Prevalence and antimicrobial susceptibility pattern of Salmonella and Shigella species among asymptomatic food handlers working in Haramaya University cafeterias, Eastern Ethiopia

Prevalence, antimicrobial susceptibility pattern and associated factors of Salmonella and Shigella among under five children with diarrhea attending Bule Hora University Teaching Hospital, Bule Hora, West Guji, Ethiopia

BACKGROUND

Salmonella and Shigella are a critical concern of the developing world and responsible for the high rate of diarrhea-related deaths. The treatment of these infections remains a challenge, due to the global rise in broad-spectrum resistance to many antibiotics. The aim of this study to determine the prevalence, antimicrobial susceptibility patterns, and associated factors of Salmonella and Shigella among under five children with diarrhea attending Bule Hora University Teaching Hospital, Bule Hora, West Guji, Ethiopia.

METHODS

A hospital-based cross-sectional study was conducted from July 01 to October 30, 2023. Three hundred sixty-five under five children with diarrhea were enrolled consecutively using convenient sampling technique. Data about patient socio-demographics, signs, and symptoms was obtained from the parents/guardians of each child using a questionnaire. Stool specimens from diarrheic children were collected and processed for isolation of Salmonella and Shigella using standard bacteriological methods. Antibiotic susceptibility patterns were determined by using the Kirby Bauer disc diffusion method. Data analysis was performed by using SPSS version 25. A p-value < 0.05 at 95% CI was considered statistically significant.

RESULTS

The prevalence of salmonella and Shigella isolates were 6.3% (23/365) and 4.9% (18/365) respectively. The isolates were 95.1% susceptible to ciprofloxacin and 73.2% to ceftriaxone. The isolates were 39.02% multidrug resistance to classes of drug choice for susceptibility tests. Presence of vomiting (AOR = 2.36), contact with diarrhoeal patient (AOR = 3.38), untrimmed fingernail (AOR = 5.20), storing cooked food in open containers (AOR = 6.5), unimproved source of drinking water from well and river (AOR = 3.86 & 3.2) showed statistically significant association with Salmonella and Shigella infections.

CONCLUSION

The prevalence of Salmonella and Shigella isolates were relatively high in the study area. The isolates were found to be sensitive to Ceftriaxone, ciprofloxacin, and cotrimoxazole; and could be possible antimicrobial choices of infection. Contact with diarrhoeal patients, untrimmed fingernails, storing cooked food in open containers and unimproved sources of drinking water were the main sources of infection. Therefore, to alleviate this infection, culture based bacterial species identification and promoting antibiotics sensitivity-based treatment are strongly recommended to avoid empirical treatment in the study area.

Prevalence of Salmonella spp., Shigella spp., and intestinal parasites among food handlers working in University of Gondar student's cafeteria, Northwest Ethiopia

Background

Food-borne infections continue to be a major public health problem at the international level. The issue becomes more serious in developing countries like Ethiopia.

Objective

This study aimed to examine the prevalence of Salmonella and Shigella species and intestinal parasites, as well as antimicrobial resistance patterns and associated factors among food handlers at the University of Gondar cafeteria in northwest Ethiopia.

Methods

An institutional-based cross-sectional study was conducted from February to June 2021 in the University of Gondar cafeterias. Data related to the socio-demographic characteristics and hygienic practices of study participants were collected using structured questionnaires. A total of 290 stool samples were collected from food handlers. Culture and conventional biochemical tests were used to isolate the Salmonella and the Shigella species. Wet mount, Formol-ether concentration, and Kato Katz techniques were applied to identify intestinal parasites. Additionally, drug susceptibility tests were performed using the disk diffusion method. Statistical analysis was done using SPSS version 26.

Results

Of 290 food handlers' stool samples analyzed, Twenty-seven 27 (9.3%) were positive for both Salmonella and Shigella species. The prevalence of Salmonella and Shigella species was 16 (5.5%) and 11 (3.8%), respectively. Most of the isolated pathogens were resistant to tetracycline 19 (70.4%), and trimethoprim/sulphamethoxazole 19 (70.4%). The overall rate of multi-drug resistant Shigella and Salmonella isolate was 59.3%. Besides, Fifty-seven 57 (19.7%) of the participants were positive for one or more intestinal parasites. The most prevalent intestinal Parasitosis was E. histolytica/dispar 22 (7.6%), followed by G. lamblia 13 (4.5%), and Ascaris lumbricoides 11 (3.8) not washing hands after using the toilet (AOR: 4.42, 95% CI: 1.57, 10.56), and consuming unpasteurized milk (AOR: 3.14, 95% CI: 1.65, 3.96), were factors significantly associated with the prevalence of Salmonella, and Shigella infection. Similarly, not washing hands after using the toilet (AOR: 2.19, 95% CI: 1.0, 1.4), and consuming unpasteurized milk (AOR: 10.4, 95% CI: 3.8, 28.8), were factors significantly associated with the prevalence of intestinal parasites infection.

