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Zhang Y, Liu B, Yang M, Li S, Qu Y, Ma Y, Ye L, Mei J. 16S rRNA sequencing in chronic dacryocystitis. Clin Exp Optom 2024:1-10. [PMID: 38811366 DOI: 10.1080/08164622.2024.2358246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 04/28/2024] [Indexed: 05/31/2024] Open
Abstract
CLINICAL RELEVANCE The pathogenesis of chronic dacryocystitis (CDC) is associated with a variety of bacteria. Investigating microflora has the potential to provide a theoretical basis for preventing and treating CDC. BACKGROUND 16S rRNA sequencing is a sequence-based bacterial analysis. The application of 16S rRNA sequencing in CDC is rarely reported. METHODS A case-control study of infected and healthy eyes diagnosed as CDC patients was conducted. Seventy-eight patients were divided into A (conjunctival sac secretions from healthy eyes), B (conjunctival sac secretions from affected eyes), and C (lacrimal sac secretions from affected eyes) groups. The flora of samples was analysed with 16S rRNA sequencing, and the data was analysed using QIIME, R, LefSE and other software. The potential functions were analysed by PICRUSt. RESULTS A total of 1440 operational taxonomic units (OTUs) were obtained, 139 specific to group A, 220 specific to group B, and 239 specific to group C. There was no significant difference in α index between the three groups. The beta diversity and grouping analysis data indicated that the three groups of flora were similar in species richness and diversity, but there were some differences in composition. In group A, the abundance of Pseudomonadaceae, Chlorobacteria, Moraceae, Staphylococcaceae, Bacillariophyceae, Immunobacterium spp. and Bacillus spp. was higher; in group B, the abundance of Burkholderiaceae, Sphingomonas, Rhizobia, Stalked Bacteria, Sphingomonadaceae, Enterobacteriaceae, Shortwaveomonas spp. was higher; in group C, the abundance of Streptococcus digestiveis, Propionibacterium, Enterobacteriaceae, Anaerobacteriaceae, Propionibacteriaceae, Bacillus spp. Neisseria spp. and Shortactomonas spp. was higher. Six pathways were identified to assess the potential microbial functions. CONCLUSION Alterations in the microbiota of the conjunctiva and lacrimal sac are associated with the pathogenesis of CDC, which may provide certain guidance for antibiotic treatment of CDC.
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Affiliation(s)
- Yongxin Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Beian Liu
- The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China
| | - Meina Yang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Shixu Li
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Yunhao Qu
- The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China
| | - Yingge Ma
- The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, China
| | - Lin Ye
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Jun Mei
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
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Ango TS, Gelaw NB, Zegene GM, Teshome T, Getahun T. Prevalence and antimicrobial susceptibility profile of bacteria isolated from the hands of housemaids in Jimma City, Ethiopia. Front Public Health 2024; 11:1301685. [PMID: 38348381 PMCID: PMC10859430 DOI: 10.3389/fpubh.2023.1301685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 12/27/2023] [Indexed: 02/15/2024] Open
Abstract
Introduction Bacterial pathogens continue to be a major cause of foodborne gastroenteritis in humans and remain a public health problem. Housemaids operating inside a kitchen could be the source of infection and may transmit disease-inflicting pathogens through contaminated hands. Objective This study aimed to assess the prevalence and antimicrobial susceptibility profile of bacteria isolated from the hands of housemaids in Jimma City, Ethiopia. Methods A laboratory-based cross-sectional study was employed among 234 housemaids. Hand swab samples from the dominant hand of the study participants were collected under sterile conditions following standard operating procedures. Then, in the laboratory, the swabs were inoculated aseptically using streak-plating methods on the growth media, such as mannitol salt agar [Staphylococcus aureus and coagulase-negative staphylococci], MacConkey agar [Klebsiella species and Proteus species], salmonella-shigella agar [Salmonella species and Shigella species], and eosin methylene blue agar [Escherichia coli (E. coli)]. In addition, a set of biochemical tests was applied to examine bacterial species. Data were double-entered into EpiData version 3.1 and then exported to the Statistical Package for Social Science (SPSS) version 26 for further analysis. Descriptive analyses were summarized using frequency and percentage. Results The proportion of housemaids' hands containing one or more positive bacterial isolates was 72% (95% CI: 66.2, 77.8). The dominant bacterial isolates were Staphylococcus aureus (31.6%), Escherichia coli (21.3%), Salmonella species (1.3%), Shigella species (6.7%), Klebsiella species (23.1%) and Proteus species (14.7%). Fingernail status (AOR =15.31, 95% CI: 10.372, 22.595) and the removal of a watch, ring, and bracelet during hand washing (AOR = 20.844, 95% CI: 2.190, 9.842) were significantly associated with the prevalence of bacterial isolation. Most Staphylococcus aureus isolates were susceptible to chloramphenicol (98.6%). Escherichia coli isolates were susceptible to tetracycline (75%), ceftriaxone (79.2%), chloramphenicol (87.5%), and ceftazidime (77.1%). Eighty percent of isolated Shigella species were susceptible to chloramphenicol and gentamicin respectively. In addition, Klebsiella and Proteus species exhibited high susceptibility to chloramphenicol. However, their isolates showed resistance against a number of the tested antimicrobials. Staphylococcus aureus isolates (28.2%) were resistance to tetracycline. Moreover, One-quarter of Escherichia coli isolates were resistance to tetracycline, ceftriaxone, chloramphenicol, and ceftazidime. Whereas 46.7% and 48.5% of isolated Shigella species and Proteus species were resistance to tetracycline and ceftriaxone. Conclusion The hands of housemaids are important potential sources of pathogenic bacteria that would result in the potential risk of foodborne diseases. Most bacteria isolates were resistant to tetracycline, ceftriaxone, and ceftazidime. Therefore, practicing good hand hygiene helps to prevent and control the spread of antimicrobial-resistant microbes.
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Affiliation(s)
- Tadele Shiwito Ango
- Department of Public Health, Mizan Aman Health Science College, Mizan Aman, Southwest Ethiopia People Regional State, Ethiopia
| | - Negalgn Byadgie Gelaw
- Department of Public Health, Mizan Aman Health Science College, Mizan Aman, Southwest Ethiopia People Regional State, Ethiopia
| | - Girma Mamo Zegene
- Department of Public Health, Mizan Aman Health Science College, Mizan Aman, Southwest Ethiopia People Regional State, Ethiopia
| | - Tizita Teshome
- Department of Environmental Health Sciences and Technology, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tesfalem Getahun
- Department of Environmental Health Sciences and Technology, Institute of Health, Jimma University, Jimma, Ethiopia
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Ango TS, Teshome T, Getahun T. Hand hygiene status and its associated factors among housemaids working in communal living residences in Jimma city, southwest Ethiopia. Heliyon 2023; 9:e22651. [PMID: 38107271 PMCID: PMC10724665 DOI: 10.1016/j.heliyon.2023.e22651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 11/06/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023] Open
Abstract
Objective Hand hygiene is a milestone, cost-effective, and convenient strategy to prevent the transfer of pathogenic micro-organisms. However, housemaids operating inside a kitchen can be the source of infection. In addition, hand hygiene among housemaids working in dwellings was underexplored. This study aimed to assess the hand hygiene status and associated factors among housemaids working in communal living residences in Jimma City, Southwest Ethiopia. Methods A total of 230 housemaids were included in this cross-sectional study. Total samples were proportionally allocated for each residence and a simple random sampling technique was applied to select the study participants. Hand hygiene status and relevant characteristics were collected through face-to-face interviews and observations. Hand swab samples were collected and tested for bacterial contaminants. Then, it was inoculated aseptically using streak-plating methods on mannitol salt agar (MSA), MacConkey agar (MCA), salmonella-shigella agar (SSA), and eosin methylene blue (EMB) agar and then incubated at 37 °C for 24 h. Data was edited, cleaned, and double-entered into Epidata version 3.1 and then exported to the statistical package for social science statistics version 26 for further analysis. Binary logistic regression was used to identify associated factors. Statistically significant was declared at P value < 0.05. Results Two hundred twenty-five housemaids were interviewed with a response rate of 97.8 %. The results showed that the proportion of good hand hygiene status among the housemaids was only 28.0 %. Although the majority of participants reported washing their hands frequently, the prevalence of bacterial contaminants on their hands was high at 72 %. The study identified several factors associated with hand hygiene status, including the occupational status of heads of households (AOR = 0.030, 95 % CI: 0.003, 0.348; P = 0.0050), the effectiveness of the heads of household (AOR = 13.955, 95 % CI: 1.442, 13.500; P = 0.0230), and the removal of accessories during handwashing (AOR = 20.844, 95 % CI: 2.190, 9.842; P = 0.0080). Conclusion Overall, the hand hygiene status of housemaids was found to be poor and influenced by demographics and other relevant characteristics. The study emphasizes the need for a multimodal strategy involving household heads, local and national authorities, and other stakeholders to raise awareness and advocate for hand hygiene to prevent communicable diseases in the wider community, particularly in the study area.
