (14,7%) during the first month of treatment and 19 subjects (56%) without hearing disturbance complain. Ototoxic in kanamisin group (47,9%) is more frequent compared with capreomisin (36,8%). Ototoxicity was associated with age, the risk increases 5% every 1 year older p=0,029 aOR:1,050 IK95% (1,005-1,096). The prevalences of ototoxicity are higher in diabetes and increasing serum creatinin patients but statistically not significance. Sex, body mass index, the history of using injectable antiTB drug, HIV status and total dosis were not associated with ototoxicity. Conclusion: Ototoxicity is common in intensive phase of drug resistance tuberculosis treatment. Further study needed to determine the association of contributing factors. (J Respir Indo. 2019; 39(3):180-95)


2019 ◽  
Author(s):  
Abdul Walusansa ◽  
Jacob Stanly Iramiot ◽  
Florence Najjuka ◽  
Henry Kajumbula ◽  
Benon Asiimwe

Abstract Background Non-prescribed use of antimicrobials in Agriculture incurs a transfer risk of resistant pathogens to humans, complicating treatment. The aim of this study was to determine the potential of Zoonotic E. coli to serve as drivers of antimicrobial resistance among animals and humans in pastoralist communities in Kasese district, so as to protect the community.Materials and methods A laboratory based cross-sectional study was done using archived E. coli isolates previously obtained from humans in pastoralist communities of Kasese district, Uganda. Recovery of the isolates was done by conventional culture, and Identification by biochemical methods, serotyping and PCR. Antimicrobial resistance profiling was done by using Kirby Bauer disc diffusion method. The isolates were also screened for resistance mechanisms including Extended Spectrum β-lactamase (ESBL), Carbapenemase and AmpC production using disc diffusion based methods.Results The prevalence of Enterohemorrhagic E.coli (EHEC) was 16% (28/180). These EHEC isolates belonged to phylogroups; B 1 (94%, 26/28), B2 (3%, 1/28) and A (3%, 1/28). The most prevalent virulence gene was Stx1 (100%, 28/28) followed by Stx2e (94%, 26/28); none of the isolates was Stx2 positive. Highest resistance was seen to Cotrimoxazole (89%, 25/28), Tetracycline (71%, 20/28), Ampicillin (65%, 18/28) and Nitrofurantoin (28%, 8/28), these are the most commonly used antimicrobials in the agricultural sector in Uganda. Minimal resistance was observed to the antimicrobials that are commonly used in human medicine especially β-lactams, β-lactam+inhibitors and Carbapenems. Of the 28 zoonotic E. coli isolates, 17%, (5/28) were ESBL positive and among these 1 (3%, 1/28) was a Carbapenemase producer.Conclusion There is a high prevalence of highly pathogenic and resistant zoonotic E. coli among humans in pastoralist communities in Uganda. We suspect that these pathogens, along with their AMR genes, were acquired from animals because they largely contained the animal specific Vero toxin gene VT2e and majority belonged Pylo-group B 1 which has been documented as the most common EHEC phylo-group inhabiting domestic animals. We recommend that studies involving relatedness of drug resistant isolates from humans and animals should be conducted to ascertain the role of enterohemorrhagic E. coli in the zoonotic spread of antimicrobial resistance in pastoralist communities.


Vaccines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 465
Author(s):  
Leena R. Baghdadi ◽  
Shatha G. Alghaihb ◽  
Alanoud A. Abuhaimed ◽  
Dania M. Alkelabi ◽  
Rawan S. Alqahtani