Conclusion

The prevalence of intestinal parasites, Salmonella, and Shigella species was high. Therefore, it is imperative to implement a public health policy that includes ongoing microbiological surveillance.

Antibiotic resistance patterns of Staphylococcus aureus and Enterobacteriaceae isolated from street foods in selected towns of Ethiopia

BACKGROUND

Street foods are any foods or drinks prepared or sold by street vendors in an open space. The purpose of this study was to determine the Bacteriological safety and antibiotic resistance patterns of Staphylococcus aureus and Enterobacteriaceae isolated from street foods.

METHOD

A laboratory-based cross-sectional study was used from December 2022 to February 2023 on street foods of Addis Ababa, Hawassa, Dire Dawa, and Jimma towns of Ethiopia. 525 street foods and 175 water samples were taken from 175 street food vending stalls. Proportional allocation to the total town population and stratified sampling techniques were used to select vending stalls. Samples were analyzed for the presence of bacteria following the standard microbiological methods used for the isolation, enumeration, and identification of bacteria. Pour plate technique was used to transfer the suspension to MacConkey agar, Mannitol Salt Agar, and Salmonella Shigella Agar. The antibiotic susceptibility test was performed using the Kirby-Bauer disk diffusion method. SPSS software was used to analyze the data.

RESULT

Out of 525 food samples, 279 (53%) were contaminated by bacteria. From 175 water samples, 95 (54.3%) were contaminated with Escherichia coli. From both samples in total, eleven bacterial species were isolated. Staphylococcus aureus was the most frequently isolated species. Shigella, Klebsiella, and Salmonella group A have statistically significant with the type of food. Erythromycin (54%), Streptomycin (17%), and Amoxicillin (14%) were the most resistant antibiotics. Least resistance was observed to Ciprofloxacin (5%).

CONCLUSION

Street foods of the selected towns were highly contaminated with various antibiotic-resistant organisms. Hence, the relevant authorities ought to ensure the proper handling of street food by enforcing safety measures. Additionally, they should initiate a widespread awareness campaign promoting the prudent use of antibiotics among both street food vendors and the broader population.

Enteric Bacterial Infections, Antimicrobial Susceptibility Pattern, Intestinal Parasites, and Associated Factors Among Food Handlers in Yabelo Town, Borena Zone, Southern Ethiopia

Background

Foodborne illnesses are the main cause of morbidity and mortality in the twenty-first century, and food handlers are the main source of these illnesses.

Objective

The study aimed to assess the prevalence of intestinal parasites, enteric bacteria, antimicrobial susceptibility patterns, and associated factors among food handlers working in a food and drinking establishment in Yabelo town, Borena zone, Southern Ethiopia, in 2022.

Methods

A facility-based cross-sectional study design was employed to assess the food handler's state of health. Data were gathered using semistructured questionnaires and observational checklists, and 396 regular stool samples were collected. Samples were examined with microscopy and bacteriological culture to isolate enteric bacteria. Statistical Package for the Social Sciences, version 26 The factors that had a P-value of <.05 were considered statistically significant.

Result

Of the 396 stool samples collected, 164 (41.4%) were tested positive for intestinal parasites, while 40 (10.1%) were positive for enteric bacteria (Salmonella and Shigella). Among intestinal parasites, the most predominant parasite was Ascaris lumbricoides 48 (12.1%). All isolates of Salmonella and Shigella showed resistance to ampicillin. In multivariable analysis, not trimming fingernails regularly (AOR = 2.02, 95% CI 1.97-5.37), not washing hands with soap after the toilet (AOR = 3.02, 95% CI 2.37-5.62), and eating raw food (AOR = 2.1, 95% CI 1.79-6.51) have a significant association with the prevalence of bacteria and parasites.

Conclusion

The majority of food handlers had poor hygiene practices, and the prevalence of parasites and bacteria was high in the study setting. Educational status, eating raw vegetables or fruit, hand washing after the toilet, and fingernail trimming have associations with the health status of food handlers.

Occurrence of Diarrheagenic Pathogens and Their Coinfection Profiles in Diarrheic Under Five Children and Tracked Human Contacts in Urban and Rural Settings of Eastern Ethiopia

