Antibiotic resistance and sero-groups of shigella among paediatric out-patients in southwest Ethiopia.

OBJECTIVE: To determine the prevalence of Shigella sero-groups and resistance pattern of isolates to commonly used antibiotics in Jimma. DESIGN: Cross-sectional survey. SETTING: The study was conducted in Jimma, southwest Ethiopia. SUBJECTS: A total of 384 paediatric out-patients with diarrhoea aged 14 years and below were studied. METHODS: Stool specimens were collected from children presenting with diarrhoea using Cary-Blair transport medium and buffer treated swabs from Jimma hospital and Jimma health centre. Isolation, biochemical characterisation, sero-grouping and antibiotic sensitivity testing were performed according to standard methodology in the Microbiology laboratory of Jimma University. RESULTS: Out of the 77 Shigella strains isolated, sero-group A comprised 29.9%, B 40.3%, C 19.5% and D 10.4%. Among all Shigella sero-groups, highest resistance was encountered to tetracycline (63.6%), ampicillin (70.1%), cephalothin (57.1%), trimethoprim-sulphamethoxazole (32.5%) and chloramphenicol (40.3%) whileleast resistance was observed to gentamicin (1.3%), polymyxin B (3.9%) and nalidixic acid (6.5%). CONCLUSION: Gentamicin, polymyxin B and nalidixic acid were found to be the drugs of choice for cases related with shigellosis.

Prognostic value of objective semen parameters in an in vitro fertilization program.

PURPOSE: The basic semen parameters seem to have a limited predictive value in male fertility. Could other objective sperm analyses be helpful in the choice of the most adapted assisted procreation technique? METHODS: This study concerns 78 infertile couples with insemination failures. For each semen, 21 objective parameters are analyzed in fresh semen and after sperm selection procedure. The 78 couples are then included in an IVF protocol and classified into two groups: fertile (at least one cleaved embryo is obtained) and infertile. RESULTS: Using multiple variant discriminant factorial analysis, we have found nine nonconventional parameters which induce us to define two classes of semen. These two classes fit with the classification into fertile and infertile groups in 74.4% of the cases. CONCLUSIONS: So these parameters allow us to predict the chance of obtaining embryos during an IVF trial and to choose for each couple the most appropriate technique: IVF or ICSI.

Shigella serogroups identified from adult diarrhoeal out-patients in Addis Ababa, Ethiopia: antibiotic resistance and plasmid profile analysis.

Fifty shigella strains were isolated from 700 diarrhoeal samples collected from adult diarrhoeal out-patients in Addis Ababa. Among the isolates, serogroup A comprised 28%, B 44%, C 18% and D 10%. Among all shigella serogroups, highest resistance was encountered to tetracycline (74%), ampicillin (70%), cephalothin (64%), trimethoprim-sulfamethoxazole (52%) and chloramphenicol (50%) while least resistance was observed to gentamicin (0%), polymyxin B (10%) and nalidixic acid (14%). Gentamicin, polymyxin B and nalidixic acid were found to be the drugs of choice for cases of shigellosis. All drug resistant isolates analysed for plasmids contained multiple plasmids ranging from 1.8 to greater than 21 Kilobases.

Salmonella serogroups identified from adult diarrhoeal out-patients in Addis Ababa, Ethiopia: antibiotic resistance and plasmid profile analysis.

Forty five Salmonella strains were isolated from 700 diarrhoeal samples collected from adult diarrhoeal out-patients in Addis Ababa. Among the isolates, serogroup C comprised 31.1%, B 24.4%, S.typhi 15.6%, D 13.3%, A 8.9% and E 6.7%. Among the isolates, 71.1% were resistant to tetracycline, 68.9% to ampicillin, 66.7% to cephalothin, 57.8% to trimethoprim-sulphamethoxazole, 53.9% to kanamycin, 46.7% to chloramphenicol and less than 31.8% of the isolates were resistant to other drugs. Among S.typhi isolates, 28.6% were resistant to chloramphenicol and this shows the emergence of chloramphenicol resistant S.typhi strains in Ethiopia. Gentamicin and polymyxin B were found to be the drugs of choice for cases of salmonellosis including S.typhi. All drug resistant isolates analysed for plasmids contained multiple plasmids ranging in sizes from 1.8 to greater than 21 Kilobases.

Repair of neonatal aortic coarctation.

From 1981 to 1991, 146 infants under 1 month of age underwent repair of aortic coarctation. Forty-two had isolated coarctation, 53 had associated ventricular septal defect, and 51 had complex cardiac defects. The principal mode of presentation was congestive heart failure. The mean age at operation was 10.6 days. The technique for repair was left subclavian artery flap angioplasty in 126, resection with end-to-end anastomosis in 14, and a variety of repairs in 6 patients. Concomitant pulmonary artery banding was performed in 62 patients. The overall hospital mortality rate was 11%, and there was a strong association with pre-existing renal failure. The mean aortic clamp time in survivors was 23.9 minutes; mean hospital stay was 13.4 days. Significant restenosis occurred in 16 patients (11%) with an incidence of 10% after subclavian artery flap angioplasty. Eleven patients have undergone reoperation, and 5 were managed successfully with balloon dilatation.