Prevalence, antimicrobial susceptibility test and associated factors of Salmonella and Shigella in ready-to-eat fruit juices and salads in Mekelle, northern Ethiopia.

BACKGROUND: Food borne diseases is a challenging problem nowadays. Salmonella and Shigella species are great concern of food-born outbreaks. Thus, this study was aimed to assess the prevalence, antimicrobial susceptibility test and associated factors of Salmonella and Shigella species in fruit juices and salads. METHODS: A community based cross sectional study design was carried out on 50 juice houses from December to March 2020 in Mekelle. One hundred fifty samples were collected aseptically from the juice houses for laboratory analysis. Information related to risk factors was obtained using a structured questionnaire. In the laboratory, samples were homogenized using peptone water and incubated overnight for enrichment. Then, Salmonella and Shigella species were isolated on Salmonella-Shigella agar and Xylose Lysine Deoxycholate agar. Disc diffusion method was used to perform antimicrobial susceptibility test. Using SPSS (version 22) package, descriptive statistics and Chi square test (χ2) were used to analyze the data, and p < 0.05 was considered as statistically significant. RESULT: The overall prevalence of Salmonella and Shigella species was 41/150 (27.33%; 95% CI: 20.20 - 34.46) with 33 (22%) Salmonella spp. and 8(5.33%) Shigella spp. Antimicrobial susceptibility tests of both Salmonella and Shigella spp.showed high resistance against ampicillin (100%), tetracycline (63.6 and 62.5%, respectively) and amoxicillin-clavulanic acid (100%). Accessibility of fruits to flies and dust had statistical association (p = 0.021) with occurrence of Salmonell a and/or Shigella spp. CONCLUSION: The overall prevalence of Salmonella and Shigella spp. was found to be significant. The resistant rate of isolates against ampicillin, tetracycline and amoxicillin-clavulanic acid was high. Storage sites for fruits should be inaccessible to flies and dust. Therefore, routine monitoring of juice houses should be promoted and regular evaluation of bacterial resistance pattern should be done for selective antimicrobial therapy. Furthermore, consistent training of juice makers on food safety and hygiene should be implemented by the concerned body.

Hepatitis B and C viral coinfections and their association with HIV viral load suppression among HIV-1 infected patients on ART at Mekelle hospital, northern Ethiopia.

BACKGROUND: Although Ethiopia is endemic to viral hepatitis and HIV, data that could guide population-specific interventions are limited. In this study, we determined the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) and assessed their associations with HIV-1 viral load suppression among HIV-1 infected patients on antiretroviral therapy (ART) at Mekelle hospital in northern Ethiopia. METHODS: Between February and April 2020, blood samples were collected from 439 participants. Samples were screened for HBsAg and anti-HCV on the immunochromatographic test and confirmed using the Enzyme-Linked Immuno-sorbent assay (Beijing Wantai Co. China). HIV-1 viral load was quantified using reverse transcription-polymerase chain reaction (RT-PCR) on the Abbott platform. Binary and multivariable logistic regression was performed to identify potential predictors. RESULTS: Overall, 10% (44/439) and 3.6% (16/439) of the participants were coinfected with HBV and HCV, respectively. In a multivariate analysis, being illiterate (AOR = 6.57; 95% CI 1.04-41.6), and having a history of sexually transmitted infections (AOR = 4.44; 95% CI 1.31-15.0) and multiple sexual partners (AOR = 29.9; 95% CI 7.82-114.8) were associated with HBV infection. On the other hand, participants with a history of chronic non-communicable diseases (AOR = 10.6, 95% CI 1.61-70.1), and those reporting a history of sexually transmitted infections (AOR = 5.21, 95% CI 1.39-19.5) were more likely to be infected with HCV. In further analysis, HCV infection status was significantly associated with decreased viral load suppression rate (AOR = 7.14; 95% CI 2.18-23.3) whereas no significant association was observed with the HBV infection. CONCLUSIONS: The HBV coinfection rate in our study is high and, as per WHO's standard, corresponds to a hyperendemic level. The HCV coinfection rate is also substantially high and urges attention given its influence on the viral load suppression of HIV patients on ART at our study site. Our findings suggest the need to adopt universal screening and vaccination of people with HIV against HBV and screening for HCV at our study site and in Ethiopia at large, which contributes to Ethiopia's progress towards the 2030 global target of reducing the HBV infection.

Nasal carriage, risk factors and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus among healthcare workers in Adigrat and Wukro hospitals, Tigray, Northern Ethiopia.

OBJECTIVE: The aim of this study was to determine nasal carriage, risk factors and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus among health care-workers of Adigrat and Wukro hospitals Northern Ethiopia. RESULTS: The overall prevalence of S. aureus and methicillin resistance S. aureus (MRSA) in the present study were 12% (29/242) and 5.8% (14/242) respectively. The rate of MRSA among S. aureus was 48.3%(14/29). In this study, MRSA carriage was particularly higher among nurse professionals (7.8%) and surgical ward (17.1%). None of the MRSA isolates were sensitive to penicillin and ampicillin. However, low resistance was found for chloramphenicol and clindamycin. Being diabetic and use of hands rub was statistically significant with MRSA colonization.

Ocular bacterial infections at Quiha Ophthalmic Hospital, Northern Ethiopia: an evaluation according to the risk factors and the antimicrobial susceptibility of bacterial isolates.