Diarrheagenic Escherichia coli, Campylobacter, Nontyphoidal Salmonella, and Shigella are common cause of childhood diarrhea in countries like Ethiopia, but data on their sources and coinfection profiles is limited. A cross sectional study was conducted from November 2021 to January 2023 to determine the prevalence, coinfection, and monthly occurrence rates of major diarrheagenic bacteria in diarrheic under five children and asymptomatic contacts at urban and rural settings in Ethiopia. A total of 345 stool samples were collected from; 262 diarrheic children visiting Hiwot Fana Hospital, Kersa, and Adelle Health Centers; and 83 caretakers and siblings through case based contact tracing. Samples were analyzed using standard laboratory procedures and the overall prevalence of enteric pathogens was 26.96%, with the highest isolation rate during the winter and peaks of 73.91% in February. The occurrence of the pathogens in children and tracked contacts was 27.86 and 24.09%, respectively. In our study, 8.53% coinfection and 23.66% single pathogen infection was recorded in diarrheic children. The study also showed 4.51 and 3.88% of diarrhea in children from urban and rural had attributed to bacterial coinfection, respectively. The most prevalent pathogen in diarrheic children was Diarrheagenic E. coli (10.31%), and followed by Campylobacter. On the other hand, Diarrheagenic E. coli was the second dominant bacteria following Shigella in the traced contacts, with prevalence of 8.43% and 9.64%, respectively. Based on the study site, the prevalence of Diarrheagenic E. coli and Nontyphoidal Salmonella was higher in children from urban than those from rural. However, the occurrence of each pathogen had no significant differences (P > .05) between settings. The high pathogens occurrence rate in the current study indicates the need for strong control strategies and better child carrying and treatment of diarrheal diseases at both urban and rural settings. Further studies on possible sources and factors attributing to the occurrence of enteric pathogens in children are also recommended.

Prevalence and Antimicrobial-Resistant Features of Shigella Species in East Africa from 2015-2022: A Systematic Review and Meta-Analysis

Background

Shigellosis is the most common cause of epidemic dysentery found worldwide, particularly in developing countries, where it causes infant diarrhea and mortality. The prevalence of Shigella species resistant to commonly used antimicrobial drugs has steadily increased. The purpose of this review is to describe the prevalence and antimicrobial resistance (AMR) characteristics of Shigella species in East Africa between 2015 and 2022.

Methods

Studies were identified using a computerized search of Medline/PubMed, Google Scholar, and Web of Science databases, with a detailed search strategy and cross-checking of reference lists for studies published between 2015 and 2022. Articles presenting data on prevalence and AMR, accessibility of the full-length article, and publication dates between 2015 and 2022 were the eligibility criteria for inclusion in the review. Original research reports written in English were considered. The heterogeneities of the studies were examined, and a meta-analysis was performed to estimate the pooled prevalence and AMR using a random effects model.

Results

The pooled prevalence of Shigella species in East Africa was 6.2% (95% CI -0.20-12.60), according to an analysis of 22 studies. Shigella species prevalence was 4.0% in Ethiopia, 14.6% in Kenya, 0.7% in Sudan, 5.2% in South Sudan, and 20.6% in Somalia. The association of Shigella infection significantly varied among the countries (p = 0.01). Among the antibiotics tested, most Shigella isolates were susceptible to ciprofloxacin, norfloxacin, nalidixic acid, and ceftriaxone. Despite the fact that the reports varied in study sites and time, Shigella species were resistant to tetracycline, ampicillin, amoxicillin, chloramphenicol, and co-trimoxazole.

Conclusion

The pooled estimate indicates high burden of Shigella infection in East Africa, as well as a high proportion of drug resistance pattern to tetracycline, ampicillin, chloramphenicol, and amoxicillin. Therefore, initiating and scale-up of performing drug susceptibility test for each shigellosis case need to be considered and strengthened.

Foodborne disease hazards and burden in Ethiopia: A systematic literature review, 1990–2019

Background

Foodborne disease (FBD) affects millions of people each year, posing a health burden similar to malaria, tuberculosis or HIV. A recent World Bank study estimated the productivity losses alone attributed to unsafe food within Africa at $20 billion in 2016, and the cost of treating these illnesses at an additional $3.5 billion. Ethiopia faces multiple food safety challenges due to lack of infrastructure and basic pre-requisites for food safety such as clean water and environment, washing facilities, compounded by limited implementation of food safety regulations, and a lack of incentives for producers to improve food safety. A consolidation of our understanding and evidence of the source, nature and scale of FBD in Ethiopia is needed to inform policy and future research. We performed a Systematic Literature Review (SLR) of publications on FBD occurrence in Ethiopia including hazard presence and impact.

Method

The SLR followed Cochrane and PRISMA guidelines. We searched PubMed and CAB-Direct for relevant publications between 1990 and 2019 (inclusive). Observational studies and reviews were included. Two reviewers screened titles and abstracts, and retained publications were reviewed in full for quality and data extraction.

Result

In total 128 articles met the inclusion criteria. Most articles focused on the identification of biological hazards in food. High levels of microbial contamination in different food value chains were often found in the small, ad hoc, observational studies that dominated the literature. Raw milk (22/128, 17.0%) and raw beef (21/128, 16.4%) were the most studied food products. Foodborne (FB) parasites were often found at higher rates in food than bacterial and viral pathogens, possibly due to differences in ease of identification. High levels of bacterial contamination on the hands of food handlers were widely reported. There were no reports on the incidence of human FBDs or resulting health and economic impacts.

Conclusion

Our findings reflect existing concerns around food safety in Ethiopia. A lack of substantial, coordinated studies with robust methodologies means fundamental gaps remain in our knowledge of FBD in Ethiopia, particularly regarding FBD burden and impact. Greater investment in food safety is needed, with enhanced and coordinated research and interventions.