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Affiliation(s)
- Tadele Shiwito Ango
- Department of Public Health, Mizan Aman Health Science College, P. O. Box 240, Mizan-Aman, Sweprs, Ethiopia
| | - Tizita Teshome
- Department of Environmental Health Sciences and Technology, Institute of Health Sciences, Jimma University, P. O. Box 378, Jimma, Ethiopia
| | - Tesfalem Getahun
- Department of Environmental Health Sciences and Technology, Institute of Health Sciences, Jimma University, P. O. Box 378, Jimma, Ethiopia
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Abebe T, Teklemariam Z, Shume T, Mekuria S, Urgesa K, Weldegebreal F. Bacterial Profile of External Ocular Infections, Its Associated Factors, and Antimicrobial Susceptibility Pattern among Patients Attending Karamara Hospital, Jigjiga, Eastern Ethiopia. Int J Microbiol 2023; 2023:8961755. [PMID: 36937542 PMCID: PMC10023229 DOI: 10.1155/2023/8961755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 01/10/2023] [Accepted: 02/24/2023] [Indexed: 03/16/2023] Open
Abstract
Background External ocular infection is a global public health problem. Frequently, bacteria cause an ocular infection that ranges from morbidity to loss of vision. The increasing bacterial resistance in ocular infections leads to the risk of treatment failure with possibly serious consequences. Objective The study aimed to assess the bacterial profile of external ocular infections, their associated factors, and antimicrobial susceptibility pattern among patients admitted to Karamara hospital, Jigjiga, Eastern Ethiopia. Method Institutional-basedcross-sectional study was conducted on 288 conveniently selected patients among patients admitted to Karamara hospital from May 1 to June 30, 2020. Data were collected using a structured questionnaire. The ocular sample was collected and cultured in the appropriate culture media and identified using a series of biochemical tests. Antimicrobial susceptibility testing of isolates was performed by using the disk diffusion method. Data were double entered onto EpiData version 3.1 then exported to SPSS version 20 and analyzed to calculate descriptive frequency and odds ratio, and p value ≤0.05 was taken as the significant value. Result The prevalence of bacterial infection in external ocular samples was 62.2% (95% CI: 56.6%, 68.4%). Out of the 179 isolates, the majority of the bacterial isolates (87.7%) were Gram-positive. Staphylococcus aureus (53.1%) was the predominant isolate. Using soap for washing the face (AOR = 0.43; 95% CI: 0.29, 0.95), having diabetes mellitus (AOR = 3.11; 95% CI: 1.45, 6.75), and history of hospitalization (AOR = 2.82; 95% CI: 1.44, 5.54) were significantly associated with external ocular infection. Most (95.5%) of the Gram-positive bacteria showed resistance to penicillin, but they were susceptible to vancomycin, clindamycin, and ciprofloxacin. Conclusion The study showed a high prevalence of bacterial infections with the predominant isolate was S. aureus. Penicillin-resistant bacteria were identified among Gram-positive bacterial isolates. Soap usage, hospitalization, and diabetes mellitus were associated with the infection. Antibiotics that were susceptible to the specific bacteria should be used as a drug of choice and using soap for washing the face is advisable to protect against external ocular infection.
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Affiliation(s)
- Tigist Abebe
- 1Jigjiga University, College of Medicine and Health Sciences, Department of Medical Laboratory Sciences, Jigjiga, Ethiopia
| | - Zelalem Teklemariam
- 2Haramaya University, College of Health and Medicine Sciences, Harar, Ethiopia
| | - Tadesse Shume
- 2Haramaya University, College of Health and Medicine Sciences, Harar, Ethiopia
| | - Surafel Mekuria
- 1Jigjiga University, College of Medicine and Health Sciences, Department of Medical Laboratory Sciences, Jigjiga, Ethiopia
| | - Kedir Urgesa
- 2Haramaya University, College of Health and Medicine Sciences, Harar, Ethiopia
| | - Fitsum Weldegebreal
- 2Haramaya University, College of Health and Medicine Sciences, Harar, Ethiopia
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Osei Duah Junior I, Tchiakpe MP, Borquaye LS, Amoah K, Amankwah FKD, Kumah DB, Ofori LA, Danso-Appiah A, Prempeh BO, Gbedema SY, Munyaneza J, Danquah CA, Akuffo KO. Clinical characteristics of external bacterial ocular and periocular infections and their antimicrobial treatment patterns among a Ghanaian ophthalmic population. Sci Rep 2022; 12:10264. [PMID: 35715500 PMCID: PMC9206014 DOI: 10.1038/s41598-022-14461-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/07/2022] [Indexed: 01/02/2023] Open
Abstract
Empirical antimicrobial therapy is linked to a surge in antimicrobial resistant infections. However, an insight on the bacteria etiology of ocular infections is essential in the appropriation of choice of antimicrobial among clinicians, yet there remains a dearth of data from Ghana. We investigated the bacteria etiology of external ocular and periocular infections and antimicrobial treatment patterns among a Ghanaian ophthalmic population. A multicenter study design with purposive sampling approach was employed. Patients demographics and clinical data were collated using a pretested structure questionnaire. Cornea specimens and conjunctival swabs were obtained for bacterial isolation following standard protocols. About 95% (98/103) of ocular samples were positive for bacteria culture. The proportion of Gram-negative bacteria was 58.2%, and the predominant bacteria species were Pseudomonas aeruginosa 38.8% and Staphylococcus aureus 27.6%. Conjunctivitis 40.0% and keratitis 75.0% were mostly caused by Pseudomonas aeruginosa. The routinely administered antimicrobial therapy were polymyxin B 41.2%, neomycin 35.1% and ciprofloxacin 31.6%. Participants demographic and clinical characteristics were unrelated with positive bacteria culture (p > 0.05). Our results showed a markedly high burden of ocular bacterial infections and variations in etiology. Bacterial infection-control and antimicrobial agent management programs should be urgently institutionalized to prevent the emergence of resistant infections.
