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Background: Bacterial otitis media (OM) is a common infection among the pediatric community worldwide and is the first reason for prescribing antibiotics in pediatric practices. However, if not promptly diagnosed and appropriately treated, it may persist and cause severe intra- and extra-cranial hard-to-cure complications. Hence, knowing the magnitude, etiology, and antibiotic susceptibility profile is very important for the proper management. Methods: A cross-sectional study was carried out in 312 pediatrics (1 to 18 years) attending the Ear Nose Throat outpatient departments of the two title hospitals from 25 February to 30th August 2022. Patients were chosen through a systematic random sampling method. Data were obtained by means of a semi-structured questionnaire. Samples were collected to identify the causative bacteria as per microbiological guidelines. The antibiotic susceptibility test was done according to the Kirby-Bauer disc diffusion; SPSS version 25 was used for the analysis. Results: The overall prevalence of otitis media was 67.3% (n=210); CSOM showed a slight preponderance (n=107) Gram-negative bacteria and Gram-positive bacteria were present in 59.8% (n=137) and 40.1% (n=92), respectively. Otitis media was predominantly caused by S. aureus (n=52, 56.5%), followed by Proteus spp. (n=33, 24%). Gram-negative bacteria were highly resistant to co-trimoxazole, amoxicillin-clavulanic acid, piperacillin, and tetracycline, whereas their positive counterparts were considerably penicillin and co-trimoxazole resistant. Overall, 61.5 and 19.2% of the isolates were MDR and XDR, respectively. MRSA, MR-CoNs, and VRE were 38.4% (n=20), 17.1% (n=5), and 58.3% (n=12), respectively; 19.7% (n=25) of Gram-negative bacteria produced ESBL, and 7% (n=9) were carbapenem-resistant. History of exposure to loud noise [AOR=3.4; CI=1.14-10.23; P-value=0.028] and family history of smoking at home [AOR=2.9; CI=1.18-7.25; P-value=0.020] have the greatest odds of otitis media. Conclusion: Overall, the prevalence of otitis media is showing an upward trend, and MDR among bacterial isolates is increasing alarmingly.
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Background: Ready-to-eat foods sold by street vendors act as potential sources for the spread of various foodborne infectious diseases. Thus, local determination of the level of foodborne bacterial pathogens and their antimicrobial resistance pattern is essential. Methods: A community-based cross-sectional study was conducted from September 5th, 2022 to December 31th, 2022. The required data were collected by a structured questionnaire and observation checklist. Randomly selected street-vended foods were aseptically collected, and the bacteriological quality was assessed by using culture techniques. Different biochemical tests were used to identify and characterize bacterial isolates. The antimicrobial-resistant test for isolated foodborne bacterial pathogens was carried out by using the Kirby-Bauer disc diffusion method. The data were analyzed using SPSS version 22. Results: A total of 34.2% (113/330) with a 95% CI of 29.1-39.4 of commonly consumed street-vended foods were identified as having unsatisfactory total mean aerobic bacterial counts (>105 CFU/g; 4.3 × 105 CFU/g). The mean total Enterobacteriaceae, coliform, and staphylococcal counts were found to be 1.4 × 105 CFU/g, 2.4 × 104 CFU/g, and 3.4 × 104 CFU/g, respectively. A total of 12.7% (42/330) of foodborne pathogens were recovered attributed to Staphylococcus aureus (31, 9.4%), Salmonella species (6, 1.8%), and E. coli O157:H7 (5, 1.5%). 6.5% and 16.1% of isolated S. aureus were found to be methicillin-resistant and multidrug-resistant (MDR), respectively. Additionally, 33.3% of Salmonella isolates and 40% of E. coli O157:H7 isolates were found to be MDR. Conclusion: Street-vended foods in this setting have a considerable number of unsatisfactory bacterial qualities, along with drug-resistant foodborne pathogens. Thus, more effective health education and training for vendors, regular inspections of vending sites, and regular surveillance of drug resistance patterns of foodborne pathogens are all essential.
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Background: In the thoughts of all orthopedicians, the emergence of drug-resistant and biofilm-forming bacterial infections at orthopedic surgical sites is the most feared problem. Thus, this study aimed to determine the bacteriological profiles, antimicrobial susceptibility patterns, and biofilm forming ability of isolates, as well as factors associated with orthopedic surgical site infections (OSSIs). Methods: An institution-based cross-sectional study was conducted from March 1st, 2021, to February 30th, 2022 at Arba Minch General Hospital. About 245 suspected orthopedic patients with surgical site infection were enrolled and structured questionnaires were used to collect the required information. Wound swabs or pus aspirates were aseptically collected. The frequency and type of bacterial pathogen(s), antimicrobial susceptibility pattern, and biofilm formation were used to determine and characterize the magnitude of OSSIs. SPSS version 25 was used to analyze factors associated with OSSIs. Results: The overall magnitude of symptomatic OSSIs was 29.4% (72/245). External fixation [AOR = 4.761, 95% CI: (1.108-20.457)], implant use [AOR = 3.470, 95% CI: (1.460-8.246)], length of time for surgery [AOR = 3.225, 95% CI: (1.545-6.731)], and post-operative hospitalization [AOR = 4.099, 95% CI: (2.026-8.293)] were all statistically significant. Staphylococcus aureus was the most frequently isolated bacteria, accounting for 76%. Methicillin-resistant was observed in 57.9% and 40% of isolated S. aureus (MRSA) and coagulase-negative staphylococci (CoNS), respectively. One-third of the isolated E. faecium was vancomycin-resistant (VRE). Overall, 67.1% (51/76) of isolates were multidrug-resistant (MDR). About 27.6% (21/76) of isolates were found to be strong biofilm producers. Conclusion: OSSIs were shown to be caused by a significant number of drug-resistant and biofilm-producing bacterial isolates. To mitigate the problem, aseptic surgical practice and conventional wound management, as well as constant observation of antimicrobial resistant patterns, should be followed.