Carriage of Antibiotic Resistant Bacteria and Associated Factors Among Food Handlers in Tamale Metropolis, Ghana: Implications for Food Safety

Background

Bacteria pathogens constitute a significant proportion of diarrhoea-causing food contaminants. Transmission of antibiotic resistant foodborne pathogens to humans is a major threat to food safety, especially in developing countries where quality hygiene and sanitation facilities are lacking. Factors related to antibiotic use, sanitation and hand hygiene have been associated with the spread of infectious diseases as well as antibiotic resistant bacteria. Proper food handling ensures that food is not contaminated with potential pathogenic bacteria. This study assessed the carriage of antibiotic resistant bacteria and associated factors.

Methods

A cross-sectional study was conducted among food handlers who sell ready to eat food in the Tamale metropolis of the Northern Region of Ghana. Food vending stations with huge customer base were randomly selected and the food handlers recruited using written informed consent. Structured questionnaires were used to collect participants sociodemographic details and information on sanitation, hand hygiene practice and antibiotic use. Sterile cotton swabs soaked in phosphate buffered saline was used to swab the palms of participating food handlers for bacteria isolation. All identified bacteria were tested for susceptibility to 12 antibiotics.

Results

In all, 406 food handlers participated in this study, the mean (SD) age was 26.5 (2.64) years. Bacteria isolated were predominantly Staphylococci 60 (14.8%) and Escherichia coli 54 (13.3%). All the isolates were resistant to at least one antibiotic tested. The isolates showed high resistance to broad-spectrum antibiotics such as ampicillin (40.0%-75.0%), tetracycline (40.0%-80.0%), amoxiclav (20.0%-80.0%) and chloramphenicol (7.7%-50.0%). Logistic regression model revealed that the carriage of antibiotic resistant bacteria by food handlers was significantly associated with age, educational level, years on the job, training in food preparation, hygiene practice, water source, type of toilet facility used and antibiotic use.

Conclusion

Street food handlers could be potential sources of food-borne transmission of antibiotic resistant bacteria.

Flavonoids and Phenolic Acids from Aerial Part of Ajuga integrifolia (Buch.-Ham. Ex D. Don): Anti-Shigellosis Activity and In Silico Molecular Docking Studies

Shigellosis is one of the major causes of death in children worldwide. Flavonoids and phenolic acids are expected to demonstrate anti-shigellosis activity and anti-diarrheal properties. The aerial part of A. integrifolia is commonly used against diarrhea. This study aimed to identify flavonoids and phenolic acids responsible for this therapeutic purpose. Antioxidant activity, total phenol content, and total flavonoid content were determined. The antibacterial activity of the aerial part against Shigella spp. was also tested using the agar well diffusion method. HPLC analysis was performed using UHPLC-DAD for different extracts of the aerial part. Autodock Vina in the PyRx platform was used to screen responsible components. Ciprofloxacin was used as a reference drug. An enzyme taking part in pyrimidine biosynthesis was used as a target protein. Molecular docking results were visualized using Discovery Studio and LigPlot1.4.5 software. Antioxidant activity, total phenol content, and total flavonoid content are more significant for the aerial part of A. integrifolia. From HPLC analysis, the presence of the flavonoids, quercetin, myricetin, and rutin and the phenolic acids gallic acid, chlorogenic acid, and syringic acid were identified from the aerial part of A. integrifolia. Regarding the antibacterial activity, the aerial part shows considerable activity against Shigella spp. Binding energies, RMSD and Ki values, interaction type, and distance are considered to identify the components most likely responsible for the therapeutic effects and observed activity. Antioxidant activity, total phenol content, and total flavonoid content of the aerial part are in line with anti-shigellosis activity. The top five components that are most likely potentially responsible for therapeutic purposes and anti-shigellosis activity are chlorogenic acid, rutin, dihydroquercetin, dihydromyricetin, and kaempferol.

Assessment of Intestinal Parasites, Enteric Bacterial Infections, and Antimicrobial Susceptibility among Street Food Handlers in Jimma Town, Southwest Ethiopia

Background

Food-borne infections are common public health problems worldwide. A street food handler with poor personal hygiene contributes to the transmission of intestinal parasites and enteric bacteria to the public via contaminated foods. In Ethiopia, health risks associated with street food are common. Previous studies in this area are scanty. Hence, the aim of this study was to determine the prevalence of intestinal parasites, enteric bacterial infections, and antimicrobial susceptibility among street food handlers in Jimma town.

Methods

A cross-sectional study was conducted from October to December 2020 among 260 street food handlers in Jimma town. A semi-structured questionnaire was used to collect data through face-to-face interviews. About 3 grams of the fecal specimen were collected from each food handler for bacterial culture and concentration techniques. The data were entered into Epi-Data 3.1 and analyzed by SPSS version 20. Associated factors were identified by using binary logistic regression analysis. A statistically significant association was determined at a p-value less than 0.05.

