Hailu, Melese (2014) Evalence and Antimicrobial Resistance of Bacterial Isolates with Special Emphasis on Enterobacteriaceae among Children Suspected for Septicemia and Urinary Tract Infection in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia. Masters thesis, Addis Ababa University.
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Abstract
Background: Blood stream and urinary tract infections are a major cause of mortality and morbidity of the pediatric population. Extended spectrum beta-lactamase (ESBL) producing and carbapenem resistant enterobacteriaceae is the challenge for controlling now days. Assessing the prevalent bacteria and their antibiotic resistance helps to provide effective therapies, develop rational prescription programs and make policy decisions. Objective: To determine the prevalence and antimicrobial resistance of bacterial isolates with special emphasis on enterobacteriaceae among children suspected for septicemia and urinary tract infection in Tikur Anbessa University Hospital, Addis Ababa, Ethiopia. Method: A cross sectional study was conducted from January 10 to March 30/2014 at Tikur Anbessa University Hospital, Addis Ababa, Ethiopia. A total of 322 study participants who were suspected for septicemia and/or UTI were recruited. All blood and urine samples were cultured on Blood and MacConkey agar. All culture positives were characterized by colony morphology, Gram stain and biochemical tests using the standard procedure. Significant bacteriuria was determined for all culture positive urine samples. Antimicrobial susceptibility test was performed for all bacterial isolates using Kirby-Bauer method. ESBL was detected using combination disk & double disk synergy methods on Muller Hinton agar. Carbapenemase were detected by Modified Hodge method using Meropenem. All demographic & laboratory data were entered to EPI INFO & exported to SPSS version 20 for analysis. Result: The overall prevalence of bacteria isolates from blood and urine cultures was 17.1%. From 177 blood samples 13.0% (n=23/177) and from 145 urine samples 22.1% (n=32/145) were culture positives. Coagulase negative Staphylococci & Klebsiella ozaenae were the predominate bacteria isolated in blood and urine cultures respectively. Most of them 89.1% (n=49/55) developed multidrug resistance (MDR≥2 drugs) to most commonly used antibiotics. Multiple resistances were observed in 71.42% of Gram positive and 95.11% Gram negative isolates. Prevalence of ESBL producing and carbapenem resistant enterobacteriaceae was 78.57% and 12.12% respectively. Conclusion: The choice of drugs in the treatment of bacteria isolates from blood and urine is quite narrow today due to the wide scale resistance to common antibiotics. The emergence of MDR calls for continuous monitoring & reviewing of antimicrobial policy in hospitals and the country at large.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Septicemia, UTI, Bacterial isolates, antimicrobial resistance pattern, ESBL, Carbapenem resistance, Tikur Anbessa University Hospital, Addis Ababa, Ethiopia |
| Subjects: | Q Science > QR Microbiology R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services |
| Divisions: | Africana |
| Depositing User: | Emmanuel Ndorimana |
| Date Deposited: | 29 Oct 2018 13:41 |
| Last Modified: | 29 Oct 2018 13:41 |
| URI: | http://thesisbank.jhia.ac.ke/id/eprint/7105 |
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