BACKGROUND: External and intraocular infections can lead to visual impairments, which is a major public health problem. Bacteria are the most frequent pathogens affecting ocular structures; the increasing rate of antimicrobial drug resistance is a worldwide concern. The aim of this study was to determine the occurrence of bacteria in ocular infections, their antimicrobial susceptibility patterns, and risk factors in bacterial ocular infection. METHODS: A hospital based cross-sectional study was conducted from September 2015 to December 2015 at Quiha Ophthalmic Hospital, Tigray, northern Ethiopia. Ocular specimens from blepharitis, blepharoconjunctivitis, conjunctivitis, keratitis, endophthalmitis, periorbital cellulitis and dacrocystitis were collected from 270 individuals with suspected ocular infection. Data on sociodemographic and risk factors were also collected using a structured questionnaire. Data analysis was performed using SPSS version 21 and 0.05 with a corresponding 95% confidence interval (CI) was considered statistically significant. RESULTS: Among 270 study subjects, 180 (66.7%) were culture positive for different bacterial isolates. The predominant bacterial isolates were Staphylococcus aureus (40, 22.2%), coagulase negative staphylococci (31, 17.2%) and Pseudomonas aeruginosa (21, 11.7%). Ocular surface disease, ocular trauma, hospitalization and cosmetic application practices were significantly associated with the occurrence of bacterial infection. Concerning antimicrobial susceptibility, most isolates were susceptible to amikacin (137, 93.2%), gentamicin (131, 89.1%) and ciprofloxacin (141, 89.2%). Overall, 40 (22.5%), 34 (19.1%) and 62 (34.8%) isolates were resistant to one, two, and three or more antimicrobials, respectively. CONCLUSION: Bacteria were isolated from the majority of the study subjects. More than half of the bacterial isolates were resistant at least to one drug and a significant rate of multidrug resistance was detected. Therefore, identification of the etiologic agent and antimicrobial susceptibility testing should be practiced to select the appropriate antimicrobial agent to treat eye infections and prevent the emergence of drug resistant bacteria.

More than half of presumptive multidrug-resistant cases referred to a tuberculosis referral laboratory in the Tigray region of Ethiopia are multidrug resistant.

OBJECTIVE/BACKGROUND: Generating epidemiological data on multidrug-resistant tuberculosis (MDR-TB) is essential to assess the magnitude and trends of anti-TB drug resistance. This study determined the prevalence of MDR-TB among presumptive MDR cases referred to a TB referral laboratory in the Tigray region of Ethiopia. METHODS: A retrospective cross-sectional study was conducted on 262 culture-positive presumptive MDR-TB samples submitted to the Tigray Regional Research Laboratory for MDR testing between January 2013 and August 2014. Relevant data were recorded using a structured recording format. RESULTS: Out of 262 Mycobacterium tuberculosis isolates, 143 (54.6%) were MDR, 28 (10.7%) were resistant to rifampicin only, and 19 (7.3%) were resistant to isoniazid only. The prevalence of MDR-TB among newly infected cases was 66.7% (8/12) and that among previously treated cases was 54.1% (97/179). Of the variables tested, being a male was found to be associated with the development of MDR-TB (p=.003). CONCLUSION: More than half of the presumptive MDR cases referred to the Tigray Regional Research Laboratory were MDR. The prevalence was high in both newly infected and previously treated cases. Hence, re-enforcing the TB prevention methods, and strengthening the directly observed treatment short-course (DOTS) strategy and the capacity of laboratories to undertake drug susceptibility testing (DST) in the region are imperative in order to curb the emergence and transmission of MDR-TB.

Nasal and hand carriage rate of methicillin resistant Staphylococcus aureus (MRSA) among health care workers in Mekelle Hospital, North Ethiopia.

BACKGROUND: Methicillin resistant Staphylococcus aureus (MRSA) is significant major pathogen responsible for hospital and community based infections. OBJECTIVE: The aim of this study was to assess the nasal and hand carriage of methicillin resistant Staphylococcus aureus in health care workers of Mekelle Hospital METHODS: The study was carried out during November 2010 to January 2011. Swab samples from both anterior nares and hands were taken. The samples were cultured on mannitol salt agar and incubated aerobically at 37 degrees C for 48 hours. Staphylococcus aureus was identified as nmannitol fermenter and coagulase test positive. Antimicrobial susceptibility test for MRSA was done by disk diffusion method using oxacillin disks. Data were analysed using SPSS version 16 software. RESULTS: Out of the 177 health care workers screened, 36 (20.3%) of them were methicillin resistant Staphylococcus aureus carriers in their hand and anterior nares. More females, 25(14.1%) were colonized by methicillin resistant Staphylococcus aureus than males 11 (6.2%) (P = 0.044). Nasal carriage of MRSA of 25 (14.1%) was higher than hand carriage 11 (6.2%) (p < 0.05). Nurses and medical doctors had methicillin resistant Staphylococcus aureus carriage rates of 26 (13.6%) and 4 (2.3%), respectively. The isolated MRSA were resistant to multiple antibiotics. The highest resistance was observed for ampicillin (88.9%) and tetracycline (86.1%). Two (5.6%) of the nasal isolates were vancomycin resistant. CONCLUSION: Methicillin resistant Staphylococcus aureus carriage among health care workers in this study was high. The carriage rate was higher among nurses and doctors. The MRSA isolates were multi drug resistant to other antibiotics. So, the result of this study emphasizes the need of regular surveillance of health care workers. It also calls a need for an effective infection prevention and control program.