Results

The overall prevalence of intestinal parasites and enteric bacterial pathogens was 39.2% (33.3%–45.2%) and 8.85% (5.4%–12.3%), respectively. Ascaris lumbricoides (18.5%) and Salmonella (8.1%) were the most predominant parasite and enteric bacterial isolates, respectively. Not trimming fingernails (AOR = 2.884; 95% CI: 1.682–4.945) and not washing hands with soap after toilet (AOR = 3.342; 95% CI: 1.939–5.761) were factors associated with increased risk of infection by intestinal parasites or enteric bacterial pathogens. All Salmonella and Shigella isolates were 100% resistant to ampicillin.

Conclusion

The infection with intestinal parasites and enteric bacterial pathogens detected in this study indicated that street food handlers may serve as sources of pathogens/parasites for transmission and experience morbidities due to the infections. Therefore, periodic medical checkups and creating awareness of personal hygiene are mandatory to reduce the risk of infections.

Isolation, antimicrobial susceptibility patterns, and risk factors assessment of non-typhoidal Salmonella from apparently healthy and diarrheic dogs

Background

Dogs are one of the important asymptomatic carriers of antimicrobial resistant and potentially pathogenic strains of Salmonella. They can harbor large bacterial load in the intestines and mesenteric lymph nodes which can be shed in their feces with the possibility of transmission to humans. Therefore, a cross-sectional study was conducted with the objectives of estimating the prevalence of non-typhoidal Salmonella, assessing the risk factors for dog’s Salmonella carriage, and profiling the antimicrobial resistance pattern of Salmonella isolates among housed dogs in Harar town, Eastern Ethiopia. A total of 415 rectal swab samples were collected from randomly selected dogs. Samples were examined for non-typhoidal Salmonella using standard bacteriologic culture and biochemical tests. The disk diffusion method (Kirby-Bauer test) was employed to evaluate the isolates for their susceptibility against five antimicrobials.

Results

Non-typhoidal Salmonella were isolated from 26 (6.3%) of the rectal swab samples, with significantly higher occurrence in diarrheic (15.2%) than non-diarrheic (5.5%) dogs. The risk of Salmonella harboring was significantly higher in female dogs than in male dogs (OR = 2.5, p = 0.027). Dogs fecal shedding of Salmonella was relatively higher in households who used offal as a main feed type for their dogs (23.1%; 95% CI = 5–53.8) than those who used leftover food (10.1%; 95% CI = 5.7–16.1) and practiced mixed feeding system (17%; 95% CI = 7.6–30.8). Salmonella isolates showed higher resistance to ampicillin (41.7%), while all isolates were fully susceptible to gentamicin. Moreover, 58.3% of Salmonella isolates showed resistance to at least one of the tested antimicrobials. Majorities (72.7%) of the dog owners had no awareness on the risk of zoonotic salmonellosis from dog and all of the respondents use bare hand to clean dog kennel.

Conclusion

Our study reveals the importance of both diarrheic and apparently healthy housed dogs in the harboring and shedding of antimicrobial resistant non-typhoidal Salmonella. The risk of non-typhoidal Salmonella spread among pet owners is not negligible, especially in households who use offal as main feed type. Therefore, an integrated approach such as: proper dog handling practices; continuous evaluation of antimicrobial resistance; and rational use of antimicrobials in the field of veterinary sector are necessary to tackle the problem.

Prevalence and epidemiological distribution of selected foodborne pathogens in human and different environmental samples in Ethiopia: a systematic review and meta-analysis

Bacterial Foodborne Pathogens (FBP) are the commonest cause of foodborne illness or foodborne diseases (FBD) worldwide. They contaminate food at any stages in the entire food chain, from farm to dining-table. Among these, the Diarrheagenic Escherichia coli (DEC), Non typhoidal Salmonella (NTS), Shigella spp. and Campylobacter spp. are responsible for a large proportion of illnesses, deaths; and, particularly, as causes of acute diarrheal diseases. Though existing studies indicate the problem may be severe in developing countries like Ethiopia, the evidence is commonly based on fragmented data from individual studies. A review of published and unpublished manuscripts was conducted to obtain information on major FBP and identify the gaps in tracking their source attributions at the human, animal and environmental interface. A total of 1753 articles were initially retrieved after restricting the study period to between January 2000 and July 2020. After the second screening, only 51 articles on the humans and 43 on the environmental sample based studies were included in this review. In the absence of subgroups, overall as well as human stool and environmental sample based pooled prevalence estimate of FBP were analyzed. Since, substantial heterogeneity is expected, we also performed a subgroup analyses for principal study variables to estimate pooled prevalence of FBP at different epidemiological settings in both sample sources. The overall random pooled prevalence estimate of FBP (Salmonella, pathogenic Escherichia coli (E. coli), Shigella and Campylobacter spp.) was 8%; 95% CI: 6.5-8.7, with statistically higher (P <  0.01) estimates in environmental samples (11%) than in human stool (6%). The subgroup analysis depicted that Salmonella and pathogenic E. coli contributed to 5.7% (95% CI: 4.7-6.8) and 11.6% (95% CI: 8.8-15.1) respectively, of the overall pooled prevalence estimates of FBD in Ethiopia. The result of meta-regression showed, administrative regional state, geographic area of the study, source of sample and categorized sample size all significantly contributed to the heterogeneity of Salmonella and pathogenic E. coli estimates. Besides, the multivariate meta- regression indicated the actual study year between 2011 and 2015 was significantly associated with the environmental sample-based prevalence estimates of these FBP. This systematic review and meta-analysis depicted FBP are important in Ethiopia though majority of the studies were conducted separately either in human, animal or environmental samples employing routine culture based diagnostic method. Thus, further FBD study at the human, animal and environmental interface employing advanced diagnostic methods is needed to investigate source attributions of FBD in one health approach.