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BACKGROUND: Currently extended-spectrum ß-lactamase (ESßL) and carbapenemase producing gram-negative bacteria are the greatest concern among the neonatal population with very limited therapeutic options. The aim of this study was to assess the prevalence of ESßL and carbapenemase producing gram-negative bacilli, associated factors and antimicrobial resistance patterns among neonates in intensive care units. METHODS: An institutional-based cross-sectional study was conducted from February to June 2021 on 212 neonates in intensive care units. Risk factors data were collected by using a well-designed questionnaire. A rectal swab sample was collected using a sterile cotton swab and inoculated on MacConkey agar. Bacterial isolates were identified using various biochemical tests. ESßL and carbapenemase were first screened by indicator cephalosporins (cefotaxime (30µg) and ceftazidine (30µg)) and carbapenem (meropenem and ertapenem), respectively. ESßL and carbapenemase were confirmed by a double-disk synergy test and modified carbapenem inactivation methods, respectively. SPSS version 21.0 was used for data analysis. A P-value ≤ 0.05 was considered as statistically significant. RESULTS: The overall prevalence of ESßL-producing gram-negative bacilli was 72/212 (34%). The predominant ESßL-producing isolate was Klebsiella pneumoniae 23/72 (31.9%) followed by Escherichia coli 17/72 (23.6%). Five (2.4%) carbapenemase-producing gram-negative bacilli were isolated. ESßL-producing isolates showed a high resistance against ampicillin 72/72 (100%), augmentin 69/72 (95.8%) and gentamycin 57/72 (79.2%). The majority 63/72 (87.5%) of isolated ESßL-producing gram-negative bacilli were multi-drug resistant (MDR). Rectal carriage of ESßL by neonates showed a statistically significant association with endotracheal intubation (p = 0.001; AOR = 4.2; 96% CI = (1.8-9.5)), treatment with ampicillin+gentamycin (p = 0.004; AOR = 3.3; 95% CI = (1.5-7.6)) and staying in a neonatal intensive care unit (NICU) between 11 and 20 days (p = 0.042; AOR = 2; 95% CI = (1.0-4.5)). CONCLUSION: A high prevalence of ESßL-producing bacterial isolates was observed for commonly used antibiotics which needs further attention. Therefore, continuous and regular follow-ups of drug resistance patterns is important for the proper treatment and management of ESßL and carbapenemase producing gram-negative bacilli.
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INTRODUCTION: Catheter-associated urinary tract infections (CAUTIs) are the most common nosocomial infection and a leading cause of morbidity. The aim of this study was to determine the prevalence, associated factors and antibiogram of the bacterial isolates among CAUTIs patients. METHODS: A facility-based, cross-sectional study was conducted from March to December 2019 at Arba Minch General Hospital, Southern Ethiopia. Clinical and socio-demographic data were obtained using a questionnaire. Clean catch midstream urine samples were collected and inoculated onto blood agar, MacConkey agar, and cysteine lactose electrolyte deficient agar (CLED). The inoculated culture media were incubated in an aerobic atmosphere at 37°C for 24 h. After overnight incubation, the bacterial growth on the respective media was inspected visually and graded for the presence of significant bacteriuria. A significant bacteriuria was considered, if pure culture at a concentration of ≥105 colony forming unit (CFU)/mL. All isolates were further identified using colony morphology and biochemical tests. Antimicrobial sensitivity was determined by modified Kirby-Bauer disc diffusion method. Data were analyzed using SPSS version 25. P-value less than 0.05 was used as statistical significance. RESULTS: The overall incidence of symptomatic CAUTIs was 39/231 (16.8%). Independent predictors of CAUTIs were prolonged (≥7 days) catheterization (AOR = 3.6, 95% CI = 1.0-12.2), diabetes mellitus (AOR = 5.3, 95% CI = 1.4-19.6) and insertion of catheter in surgical ward (AOR = 3.6, 95% CI = 1.08-12.28). The most common bacterial isolates were E. coli 17/42 (40.5%), Klebsiella species 9/42 (21.4%) and Enterococcus species 5/42 (11.9%). High (>80%) drug resistance was observed against cotrimoxazole, cefoxitin and tetracycline. Ciprofloxacin and nitrofurantoin were the most active drugs. The overall prevalence of MDR among isolates was 37/42 (88.1%). Most bacterial isolates 30/42 (71.4%) were biofilm producers. CONCLUSION: High levels of drug resistance were observed to commonly used antibiotics. In our study, biofilm-producing bacterial isolates were the predominant cause of CAUTIs. Therefore, continuous surveillance of antimicrobial resistance patterns is necessary to help physicians in treatment and management of CAUTIs.