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Affiliation(s)
- Isaiah Osei Duah Junior
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michel Pascal Tchiakpe
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lawrence Sheringham Borquaye
- Department of Chemistry, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Central Laboratory, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kwadwo Amoah
- The Eye Clinic, Kumasi South Hospital, Atonsu-Agogo, Kumasi, Ghana
| | - Francis Kwaku Dzideh Amankwah
- Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - David Ben Kumah
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Linda Aurelia Ofori
- Department of Theoretical and Applied Biology, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Anthony Danso-Appiah
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Ghana
- University of Ghana Centre for Evidence Synthesis and Policy, School of Public Health, University of Ghana, Legon, Ghana
| | - Bright Owusu Prempeh
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- The Anglican Eye Hospital, Jachie, Ghana
| | - Stephen Yao Gbedema
- Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Justin Munyaneza
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Cynthia Amaning Danquah
- Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kwadwo Owusu Akuffo
- Department of Optometry and Visual Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
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Woreta AN, Kebede HB, Tilahun Y, Teklegiorgis SG, Abegaz WE. Antibiotic Susceptibility Pattern and Bacterial Spectrum Among Patients with External Eye Infections at Menelik II Referral Hospital in Addis Ababa, Ethiopia. Infect Drug Resist 2022; 15:765-779. [PMID: 35264860 PMCID: PMC8901190 DOI: 10.2147/idr.s352098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/22/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Asmamaw Nitsuh Woreta
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Microbiology Unit, Department of Laboratory Sciences, Menelik II Referral Hospital, Addis Ababa, Ethiopia
| | - Habtamu Biazin Kebede
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Correspondence: Habtamu Biazin Kebede, Email
| | - Yonas Tilahun
- Department of Ophthalmology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Woldaregay Erku Abegaz
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Fenta F, Alemu D, Alelign D. Magnitude of Drug-Resistant Gram-Positive Bacterial Pathogens, and Its Associated Factors from External Ocular Infected Patients Attending at Jinka General Hospital Ophthalmic Clinic, Southern Ethiopia. Infect Drug Resist 2022; 15:947-959. [PMID: 35299852 PMCID: PMC8921825 DOI: 10.2147/idr.s356974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 03/04/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Fikremariam Fenta
- Department of Medical Laboratory Science, Arba Minch College of Health Science, Arba Minch, Ethiopia
| | - Derbie Alemu
- Department of Medical Laboratory Science, Arba Minch College of Health Science, Arba Minch, Ethiopia
| | - Dagninet Alelign
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- Correspondence: Dagninet Alelign, Tel: +251 964-428-118, Email
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Ashagrie D, Genet C, Abera B. Vancomycin-resistant enterococci and coagulase-negative staphylococci prevalence among patients attending at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia. PLoS One 2021; 16:e0249823. [PMID: 33831089 PMCID: PMC8031390 DOI: 10.1371/journal.pone.0249823] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/26/2021] [Indexed: 12/04/2022] Open
Abstract
Background Vancomycin resistant enterococci (VRE) and vancomycin resistance coagulase negative staphylococci (VRCoNS) are common pathogens causing difficult to treat health care associated infections (HAI). Hence, the World Health Organization listed VRE as one of the high priority pathogens for new antibiotic discovery and antimicrobial resistance surveillance. Despite this, data on the prevalence of VRE and VRCoNS in Ethiopia is scarce. Thus, the present study determined prevalence of VRE and VRCoNS among patients attending Felege-Hiwot comprehensive specialized hospital, Ethiopia. Methods A hospital based cross-sectional study was conducted on 384 patients selected conveniently from February to March 2020. Data on demographic and clinical variables were collected using a structured questionnaire by face-to-face interview. Simultaneously urine, venous blood and wound swab were collected and processed following standard bacteriological technique. Antimicrobial susceptibility test was performed by minimum inhibitory concentration method using E-test for vancomycin and Kirby-Bauer disc diffusion method for other classes of antibiotics. Data was entered and analyzed using SPSS version 23. Logistic regression was performed to identify factors associated with VRE infection. P. value < 0.05 was considered as statistically significant. Results The prevalence of enterococci and CoNS were 6.8% and 12% respectively. The prevalence of VRE was 34.61% (9/26), while all CoNS (46 isolates) were susceptible to vancomycin. The majority (66.7%) of VRE was isolated from blood samples. Furthermore all VRE (100%), 58.8% of vancomycin susceptible enterococci and 45.7% of CoNS were multidrug resistant (MDR). Having educational level of secondary school and below (AOR = 12.80, CI = 1.149–142.5), previous exposure to catheterization (AOR = 56.0, CI = 4.331–724.0) and previous antibiotic use practice (AOR = 26.25, CI = 3.041–226.2) were a significant associated explanatory factor for VRE infection. Conclusions The prevalence of vancomycin resistance enterococci, which is also multidrug resistant, was significantly high. Though no vancomycin resistance CoNS detected, the MDR level of CoNS was high. Thus to limit enterococci and CoNS infections and MDR development, focused infection prevention measures should be implemented.
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Affiliation(s)
- Degu Ashagrie
- Diagnostic Medical Laboratory Unit, Felege-Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia
| | - Chalachew Genet
- Department of Medical Laboratory Science, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
- * E-mail:
| | - Bayeh Abera
- Department of Medical Laboratory Science, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Dago TR, Woldemichael DK, Daba FB. Medical History, Clinical Features, Treatment Outcome and Its Predictors Among Infectious Keratitis Patients in Jimma University Medical Center, Southwest Ethiopia: Prospective Observational Study. Clin Ophthalmol 2021; 15:1223-1237. [PMID: 33790530 PMCID: PMC7997589 DOI: 10.2147/opth.s291880] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/22/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Infectious keratitis is a major global cause of visual impairment and irreversible blindness among the corneal diseases. Its diagnosis and management remain getting challenge. The clinical and visual outcome remains poor in developing countries. The aim of this study was to determine treatment outcome and its predictors among patients with infectious keratitis. METHODS Prospective observational study was conducted among adult patients diagnosed with infectious keratitis at the Ophthalmology Department in Jimma University Medical Center from April 1 to September 30, 2019. The primary outcome indicator was response of the ulcer to empirical treatment. Ulcers that did not heal and required surgery had a poor outcome. Variables with a p-value of <0.25 were entered into a multivariate logistic regression model to determine the independent predictors of poor treatment outcome and variables with a p-value of <0.05 were considered statistically significant. RESULTS The research involved 131 adult patients. Eighty-seven (66.4%) were males. The mean age was 39.38 (±18.9) years. Eighty-three (63.4%) patients had poor treatment outcome. Mean length of hospital stay was 17.38 (±12.563) days. Poor visual outcome was observed among 71 (54.2%) participants. Evisceration was done for seven (5.3%) patients. Independent predictors of poor treatment outcome include perforation at admission (AOR=6.1, 95%CI: 1.5-25.1), presence of comorbidity (AOR=7.7, 95%CI: 2.16-27.3), poor adherence (AOR=5.3, 95%CI: 1.8-25.9), traditional medicine use (AOR=6.7, 95%CI: 1.8-25.4), ulcer depth >1/3 (AOR=7.6, 95%CI: 2.48-48.23) and farm workers (AOR=3.59, 95%CI: 1.09-11.77). Major complications occurred after admissions were perforation (14.5%), followed by endophthalmitis (7.63%) and corneal opacity (6.87%). CONCLUSION AND RECOMMENDATION Our study found high poor treatment outcomes and high poor visual outcomes. Presence of comorbidity, perforation at admission, traditional medicine use, working on a farm, poor adherence, and ulcer depth were the predictors of poor treatment outcome. This high poor outcome requires a nationwide interventional study and urgent intervention that may reach rural communities.
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Affiliation(s)
- Tolcha Regasa Dago
- School of Pharmacy, College of Medicine and Health Science, Mizan Tepi University, Mizan-Aman, Ethiopia
| | | | - Fekede Bekele Daba
- School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
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Ayehubizu Z, Mulu W, Biadglegne F. Common bacterial causes of external ocular infections, associated risk factors and antibiotic resistance among patients at ophthalmology unit of Felege Hiwot Referral Hospital, Northwest Ethiopia: a cross-sectional study. J Ophthalmic Inflamm Infect 2021; 11:7. [PMID: 33644821 PMCID: PMC7917034 DOI: 10.1186/s12348-021-00238-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 02/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ocular infections are a serious public health problem in Ethiopia with increased incidence of morbidity and blindness. Empirical therapy with topical ophthalmic broad spectrum antibiotic formulations is also a prevailing practice. The aim of this study was to determine the bacterial causes of external ocular infections (EOIs), antimicrobial resistance and its associated risk factors among patients at Felege Hiwot Referral Hospital, Northwest Ethiopia. METHODS A hospital based cross - sectional study was conducted from 1 February to 30 April 2019. Patients with EOIs were consecutively included from 1 February to 30 April, 2019. Data were collected using structured questionnaire by face-to-face interview and complemented with patient card review. Conjunctival, eyelid margin and lacrimal sac swabs were collected aseptically. Bacterial species were identified using standard bacteriological techniques. Antimicrobial susceptibility testing was done using Kirby-Bauer disk diffusion method. Binary logistic regression analysis was calculated to identify the factors associated with EOIs. P.value (p) < < 0.05 was considered as statistically significant. RESULTS A total of 360 patients took part in the study and majority of them were males (64.7%). The median age of study participants was 59.5 years. Overall, 208(57.8%) (95%CI = 52.6- - 62.8%) of patients had culture confirmed bacterial EOIs. The proportion of culture confirmed EOIs was 60.4% among conjunctivitis cases and 55.8% among blepharitis. Ocular trauma (P < < 0.001), ocular disease (P < < 0.001) and having eye allergy (P = 0.027) were significantly associated with EOIs. The most frequent isolates were S. aureus (37%), K. pneumoniae (13.5%), Proteus(7.2%) spp., S. pneumoniae (4.3%), Citrobacter spp. (3.4%) and P. aeruginosa (2.9%). Gram positive isolates were resistant to penicillin in 87% and ampicillin in 86.2%. Gram negative isolates were resistant to ampicillin (87.5%). P.aeruginosa isolates (85.3%) were resistant to piperacillin and 50% were resistant to tobramycin. Overall, 45.2% of the isolates were multi-drug resistant. The percentage of multi-drug resistance was 80% among Enterobacter isolates and 64.3% among K. pneumoniae. CONCLUSIONS Bacterial external ocular infections linked with multi-drug resistance and resistance to penicillin, ampicillin, tetracycline and piperacillin are high. Therefore, empirical treatment of eye infections in the study area needs to be monitored by regular antimicrobial-susceptibility testing of isolates.