Antibiotic susceptibility and genetic relatedness of Shigella species isolated from food and human stool samples in Qazvin, Iran

Objective

The aim of this study was to investigate the genetic relatedness and antimicrobial resistance among Shigella species isolated from food and stool samples. Using cross sectional study method, Shigella spp. were isolated from food and clinical samples using culture-based, biochemical and serological methods. Antimicrobial susceptibility and genetic relatedness among the isolates were evaluated using disk diffusion and RAPD-PCR methods respectively.

Results

The prevalence of Shigella spp. were 4.84 and 7.7% in food and stool samples respectively. All food isolates were Sh. sonnei. 91.42% of the Shigella stool isolates were Sh. sonnei. 62.5% of food isolates were resistant to tetracycline. 46.8, 50 and 65.8% of clinical isolates were resistant to imipenem, amikacin and azithromycin respectively. 50 and 85.7% of the food and clinical isolates respectively were MDR. Dendrogram generated by RAPD-PCR showed that the isolates from food and stool samples were categorized in a same group. Close genetic relatedness between MDR Shigella isolates from food and clinical samples indicate that foods can be considered as one of the main vehicles for transmission of MDR Shigella to human causing acute diseases. Survey of MDR Shigella among food and clinical samples is strongly suggested to be implemented.

Prevalence, Risk Factors, and Antibiogram of Nontyphoidal Salmonella from Beef in Ambo and Holeta Towns, Oromia Region, Ethiopia

Background

Salmonella has been recognized as a major cause of food-borne illness associated with the consumption of food of animal origin. The present cross-sectional study was conducted from December 2017 to May 2018 in Ambo and Holeta towns to assess the prevalence, risk factors, and antimicrobial susceptibility patterns of nontyphoidal Salmonella isolates from raw beef samples from abattoirs, butchers, and restaurants in Ambo and Holeta towns, Oromia region, Ethiopia.

Methods

A total of 354 beef samples were collected from abattoirs, butchers, and restaurants. Salmonella isolation and identification were carried out using standard bacteriological methods recommended by the International Organization for Standardization. Antimicrobial susceptibility testing was performed using the disk diffusion method. Besides, a structured questionnaire was used to collect sociodemographic data and potential risk factors for contamination of meat. Chi-square tests and logistic regression were used for data analyses.

Results

Of the total 354 meat samples examined, 20 (5.7%, 95% confidence interval (CI): 3.5–8.6) were positive for Salmonella. Two serotypes belonging to S. typhimurium (11 isolates) and I:4,5,12: i:- (9 isolates) were identified. The Salmonella detection rate in abattoirs, butchers, and restaurants was 4.2% (5/118), 8.5% (10/118), and 4.2% (5/118), respectively. The antimicrobial susceptibility test showed that 40%, 30%, and 20% of the Salmonella isolates were resistant to azithromycin, amoxicillin, and ceftriaxone, respectively. The odds of Salmonella isolation when meat handlers are illiterate were 7.8 times higher than those when they are educated to the level of secondary and above (P=0.032). Similarly, the likelihood of Salmonella isolation was 6.3 and 7.6 times higher among workers of butcher and restaurants, respectively, who had no training (P=0.003) and no knowledge (P=0.010) on food safety and hygiene.

Conclusions

The study showed widespread multidrug-resistant Salmonella isolates in the study areas. Therefore, raw meat consumption and indiscriminate use of antimicrobial drugs should be discouraged. Provision of food safety education for meat handlers and further surveillance of antimicrobial-resistant isolates are suggested.