In 2019, a novel severe acute respiratory syndrome (SARS-CoV-2 (COVID-19)) caused a global pandemic. There was an urgent need to develop a vaccine against COVID-19 to reduce its spread and economic burden. The main objective of this study was to understand the attitudes and concerns of healthcare workers (HCWs) towards the upcoming COVID-19 vaccine, whether their decision was influenced by their history of taking the seasonal influenza vaccine, and factors that influence the acceptance of the upcoming COVID-19 vaccine. This was a cross-sectional study conducted in Riyadh, Saudi Arabia. We selected and surveyed 356 HCWs via an electronic self-administered questionnaire. A total of 61.16% of HCWs were willing to receive the COVID-19 vaccine, and 55.9% of them had received the seasonal influenza vaccine in the preceding year (2019–2020). The strongest predictors for taking the COVID-19 vaccine were the HCWs’ belief that the COVID-19 vaccine would be safe, needed even for healthy people, that all HCWs should be vaccinated against COVID-19, and that HCWs will have time to take the vaccine. Being female, being middle aged, having <5 years of work experience, having no fear of injections, and being a non-smoker were predictive factors for taking the upcoming COVID-19 vaccine. No associations were found between the intention to take the COVID-19 vaccine and a history of taking the seasonal influenza vaccine.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sivaporn Gatechompol ◽  
Weerakit Harnpariphan ◽  
Ruamthip Supanan ◽  
Gompol Suwanpimolkul ◽  
Jiratchaya Sophonphan ◽  
...  

Abstract Background Prisons are considered as major reservoirs for tuberculosis. Preventive therapy for latent TB infection (LTBI) is an adjunctive strategy to control TB. However, LTBI data in Thai prisoners is limited. This study assessed the prevalence of LTBI and feasibility of isoniazid preventive therapy (IPT). Methods A cross-sectional study was conducted among prisoners in Klong Prem Central Prison, Bangkok. Participants were screened for active TB by questionnaire and chest X-ray. LTBI was evaluated by Tuberculin skin test (TST) and QuantiFERON-TB Gold Plus (QFTP) among subgroup. Participants with positive TST or QFTP were considered to have LTBI. Participants with LTBI were offered IPT. Results From August 2018–November 2019, 1002 participants were analyzed. All participants were male with a median age of 38 (IQR 32–50) years. LTBI identified by either TST/QFTP was present in 466 (46.5%) participants. TST was positive in 359 (36%) participants. In the subgroup of 294 participants who had both TST and QFTP results, 181/294 (61.6%) tested positive by QFTP. Agreement between TST and QFTP was 55.1% (Kappa = 0.17). The risk factors associated with LTBI were previous incarceration (aOR 1.53, 95%CI, 1.16–2.01, p = 0.002), history of prior active TB (aOR 3.02, 95%CI, 1.74–5.24, p < 0.001) and duration of incarceration ≥10 years (aOR 1.86, 95%CI, 1.24–2.79, p = 0.003). Majority of LTBI participants (82%) agreed to take IPT. Three hundred and 56 (93%) participants completed treatment whereas 27 (7%) participants discontinued IPT due to the side effects of INH. Conclusion This is the first study to evaluate the prevalence of LTBI and feasibility of IPT among Thai prisoners. LTBI prevalence in male prisoners in Thailand is high. LTBI screening and treatment should be implemented together with other preventive components.


2020 ◽  
pp. 004947552098130
Author(s):  
Fabián R Carreño-Almánzar ◽  
Adán Coronado-Galán ◽  
Sonia A Cala-Gómez ◽  
Agustín Vega-Vera

Imported malaria has increased in Colombia since 2015 and has been attributed to migrants coming from Venezuela. We present a series of malaria cases, nested in a retrospective cross-sectional study between 2017 and 2018, aimed at calculating the prevalence of medical diseases among immigrants in a University Hospital in Colombia. Among 154 immigrants admitted for medical causes between 2017 and 2018, 8 were diagnosed with malaria, all due to Plasmodium vivax. Of these, seven had uncomplicated malaria, five had a previous history of malaria, one was critically ill, but none died. We highlight that, similar to other case series of imported malaria, Latin American migrants were young, with similar clinical profiles, having a low proportion of severe cases, and P. vivax was the most frequent cause.


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