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Affiliation(s)
- Zimam Ayehubizu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Wondemagegn Mulu
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Fantahun Biadglegne
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Clinical and Microbiological Profile of Bacterial and Fungal Suspected Corneal Ulcer at University of Gondar Tertiary Eye Care and Training Centre, Northwest Ethiopia. J Ophthalmol 2021. [DOI: 10.1155/2021/3940151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background. A corneal ulcer is a major cause of monocular blindness in developing countries, including Ethiopia. Its etiology varies based on its geographical location and climatic conditions. Therefore, the main objective of this research was to assess the clinical and microbiological profile of suspected bacterial and fungal corneal ulcers at the Tertiary Eye Care and Training Centre at Gondar University. Methods. A cross-sectional hospital-based study of corneal ulcer cases was performed from February to October 2019. Sociodemographic and clinical data were collected using a standardized questionnaire. Corneal scrapings were used to classify bacterial and fungal pathogens. The specimens were inoculated on BHI media and sub-cultured on culture media for the separate cultivation of bacteria and fungi. Biochemical tests have been carried out to classify bacteria. Following CLSI, the antimicrobial resistance pattern of bacterial isolates was carried out. Wet mounting, Lactophenol cotton blue staining, and colony characteristics on SDA were used to classify fungal species. The data were analyzed with version 20 of the SPSS. Results. A total of 30 suspected bacterial and fungal keratitis patients have been enrolled in this study. The visual acuity presented in 90% of the affected eyes was in the category of blindness (<3/60). In 71% of the cases, clinically presumed risk factors were identified. Trauma was the most common risk factor found in 46% of cases, followed by keratitis exposure (13%). Of the corneal scrape tests, 76.6% were positive for bacteria and fungi. Fungi were identified in 53.3% of corneal ulcers followed by 33.3% of bacterial growth. The commonest fungi and bacteria isolated were Aspergillus species (69%) and S. aureus, respectively. The prevalence of Methicillin-resistant S. aureus (MRSA) was 2 (40%). The identified Pseudomonas species were susceptible to Gentamicin and Ciprofloxacin but resistant to Ceftriaxone. Conclusion. The primary microbial agents for corneal ulcers were fungi, and trauma was the most significant risk factor associated with corneal ulcers. To avoid chronic ocular morbidity and blindness, early identification of the etiologic agent and the provision of adequate management are recommended.
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12
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Abstract
Background To investigate the microbiologic spectrum of dacryocystitis in adult and pediatric groups, specifically the microbiologic differences between chronic dacryocystitis with nasolacrimal duct obstruction (NLDO) and acute dacryocystitis in pediatric group. Methods This retrospective study was reviewed for demographic and microbiologic profile of dacryocystitis. The culture results were reported. Results Sixty-four adults and one hundred and five pediatrics with dacryocystitis were included in this study. Of all adults, only chronic dacryocystitis with NLDO was observed. Of all pediatric patients, 89 had chronic dacryocystitis with NLDO and 16 had acute dacryocystitis. Gram positive and negative isolates were numerically equal in adult group (both 36(48.65%)), while gram positive isolates were the major organism in pediatric group (71(58.68%)). Streptococcus pneumonia was the most common isolate in both adult (11(14.86%)) and pediatric (30(24.79%)) dacryocystitis. For both pediatric subgroups, gram positive isolates were the major organism (59(57.84%) for chronic dacryocystitis with NLDO and 12 (63.16%) for acute dacryocystitis). However, the leading isolates in those two subgroups were distinct, with Streptococcus pneumonia (29(28.43%)) being most common in chronic dacryocystitis with NLDO and Staphylococcus aureus (8(42.11%)) being most common in acute dacryocystitis. Conclusions In adult group, gram negative isolates were more common in dacryocystitis than before. In pediatric group, gram positive isolates were still the major infection pathogen. Moreover, the more virulent organisms were more common in acute dacryocystitis than chronic dacryocystitis with NLDO.
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Liu C, Wang B, Gao X, Liang X, Wan P, Shao Y, Liu J, Lin L, Wang Z. Bacterial agents and changes in drug susceptibilities in cases of chronic dacryocystitis, Southern China. Int Ophthalmol 2020; 41:1-10. [PMID: 32813193 DOI: 10.1007/s10792-020-01545-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 08/09/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE This study aimed to determine the susceptibility and the changes of bacterial agents of chronic dacryocystitis and determine the risk factors for bacterial prevalence and drug sensitivity to provide a reference for clinical selection of antibiotics. METHODS A case-control study was conducted using 112 patients with chronic dacryocystitis and 112 patients with non-infectious ophthalmopathy between August 2017 and April 2018. Lacrimal and conjunctival sac secretions were cultured for aerobic and anaerobic bacteria. Forty-five patients with chronic dacryocystitis between November 2014 and November 2015 were also included. RESULTS Positive bacterial cultures were obtained from 61.9% and 50.9% of chronic dacryocystitis and non-infectious ophthalmopathy patients, but the detection rates for pathogenic bacteria were 18.3% and 2.7%, respectively (P > 0.001). Gram-negative and anaerobic bacteria were significantly more prevalent in the patient group compared with the control group (P = 0.001 and 0.005, respectively). Bacteria were detected at a significantly higher rate in patients with irritant symptoms (itch or foreign-body sensation) than in those without (OR = 9.333, P = 0.002), particularly Staphylococcus (OR = 9.783, P = 0.002). 11.6% (10/86) and 55.8% (48/86) showed resistance to levofloxacin and tobramycin, respectively. Compared with three years ago, the detection rate for Gram-positive cocci decreased from 51.1% to 27.8% (χ2 = 8.054, P = 0.005) CONCLUSIONS: Gram-positive cocci, Gram-negative bacilli, and anaerobic bacteria were the predominant pathogens. The prevalence of Gram-positive bacteria in cases of chronic dacryocystitis is decreasing.
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Affiliation(s)
- Chengxiu Liu
- Department of Ophthalmology, Affiliated Hospital of Qingdao University Medical College, Qingdao, China
| | - Bowen Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, Guangdong, China
| | - Xinbo Gao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, Guangdong, China
| | - Xuanwei Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, Guangdong, China
| | - Pengxia Wan
- The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yingfeng Shao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, Guangdong, China
| | - Jiahui Liu
- Department of Ophthalmology, Dongguan People's Hospital, Dongguan, Guangdong, China
| | - Liping Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, Guangdong, China
| | - Zhichong Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510060, Guangdong, China.