A Case-Control Study on the Association between Salmonella Bacteriuria and Cystoscopy

To date, there is only one published report of an outbreak of urinary tract infections by Salmonella species after cystoscopy. Disinfection procedures for cystoscope have come into question. The current study aimed to determine the odds of developing Salmonella bacteriuria after cystoscopy. A retrospective case-control study was conducted on all patients with Salmonella species in urine (case) and blood (control) from 2017 to 2019 in 16 hospitals in Eastern Ontario, Canada. Eight of the 11 patients had cystoscopy prior to Salmonella bacteriuria; three of the 74 patients had urological procedures prior to Salmonella bacteremia, but none of their procedures were cystoscopy. The odds ratio of urological procedures with Salmonella bacteriuria was 63.1 (95% CI 10.9 to 366.6; p < 0.0001). In the bacteriuria group, the most frequently identified isolates were Salmonella enteritidis (n = 8), followed by Salmonella oranienburg, and Salmonella heidelberg. Seven of the S. enteritidis isolates had identical susceptibilities (ampicillin-sensitive; sulfamethoxazole/trimethoprim-sensitive; ciprofloxacin intermediate). In the bacteremia group, the most frequently identified isolates were S. enteritidis (n = 22), followed by Salmonella typhi, S. heidelberg, S. oranienburg, and Salmonella typhimurium. The result suggested cystoscopy is a risk factor for Salmonella bacteriuria. Identification of Salmonella bacteriuria should prompt public health investigations of linkage between cystoscopy and Salmonella bacteriuria.

Prevalence and antimicrobial resistance patterns of Salmonella isolates in human stools and animal origin foods in Ethiopia: A systematic review and meta-analysis

OBJECTIVE

Foodborne diseases caused by non-typhoid Salmonella and the emergence of antimicrobial resistance remain as a public health challenge, especially in developing countries. The current study aimed to estimate the pooled prevalence and the antimicrobial resistance patterns of non-typhoid Salmonella in Ethiopia.

METHODS

Literature search was conducted from major electronic databases and indexing services. Both published and unpublished studies addressing the prevalence and antimicrobial resistance profiles of Salmonella in Ethiopia from 2010 to 2020 and those studies reported sample size and the numbers of isolates/number of positive samples were included in the study. Data were extracted using format prepared in Microsoft Excel. The identified data were exported to EndNote to remove duplicated studies, then after the remained articles were screened using title, abstract, and full text to identify studies that meet the inclusion criteria and finally appraised for methodological validity using JBI guideline. The pooled prevalence of Salmonella and its drug resistance pattern was computed by a random-effects model. I2 test statistic was used to test heterogeneity across studies. The presence of publication bias was evaluated using the Begg's and Egger's tests.

RESULTS

A total of 49 eligible articles, 33 of them on human stools, 15 of them on animal origin foods, and one both on human stools and animal origin foods, were included in the study. The pooled prevalence of Salmonella among human stools and animal origin foods in Ethiopia was 4.8% (95% CI: 3.9, 5.9) and 7.7% (95% CI: 5.6, 10.4), respectively. The subgroup analysis detected high pooled prevalence, 7.6% (95% CI: 5.3, 10.7) among outpatients and low, 3.7% (95% CI: 2.6, 5.1) in food handlers. The pooled resistant level of Salmonella was 80.6% (95% CI 72.6, 86.7) for ampicillin and 63.5% (95% CI 53.7, 72.4) for tetracycline. Low pooled resistance pattern was reported in ciprofloxacin, 8.7% (95% CI 5.6, 13.3) and ceftriaxone 12.2% (95% CI 7.9, 18.3). There was some sort of publication bias.

CONCLUSION

High pooled prevalence of Salmonella among human stools and animal origin foods which were 4.8% and 7.7% respectively, and high Salmonella resistance, >72% to ampicillin and tetracycline were detected in Ethiopia. Antimicrobial stewardship efforts and infection control strategies are required to mitigate this major public health concern.

Food Hygiene Practice and Its Determinants Among Food Handlers at University of Gondar, Northwest Ethiopia, 2019

Introduction

Food hygiene is an essential matter of public health for protecting or preventing diseases caused by unsafe food due to lack of good quality from production to consumption.

Objective

The current study aimed at assessing the food hygiene practice and determinant factors among food handlers working at the University of Gondar.

Methods

Univariate and multivariable binary logistic regression analyses were used to test the association of covariates with the food safety practice. Variables with p-value <0.2 were candidates for multivariable analysis. The adjusted odds ratio with 95% confidence interval and p-values less than 0.05 were used to report associations in the final model.

Results

A total of 184(46.7%) of the study subjects had good self-reported food hygiene practice. Being male [Adjusted odds ratio (AOR): 2.37, 95% confidence interval (CI) (1.34, 4.19)], educational status (primary [AOR: 2.54, 95% CI (1.16, 5.58)] and secondary [AOR: 2.20, 95% CI (1.11, 4.37)]), workers with greater than 2 years work experience [AOR: 1.86, 95% CI (1.06, 3.25)], monthly income of 2044–4867ETB/month [AOR: 2.05, 95% CI (1.01, 4.16)] were independent predictors of food safety practice of food handlers.

Conclusion and Recommendations

Below half of the study subjects had good self-reported food hygiene practice. Sex, educational status, and income were factors associated with the food hygiene practice. There should be continuous supportive supervision to raise the skills of food handlers to comply to better food hygiene practice. Food hygiene training should be given especially to female food handlers. Frequent audits are also required to ensure the permanence of effective and continuous training. Regular medical check up and strict hygiene follow-up should be encouraged to prevent foodborne disease outbreaks at universities.

