RESUMEN
Two hundred patients with diarrhoea in a rehabilitation camp in Ethiopia were studied in October 1985 to determine the presence of pathogens in the stool and their susceptibility to antibiotics. A total of 42 (21.1%) patients had a positive culture with enterobacteriaceae, the isolation rate was 15.6% for Escherichia coli, 3.5% for Shigella spp. and 2.01% for Salmonella spp. In-vitro antibiotic resistance was frequent among the 42 isolates: 53% of E. coli strains were found to be resistant to ampicillin, 47% to chloramphenicol, 30% to co-trimoxazole and 67% to tetracycline. Of the seven Shigella, three were resistant to chloramphenicol and four to tetracycline. Multidrug resistance (two or more antibiotics) was observed in 52.3% of the 42 isolates. The protocols used for the screening of dysenteric patients for Shigella spp. or Salmonella spp. were found to be specific but poorly sensitive. The opposite was observed for amoebiasis and giardiasis. The responsibility of widespread use of common oral antibiotics is discussed as one of the major factors of antibiotic resistance occurrence at Korem.
PIP: The poor nutrition, overcrowding, lack of water, and inadequate sanitation present in the rehabilitation camps set up for the more than 50,000 Ethiopians fleeing the 1984 drought made this population especially vulnerable to diarrheal diseases. 200 rehabilitation camp residents with diarrhea were studied in 1985 to determine the presence of pathogens in the stool and susceptibility to antibiotic treatment. A total of 42 (21%) of camp residents had a positive culture with enterobacteria. The isolation rate was 15.6% for Escherichia coli, 3.5% for Shigella, and 2.01% for Salmonella. Isolation rates were higher among patients under 5 years of age (59%) than among older patients (12%). Dehydration was more likely to be observed among children under 5 years of age, those with vomiting, patients with a more severe diarrhea, pyretic patients, and those with a positive stool culture. A good specificity (92%) and a low sensitivity (33%) was found for dysentery with fever for shigella or salmonella isolation. 22 (53%) of the enterobacteria were resistant to 2 or more antibiotics, presumably because of the widespread use of common oral antibiotics in the study setting. 53% of the E coli strains were resistant to ampicillin, 47% to chloramphenicol, 30% to co-trimoxazole, and 67% to tetracycline. Of the 7 Shigella strains, 3 were resistant to chloramphenicol and 4 to tetracycline. The high prevalence of resistance indicates a need for careful and discriminate use of antibiotics in emergency situations by relief programs.