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14
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Schulte AJ, Agan BK, Wang HC, McGann PT, Davies BW, Legault GL, Justin GA. Multidrug-Resistant Organisms from Ophthalmic Cultures: Antibiotic Resistance and Visual Acuity. Mil Med 2020; 185:e1002-e1007. [PMID: 32588895 DOI: 10.1093/milmed/usaa111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION There is a growing trend of multidrug-resistant organisms (MDRO). The goal of this study was to characterize MDRO at a single center from ophthalmic cultures to better understand how treatments were tailored and to assess effect on visual acuity. MATERIALS AND METHODS The MDRO data were collected by the Multidrug-Resistant Organism Repository and Surveillance Network from the Brooke Army Medical Center clinical laboratory. Both patient- and isolate-specific data were collected and qualitatively analyzed. Primary outcome measures were organism and type of resistance, anatomic location of isolate, initial and final antibiotic choice, and visual acuity. RESULTS Thirty-one bacterial culture samples were analyzed from 29 patients. Twenty-two (72%) were Gram-positive and all were methicillin-resistant Staphylococcus aureus (MRSA). Nine (29%) were Gram-negative and of these five were Pseudomonas spp. Fourteen (45%) isolates were cultured from the cornea, nine (29%) from the lid, four (13%) from the conjunctiva, and four (13%) from other locations. The majority (66.6%) required adjustment of initial antibiotics following ocular culture results. Sixteen adult patients had recorded initial and final visual acuities. Fifteen of those 16 patients had stable or improved visual acuities following treatment of the infection, but five patients had a final visual acuity less than 20/200. CONCLUSION This study demonstrated a high frequency of corneal MDRO infections and specifically MRSA and Pseudomonas spp. isolates. Antibiotic treatments frequently required adjustment. Further prospective study of visual outcomes from ophthalmic MDRO cultures is needed.
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Affiliation(s)
- Alexandra J Schulte
- Department of Ophthalmology, Brooke Army Medical Center, 3551 Roger Brooke Drive, San Antonio, TX 78234
| | - Brian K Agan
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.,Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Dr, Bethesda, MD 20817
| | - Heuy-Ching Wang
- Naval Medical Research Unit, Combat Casualty Care and Operational Medicine, 2330 Stanley Rd, San Antonio, TX 78234
| | - Patrick T McGann
- Department of Molecular Research, 503 Robert Grant Ave, 20910, Multidrug Resistant Organism Repository and Surveillance Network, Silver Spring, MD
| | - Brett W Davies
- Department of Surgery, Uniformed Services University of the Health Science, 4301 Jones Bridge Road, 20814 Bethesda, MD.,Department of Ophthalmology, Wilford Hall Eye Center, 1100 Wilford Hall Loop, 78236 San Antonio, TX
| | - Gary L Legault
- Department of Ophthalmology, Brooke Army Medical Center, 3551 Roger Brooke Drive, San Antonio, TX 78234.,Department of Surgery, Uniformed Services University of the Health Science, 4301 Jones Bridge Road, 20814 Bethesda, MD
| | - Grant A Justin
- Department of Ophthalmology, Brooke Army Medical Center, 3551 Roger Brooke Drive, San Antonio, TX 78234.,Department of Surgery, Uniformed Services University of the Health Science, 4301 Jones Bridge Road, 20814 Bethesda, MD
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15
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Mohammed AA, Ali MM, Zenebe MH. Bacterial etiology of ocular and periocular infections, antimicrobial susceptibility profile and associated factors among patients attending eye unit of Shashemene comprehensive specialized hospital, Shashemene, Ethiopia. BMC Ophthalmol 2020; 20:124. [PMID: 32228528 PMCID: PMC7106738 DOI: 10.1186/s12886-020-01398-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 03/20/2020] [Indexed: 11/10/2022] Open
Abstract
Background Eye infection is a public health problem in developing countries including Ethiopia. Bacteria are major causative agents of eye infections that can lead to loss of vision. The objective of this study was to determine bacterial etiology of ocular and periocular infections, antimicrobial susceptibility profile and associated factors among patients who visited the eye unit of Shashamane Comprehensive Specialized Hospital (SCSH). Method A hospital-based cross-sectional study was conducted at SCSH from September 1, 2018, to March 30, 2019. Specimens from the ocular and periocular areas were collected from a total of 332 patients who visited the eye unit. Specimens were inoculated on blood agar, chocolate agar, MacConkey agar, and mannitol salt agar. Isolated bacteria were identified by a series of biochemical tests using the standard bacteriological method. Antimicrobial susceptibility test was performed according to the Clinical and Laboratory Standard Institute by disk diffusion method. Factors that could be associated with ocular and periocular infection were collected by using structured questionnaire. Data analysis was done using SPSS version 22.0 software package. A P value less than 0.05 was considered statistically significant. Result Out of the total 332 study participants with ocular and periocular infections, 198(60%) were culture positive. The proportion of Gram-positive and Gram-negative bacteria were 135(68.2%) and 63(31.8%) respectively. Among Gram-positive bacteria, Staphylococcus aureus were predominant. Among Gram-negative bacteria, Escherichia coli were predominant. Most S. aureus were resistant to penicillin. Conclusion Majority of ocular and periocular infections in this study were caused by bacteria; Gram-positive bacteria were responsible for most cases.
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Affiliation(s)
| | - Musa Mohammed Ali
- Hawassa University College of Medicine and Health Sciences department of Medical laboratory, Awassa, Ethiopia
| | - Mengistu Hailemariam Zenebe
- Hawassa University College of Medicine and Health Sciences department of Medical laboratory, Awassa, Ethiopia
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16
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In Vitro Biofilm Formation and Antibiotic Susceptibility Patterns of Bacteria from Suspected External Eye Infected Patients Attending Ophthalmology Clinic, Southwest Ethiopia. Int J Microbiol 2020; 2020:8472395. [PMID: 32318110 PMCID: PMC7155758 DOI: 10.1155/2020/8472395] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/10/2020] [Accepted: 02/13/2020] [Indexed: 12/17/2022] Open
Abstract
Background Ocular disease with its complications is a major public health problem which has significant impacts on the quality of life particularly in developing countries. An eye infection due to bacterial agents can lead to reduced vision and blindness. This study was aimed to assess the antimicrobial susceptibility pattern and biofilm-forming potential of bacteria isolated from suspected external eye infected patients in Jimma. Method A cross-sectional facility-based study was conducted on 319 suspect patients with external eye infections from March to June 2017 at Jimma University Medical Center (JUMC) Ophthalmology Department in Ethiopia. External ocular specimens were collected and standard operating procedures were followed to handle and culture throughout the study period. Antimicrobial susceptibility was determined by the disk diffusion method according to CLSI guidelines. Microtiter (96 wells) plate method was used to screen biofilm formation by ELISA reader at 570 nm. Results Out of 319 study participants with an external eye infection, the prevalence of bacterial pathogens was 46.1%. The predominant bacterial isolates were coagulase-negative staphylococcus (CoNS) (27.7%) followed by Staphylococcus aureus (19.7%). Among Gram-negative groups, Pseudomonas aeruginosa (6.8%) was the leading isolate. Increased antimicrobial resistance was observed for tetracycline (64%), erythromycin (66.7%), and penicillin (77.1%). Amoxicillin-clavulanic acid, ciprofloxacin, and gentamicin were the most effective drugs for external eye infections due to susceptibility ranging from 70 to 100% among both Gram-negative and Gram-positive groups. Methicillin-resistant S. aureus (MRSA) accounted for 13.8%. Multidrug resistance (MDR) accounted for 68.7%. The overall biofilm formation rate of bacterial ocular pathogens was 66.1%, where P. aeruginosa (40%), CoNS (34.1%), and S. aureus (31%) formed strong biofilm phenotype. Conclusion The prevalence rate of bacterial isolates was high. Almost all bacterial isolates were resistant to at least one or more drugs. MDR pathogens were observed increasingly among biofilm formers or vice versa.
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Badger-Emeka L, Emeka P, Aldossari S, Khalil H. Terfezia claveryi and Terfezia boudieri extracts: An antimicrobial and molecular assay on clinical isolates associated with eye infections. Pharmacogn Mag 2020. [DOI: 10.4103/pm.pm_199_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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18
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de Paula A, Oliva G, Barraquer RI, de la Paz MF. Prevalence and antibiotic susceptibility of bacteria isolated in patients affected with blepharitis in a tertiary eye centre in Spain. Eur J Ophthalmol 2019; 30:991-997. [PMID: 31232091 DOI: 10.1177/1120672119854985] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To describe which bacteria can be found on lid margins in patients affected with blepharitis, to show their antibiotic susceptibility pattern, and to evaluate the antibiotic resistance trend of coagulase-negative Staphylococcus through time. MATERIALS AND METHODS Consecutive cases of 198 eyes affected with blepharitis between 2012 and 2018 were reviewed. A sample was collected by rubbing a swab against the base of the eyelashes of both the eyes of all patients. The samples were inoculated in blood agar and chocolate agar. The susceptibility of the identified bacteria to common antibiotics was tested. In addition, the antibiotic susceptibility pattern of coagulase-negative Staphylococcus detected from year 2016 to 2018 was compared with that of 4 years before. RESULTS The most common isolated bacterium was coagulase-negative Staphylococcus (89%) and Staphylococcus aureus (28%). Coagulase-negative Staphylococcus showed highest susceptibility to vancomycin (100%), neomycin (94%) and chloramphenicol (91%). Coagulase-negative Staphylococcus and Staphylococcus aureus were the most resistant to penicillin and erythromycin (resistance in 92%, 91% for coagulase-negative Staphylococcus, 86% and 43% of eyes for Staphylococcus aureus). Corynebacterium was resistant to oxacillin and erythromycin. Streptococcus viridans showed resistance to gentamycin and tobramycin. Moraxella was susceptible to most antibiotics. Bacillus was resistant to oxacillin. The antibiotic resistance trend of coagulase-negative Staphylococcus showed that the resistance to rifampicin increased through the years 2012-2018. CONCLUSION Coagulase-negative Staphylococcus and Staphylococcus aureus were the most isolated bacteria in patients affected by blepharitis in our tertiary eye centre. Both bacteria were resistant to erythromycin. Through the years, it seems that coagulase-negative Staphylococcus gained resistance to penicillin, erythromycin, ciprofloxacin and rifampicin.
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Affiliation(s)
- Alessandro de Paula
- Ophthalmology Unit, NESMOS Department St. Andrea Hospital, Faculty of Medicine and Psychology, University of Rome 'Sapienza', Rome, Italy
| | - Gloria Oliva
- Centro de Oftalmología Barraquer, Barcelona, Spain.,Instituto Universitario Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rafael Ignacio Barraquer
- Centro de Oftalmología Barraquer, Barcelona, Spain.,Instituto Universitario Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain.,Universitat Internacional de Catalunya, Barcelona, Spain
| | - Maria Fideliz de la Paz
- Centro de Oftalmología Barraquer, Barcelona, Spain.,Instituto Universitario Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain
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Resistance profile of clinically relevant bacterial isolates against fluoroquinolone in Ethiopia: a systematic review and meta-analysis. BMC Pharmacol Toxicol 2018; 19:86. [PMID: 30541613 PMCID: PMC6292079 DOI: 10.1186/s40360-018-0274-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/22/2018] [Indexed: 11/13/2022] Open
Abstract
Background Fluoroquinolones are among the most frequently utilized antibacterial agents in developing countries like Ethiopia. Ciprofloxacin has become the most prescribed drug within this class and remains as one of the top three antibacterial agents prescribed in Ethiopia. However, several studies indicated that there is a gradual increase of antibacterial resistance. Therefore, this meta-analysis aimed to quantitatively estimate the prevalence of ciprofloxacin resistance bacterial isolates in Ethiopia. Methods Literature search was conducted from electronic databases and indexing services including EMBASE (Ovid interface), PubMed/MEDLINE, Google Scholar, Science Direct and WorldCat. Data were extracted with structured format prepared in Microsoft Excel and exported to STATA 15.0 software for the analyses. Pooled estimation of outcomes was performed with DerSimonian-Laird random-effects model at 95% confidence level. Degree of heterogeneity of studies was presented with I2 statistics. Publication bias was conducted with comprehensive meta-analysis version 3 software and presented with funnel plots of standard error supplemented by Begg’s and Egger’s tests. The study protocol has been registered on PROSPERO with reference number ID: CRD42018097047. Results A total of 37 studies were included for this study. The pooled prevalence of resistance in selected gram-positive bacterial isolates against ciprofloxacin was found to be 19.0% (95% confidence interval [CI]: 15.0, 23.0). The degree of resistance among Staphylococcus aureus, Coagulase negative Staphyloccoci (CoNS), Enterococcus faecalis and Group B Streptococci (GBS) was found to be 18.6, 21.6, 23.9, and 7.40%, respectively. The pooled prevalence of resistance in gram-negative bacteria was about 21.0% (95% CI: 17, 25). Higher estimates were observed in Neisseria gonorrhea (48.1%), Escherichia coli (24.3%) and Klebsiella pneumonia (23.2%). Subgroup analysis indicated that blood and urine were found to be a major source of resistant S. aureus isolates. Urine was also a major source of resistant strains for CoNS, Klebsiella and Proteus species. Conclusion Among gram-positive bacteria, high prevalence of resistance was observed in E. faecalis and CoNS whereas relatively low estimate of resistance was observed among GBS isolates. Within gram-negative bacteria, nearly half of isolates in N. gonorrhoea were found ciprofloxacin resistant. From enterobacteriaceae isolates, K. pneumonia and E. coli showed higher estimates of ciprofloxacin resistance. Electronic supplementary material The online version of this article (10.1186/s40360-018-0274-6) contains supplementary material, which is available to authorized users.
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Belyhun Y, Moges F, Endris M, Asmare B, Amare B, Bekele D, Tesfaye S, Alemayehu M, Biadgelegne F, Mulu A, Assefa Y. Ocular bacterial infections and antibiotic resistance patterns in patients attending Gondar Teaching Hospital, Northwest Ethiopia. BMC Res Notes 2018; 11:597. [PMID: 30119696 PMCID: PMC6098601 DOI: 10.1186/s13104-018-3705-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 08/10/2018] [Indexed: 11/13/2022] Open
Abstract
Objectives Empirical selections of antimicrobial therapy based on clinical observations are common clinical practices in Ethiopia. This study identified common external ocular infections and determined antibiotic susceptibility testing in northwest Ethiopia. Results Among 210 patients studied, conjunctivitis 32.9%(69), blepharitis 26.7%(56), dacryocystitis 14.8%(51), blepharoconjunctivitis 11.9%(25), and trauma 10.0%(21) were the most common external ocular infections. Pathogenic bacteria were isolated among 62.4%(131) cases. The distributions of bacteria detected in conjunctivitis, dacryocystitis, and blepharitis patients were 32.8%(43), 23.7%(31), and 16.0%(21), respectively. The most prevalent isolates were coagulase negative Staphylococci; 27.5%(36), S. aureus; 26.7%(35), Pseudomonas species; 10.7%(14), and E. coli; 7.6%(10). Tetracycline, amoxicillin, chloramphenicol, ampicillin, and nalidic acid showed resistance to bacterial isolates with a respective prevalence of 35.9%(47), 32.1%(42), 26.2%(34), 25.2%(33), and 23.7%(31). Multi-drug resistance patterns to the commonly prescribed antibiotics tested was 20.6%(27), 18.3%(24), 17.6%(23), 5.3%(7), and 4.6%(6) to two, three, four, five, and six antibiotics, respectively. Overall, the multi-drug resistance prevalence rate was 66.4%(87). This study confirmed diverse types of external ocular manifestations associated with bacterial infections with wide ranges of antibiotic resistant phenotypes. Thus, combining clinical information, bacteriological analysis, and antimicrobial susceptibility tests are useful for making an evidence-based selection of antibiotics therapy. Electronic supplementary material The online version of this article (10.1186/s13104-018-3705-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yeshambel Belyhun
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Feleke Moges
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mengistu Endris
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Banchamlak Asmare
- Arada Sub-city Health Office CDC Project, Addis Ababa City Health Bureau, Addis Ababa, Ethiopia
| | - Bemnet Amare
- Department of Biochemistry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Damtew Bekele
- Natural and Computational Sciences, Department of Biology, Debre Markos University, Debre Markos, Ethiopia
| | - Solomon Tesfaye
- Natural and Computational Sciences, Department of Biology, University of Gondar, Gondar, Ethiopia
| | - Martha Alemayehu
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantahun Biadgelegne
- Faculty of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Andargachew Mulu
- School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yared Assefa
- Department of Ophthalmology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Deyno S, Fekadu S, Seyfe S. Prevalence and antimicrobial resistance of coagulase negative staphylococci clinical isolates from Ethiopia: a meta-analysis. BMC Microbiol 2018; 18:43. [PMID: 29801462 PMCID: PMC5970528 DOI: 10.1186/s12866-018-1188-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 05/16/2018] [Indexed: 11/10/2022] Open
Abstract
Background Antimicrobial resistant Coagulase-negative Staphylococci (CoNS) have limited treatment options, rendered diseases untreatable and made hospitals to be reservoirs of the resistant strains. The aim of this study was to estimate the pooled prevalence and antimicrobial resistance of clinical isolates of CoNS from Ethiopia. Results The electronic database search yielded 6511 articles of which 21 met predefined inclusion criteria. The pooled prevalence of CoNS from Ethiopia was 12% (95% confidence interval (CI): 8, 16%). The analyses revealed high level of CoNS resistance to methicilin (37%[95% CI: 21, 55%]), vancomycin (911%[95% CI: 0, 35%]), penicillin (58%[95% CI: 42, 74%]), amoxicillin (42%[95% CI: 23, 61%]), amoxicillin-clavulanate (27%[95% CI: 2, 27%]), ampicillin (64%[95% CI: 46, 80%]), tetracycline (60% [95% CI: 49, 70%]), doxycycline (36%[95% CI:19,55%]), Sulfamethoxazole-trimethoprim (50%[95% CI: 36, 64%]), ceftriaxone (27% [95% CI: 18, 38%]), cephalothin (32% [95% CI: 7, 62%]), norfloxacin (39%[95% CI: 24, 56%]), chloramphenicol (40%[95% CI: 23, 58%]), clindamycin (11% [95% CI: 2, 27%]), ciprofloxacin (14%[95% CI: 6, 22%]), gentamicin (27%[95% CI:19,36%]) and erythromycin (30%[95% CI:20%,42%]). High heterogeneity, I2 ranging from 69.04 to 96.88%; p-values ≤0.01, was observed. Eggers’ test did not detect publication bias for the meta-analyses and low risk of bias was observed in included studies. Conclusions CoNS has gotten resistant to commonly used antimicrobials from Ethiopia. There is a need of launching national antimicrobial treatment, development and implementation of policy guidelines to contain the threat. Further research focusing on factors promoting resistance and the effect of resistance on treatment outcome studies are warranted. Electronic supplementary material The online version of this article (10.1186/s12866-018-1188-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Serawit Deyno
- PHARMBIOTRAC, Mbarara University of Science and Technology, Mbarara, Uganda. .,Department of Pharmacology, School of Medicine, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia.
| | - Sintayehu Fekadu
- Department of Microbiology, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Sisay Seyfe
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Abstract
PURPOSE Recent studies suggest an increasing incidence of gram-negative bacteria and methicillin-resistant Staphylococcus aureus in dacryocystitis. Since patients are often treated empirically without culture data, a changing microbiologic profile will markedly affect the success of oral treatment. To provide current guidelines for the treatment of this common condition, we investigated the microbiology and antibiogram of dacryocystitis seen at our institution. METHODS The charts of all patients presenting with acute and/or chronic dacryocystitis in University Hospital, Newark, from 2007 to 2015 were reviewed. Patient demographics, culture isolates, and in vitro antimicrobial susceptibility data were collected. Additional sensitivity data were obtained from the Sanford Guide to Antimicrobial Therapy. RESULTS A total of 137 patients were included in the study. Of 205 samples collected, S. aureus was the most commonly isolated organism (46 of 156, 30%) followed by Pseudomonas species (19 of 156, 12%) and Propionibacterium acnes (15 of 156, 10%). Based on sensitivity data, the two oral antibiotics that would have been most effective in this population were levofloxacin and amoxicillin/clavulanate; however, even these antibiotics would have encountered at least one resistant organism in 16% and 32% of patients, and potentially in another 15% and 8% of patients, respectively. CONCLUSIONS Given the broad range of causative organisms, routine treatment of dacryocystitis with any specific antibiotic may fail in up to one-third of patients. Obtaining a culture at the time empiric antibiotic treatment is initiated can prove extremely valuable when treating patients with dacryocystitis.
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Affiliation(s)
- Stella Y Chung
- a Institute of Ophthalmology and Visual Science , Rutgers New Jersey Medical School , Newark , NJ , USA
| | - Leon Rafailov
- a Institute of Ophthalmology and Visual Science , Rutgers New Jersey Medical School , Newark , NJ , USA
| | - Roger E Turbin
- a Institute of Ophthalmology and Visual Science , Rutgers New Jersey Medical School , Newark , NJ , USA
| | - Paul D Langer
- a Institute of Ophthalmology and Visual Science , Rutgers New Jersey Medical School , Newark , NJ , USA
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Deyno S, Fekadu S, Astatkie A. Resistance of Staphylococcus aureus to antimicrobial agents in Ethiopia: a meta-analysis. Antimicrob Resist Infect Control 2017; 6:85. [PMID: 28852476 PMCID: PMC5569497 DOI: 10.1186/s13756-017-0243-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 08/15/2017] [Indexed: 11/12/2022] Open
Abstract
Background Emergence of antimicrobial resistance by Staphylococcus aureus has limited treatment options against its infections. The purpose of this study was to determine the pooled prevalence of resistance to different antimicrobial agents by S. aureus in Ethiopia. Methods Web-based search was conducted in the databases of PubMed, Google Scholar, Hinari, Scopus and the Directory of Open Access Journals (DOAJ) to identify potentially eligible published studies. Required data were extracted and entered into Excel spread sheet. Statistical analyses were performed using Stata version 13.0. The metaprop Stata command was used to pool prevalence values. Twenty-one separate meta-analysis were done to estimate the pooled prevalence of the resistance of S. aureus to twenty-one different antimicrobial agents. Heterogeneity among the studies was assessed using the I2 statistic and chi-square test. Publication bias was assessed using Egger’s test. Because of significant heterogeneity amongst the studies, the random effects model was used to pool prevalence values. Results The electronic database search yielded 1317 studies among which 45 studies met our inclusion criteria. Our analyses demonstrated very high level of resistance to amoxicillin (77% [95% confidence interval (CI): 68%, 0.85%]), penicillin (76% [95% CI: 67%, 84%]), ampicillin (75% [95% CI: 65%, 85%]), tetracycline (62% [95% CI: 55%, 68%]), methicillin (47% [95% CI: 33%, 61%]), cotrimoxaziole (47% [95% CI: 40%, 55%]), doxycycline (43% [95% CI: 26%, 60%]), and erythromycin (41% [95% CI: 29%, 54%]). Relatively low prevalence of resistance was observed with kanamycin (14% [95% CI: 5%, 25%]) and ciprofloxacin (19% [95% CI: 13%, 26%]). The resistance level to vancomycin is 11% 995% CI: (4%, 20%). High heterogeneity was observed for each of the meta-analysis performed (I2 ranging from 79.36% to 95.93%; all p-values ≤0.01). Eggers’ test did not show a significant publication bias for all antimicrobial agents except for erythromycin and ampicillin. Conclusions S. aureus in Ethiopia has gotten notoriously resistant to almost to all of antimicrobial agents in use including, penicillin, cephalosporins, tetracyclines, chloramphenicol, methicillin, vancomycin and sulphonamides. The resistance level to vancomycin is bothersome and requires a due attention. Continued and multidimensional efforts of antimicrobial stewardship program promoting rational use of antibiotics, infection prevention and containment of AMR are urgently needed. Electronic supplementary material The online version of this article (doi:10.1186/s13756-017-0243-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Serawit Deyno
- Department of Pharmacology, School of Medicine, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia
| | - Sintayehu Fekadu
- Department of Microbiology, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Ayalew Astatkie
- School of Public and Environmental Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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24
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Getahun E, Gelaw B, Assefa A, Assefa Y, Amsalu A. Bacterial pathogens associated with external ocular infections alongside eminent proportion of multidrug resistant isolates at the University of Gondar Hospital, northwest Ethiopia. BMC Ophthalmol 2017; 17:151. [PMID: 28830451 PMCID: PMC5567627 DOI: 10.1186/s12886-017-0548-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 08/14/2017] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND External ocular infection is a public health problem in Ethiopia. The aim of this study was to determine the prevalence and antimicrobial susceptibility pattern of external ocular bacterial infections. METHODS A cross sectional study was conducted at the University of Gondar Hospital among patients seeking health services at the Department of Ophthalmology from January to April, 2016. All patients with suspected external ocular infections were examined under slit lamp microscope. External ocular samples were collected using aseptic techniques. All samples were investigated by culture and bacteria were identified using standard methods. Drug susceptibility test was done using the Kirby-Bauer Disk diffusion method according to the guidelines of Clinical and Laboratory Standard Institute (CLSI). RESULT A total of 312 samples were collected and 58.3% were culture positive. The proportion of Gram positive bacterial pathogens was (88%), and Staphylococcus aureus (50.3%) was the predominantly isolated pathogen, followed by Coagulase negative staphylococci (CoNS) (33.5%) and Klebsiella species (4.7%). Conjunctivitis was the dominant clinical feature, but a high positive result for bacterial pathogens was observed among patients with dacryocystitis cases. The Gram positive bacterial isolates were susceptible to ciprofloxacin, chloramphinicol, amoxicillin-clavulanate and ceftriaxone. However, 65% of these Gram positive bacterial pathogens showed resistance to penicillin, ampicillin and amoxicillin. The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infection was 24% and multidrug resistance (MDR) was observed in 87% of the isolated bacteria. CONCLUSION Conjunctivitis was the dominant ophthalmic disease followed by blepharitis. The dominant bacteria species was S. aureus and MRSA infection is increasingly prevalent. The overall MDR bacterial pathogen proportion was very high. The high prevalence of MRSA and MDR bacterial pathogens dictate the need for effective prevention as important as for therapies.
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Affiliation(s)
- Ergibnesh Getahun
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences (CMHS), University of Gondar (UOG), P.O. box 196, Gondar, Ethiopia
| | - Baye Gelaw
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences (CMHS), University of Gondar (UOG), P.O. box 196, Gondar, Ethiopia.
| | - Abate Assefa
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences (CMHS), University of Gondar (UOG), P.O. box 196, Gondar, Ethiopia
| | - Yared Assefa
- Department of Ophthalmology, School of Medicine, CMHS, UOG, P.O. box 196, Gondar, Ethiopia
| | - Anteneh Amsalu
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences (CMHS), University of Gondar (UOG), P.O. box 196, Gondar, Ethiopia
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25
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Ten Hove RJ, Tesfaye M, Ten Hove WF, Nigussie M. Profiling of antibiotic resistance of bacterial species recovered from routine clinical isolates in Ethiopia. Ann Clin Microbiol Antimicrob 2017. [PMID: 28651533 PMCID: PMC5485741 DOI: 10.1186/s12941-017-0221-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With the alarming rise in antibiotic resistance in African countries, the need for a surveillance system in the region has become pressing. The rapid expansion of data networks makes it possible to set up healthcare applications that can be both cost-efficient and effective. Large data sets are available for assessment of current antibiotic resistance among Ethiopian patients. Based on the data-presentation, a practical approach is proposed on how diagnostic laboratories can participate remedial action against antibiotic resistance in Ethiopia. METHODS In Addis Ababa (Ethiopia), raw data comprising bacterial species name, specimen type and antibiograms covering the period January 2014 to May 2015 was accessed from the laboratory information management system. Using R code, the data was read and fitted into data-frames and analyzed to assess antibiotic resistance in the Ethiopian patient population. RESULTS Susceptibility to an antibiotic was tested with 14.983 cultures of 54 different bacterial species or subgroups, isolated from 16 types of specimen. Half of the cultures (n = 6444) showed resistance to an antibiotic. Resistance against penicillin was highest with, on average, 91.1% of 79 bacterial cultures showing resistance. Very high resistance rates were also observed for ampicillin, whereas resistance was lowest with cefoxitin. CONCLUSIONS Extraction and analysis of raw-data from the laboratory database is relatively simple and can provide valuable insight into the relationships between type of sample and drug-resistance in countries where such data is still scarce. With the largest number of antibiotic resistance tests described for Ethiopia, a tool is proposed for consistent data collection with specified core variables. Trends in antibiotic resistance can be revealed and treatment failures avoided when used as an easy accessible reference application for healthcare providers.
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Affiliation(s)
| | - Melaku Tesfaye
- International Clinical Laboratories, Addis Ababa, Ethiopia
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26
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Deyno S, Toma A, Worku M, Bekele M. Antimicrobial resistance profile of staphylococcus aureus isolates isolated from ear discharges of patients at University of Hawassa comprehensive specialized hospital. BMC Pharmacol Toxicol 2017; 18:35. [PMID: 28506250 PMCID: PMC5433016 DOI: 10.1186/s40360-017-0141-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 05/04/2017] [Indexed: 12/23/2022] Open
Abstract
Background Drug-resistant microorganism are a growing global danger. Strains of S. aureus have developed resistance to many commonly used antimicrobials due to indiscriminate use of antimicrobials, and treatment becoming a challenge. Studies assessing pattern and determinants of S. aureus resistance in ear infection in Ethiopia are very scarce. This study presents overview of pattern and determinants S. aureus resistance from samples of ear discharge in Ethiopia. Method A prospective cross-sectional study was conducted on patients who visit ENT clinic of University of Hawassa comprehensive specialized hospital from February 1, 2016 to November 1, 2016. 117 specimens were collected with sterile applicator cotton swab from 117 patients with ear discharge visiting the clinic. Data was fed and then edited, cleared, entered and analyzed using SPSS version 20. Result The prevalence of S.aureus infection was 28.2%. S. aureus isolates revealed up to 97.0% level of resistance pattern to the antimicrobials tested. In the determination of the susceptibility of S. aureus on nine selected antibiotics by disk diffusion technique, 97.0% of the isolates were resistant to cloxacilin and 74.2% showed resistance to vancomycin. The overall rate of MDR was 100%, all of the isolates were found to be resistant to more than two tested antimicrobials. Conclusion S. aureus has gotten frighteningly resistant to many of common antimicrobials. Resistance rate to vancomyin is terrifyingly high. It urges us to take measures to delay resistance. Emergence of resistance highlights the value of prudent prescribing of antimicrobials and avoiding their irrational use. Further researches focusing on identifying dynamics promoting resistance, identifying high risk strains and molecular basis of resistance are required.
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Affiliation(s)
- Serawit Deyno
- Department of Pharmacology, School of Medicine, College of Medicine and Health Sciences, University of Hawassa, P. O. Box 1560, Hawassa, Ethiopia.
| | - Alemayehu Toma
- Department of Pharmacology, School of Medicine, College of Medicine and Health Sciences, University of Hawassa, P. O. Box 1560, Hawassa, Ethiopia
| | - Mesfin Worku
- Department of medical laboratory technology, College of Medicine and Health Sciences, University of Hawassa, Hawassa, Ethiopia
| | - Muluken Bekele
- Department of ear, nose and throat, School of Medicine, College of Medicine and Health Sciences, University of Hawassa, Hawassa, Ethiopia
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27
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Teweldemedhin M, Saravanan M, Gebreyesus A, Gebreegziabiher D. Ocular bacterial infections at Quiha Ophthalmic Hospital, Northern Ethiopia: an evaluation according to the risk factors and the antimicrobial susceptibility of bacterial isolates. BMC Infect Dis 2017; 17:207. [PMID: 28292273 PMCID: PMC5351251 DOI: 10.1186/s12879-017-2304-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 03/04/2017] [Indexed: 12/11/2022] Open
Abstract
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.
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Affiliation(s)
- Mebrahtu Teweldemedhin
- Department of Medical Microbiology and Immunology, Institute of Biomedical Sciences, College of Health Sciences, Mekelle University, 1871, Mekelle, Ethiopia
- Unit of Biomedical Science, School of Medicine, College of Health Sciences, Aksum University, Aksum, Tigray Ethiopia
| | - Muthupandian Saravanan
- Department of Medical Microbiology and Immunology, Institute of Biomedical Sciences, College of Health Sciences, Mekelle University, 1871, Mekelle, Ethiopia
| | - Araya Gebreyesus
- Department of Medical Microbiology and Immunology, Institute of Biomedical Sciences, College of Health Sciences, Mekelle University, 1871, Mekelle, Ethiopia
| | - Dawit Gebreegziabiher
- Department of Medical Microbiology and Immunology, Institute of Biomedical Sciences, College of Health Sciences, Mekelle University, 1871, Mekelle, Ethiopia
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