Assessment of knowledge, practice, and status of food handlers toward Salmonella, Shigella, and intestinal parasites: A cross-sectional study in Tigrai prison centers, Ethiopia

Background

Unsafe food becomes a global public health and economic threat to humans. The health status, personal hygiene, knowledge, and practice of food handlers have crucial impact on food contamination. Hence, this study is aimed at assessing the knowledge, practice, and prevalence of Salmonella, Shigella, and intestinal parasites among food handlers in Eastern Tigrai prison centers, Northern Ethiopia.

Methods

An institutional-based cross-sectional study was carried out from April to September 2019 among food handlers in Eastern Tigrai prison centers, Northern Ethiopia. A structured questionnaire was used to collect the demographic characteristics, the knowledge, and the practice of the study participants. Direct wet mount and formol-ether concentration techniques were applied to identify intestinal parasites. Culture and biochemical tests were used to isolate the Salmonella and the Shigella species. Additionally, antimicrobial susceptibility tests to selected antibiotics were performed using Kirby-Baur disk diffusion method. We used SPSS version 23 software for statistical analysis.

Results

Thirty-seven (62.7%, 37/59) of the participants had harbored one or more intestinal parasites. The protozoan Entamoeba histolytica/dispar was detected among 23.7% (14/59) of the study participants who provided stool specimen. Besides, 6.8% (4/59) of the samples were positive for either Salmonella or Shigella species. The Salmonella isolates (n = 2) were sensitive to Gentamicin, Ciprofloxacin, Ceftriaxone, and Clarithromycin but resistant to Amoxicillin, Ampicillin, and Amoxicillin/clavulanic acid. Similarly, the two Shigella isolates were susceptible to Gentamicin, Ciprofloxacin, and Ceftriaxone but showed resistance to Amoxicillin, Tetracycline, and Chloramphenicol. Further, 60.6% (40/66) of the participants had good level of knowledge, and 51.5% (34/66) had good level of practice on foodborne diseases and on food safety.

Conclusions

We conclude that foodborne pathogens are significant health problems in the study areas. Regular health education and training programs among the food handlers are demanded to tackle foodborne diseases at the prison centers.

Prevalence, antimicrobial susceptibility pattern, and associated factors of Salmonella and Shigella among food handlers in Adigrat University student's cafeteria, northern Ethiopia, 2018

BACKGROUND

Food handlers play a significant role in the transmission of foodborne infections. Salmonella and Shigella are the most common foodborne pathogens and their infections are a major public health problem globally. Thus, this study aimed to determine the prevalence, antimicrobial susceptibility patterns, and associated factors of Salmonella and Shigella colonization among food handlers.

METHODOLOGY

A cross-sectional study was conducted from March to August 2018 at Adigrat University student cafeteria, Northern Ethiopia. Data on socio-demographic and associated factors were collected using a structured questionnaire. Fresh stool samples were collected from 301 food handlers and transported to Adigrat University Microbiology Laboratory. Bacterial isolation and antimicrobial susceptibility test were performed using standard bacteriological methods. Data analysis was performed using SPSS version 22 and P < 0.05 where a corresponding 95% confidence interval was considered statistically significant.

RESULTS

A total of 301 food handlers were included in this study. The majority of study participants were females 265 (88.0%). About 22 (7.3%) and 11 (3.7%) of food handlers were found to be positive for Salmonella and Shigella respectively. Hand washing after using a bathroom with water only, no hand washing after using the bathroom, no hand washing after touching dirty materials, no hand washing before food handling, and untrimmed fingernails were significant associated factors identified. None of the Salmonella and Shigella isolates were sensitive to ampicillin, yet low resistance against chloramphenicol, ceftriaxone, and ciprofloxacin was found.

CONCLUSION

The present study revealed that the prevalence of Salmonella and Shigella among food handlers was 22 (7.3%) and 11 (3.7%) respectively. Such colonized food handlers can contaminate food, and drinks and could serve as a source of infection to consumers. This indicates that there is a need for strengthened infection control measures to prevent Salmonella and Shigella transmission in the students' cafeteria.

Prevalence and Antimicrobial Resistance Pattern of Salmonella, Shigella, and Intestinal Parasites and Associated Factor among Food Handlers in Dilla University Student Cafeteria, Dilla, Ethiopia

BACKGROUND

Food-borne disease is mostly caused by unsafe food handling and processing as well as poor hygienic practice. Recently, it is a worldwide and local burden to the human health. It is estimated that about one-third of the world population is affected by food-borne diseases annually and become a global public health problem. Hence, this study aimed to determine the prevalence, antimicrobial susceptibility patterns, and associated risk factors of Shigella, Salmonella, and intestinal parasites among food handlers in Dilla University, Southern Ethiopia.

METHODS

An institutional-based cross-sectional study was conducted from November to September 2018/2019. A structured questionnaire was used for the collection of data on sociodemographic characteristics. Parasite and bacterial identification, as well as susceptibility testing, was done using standard parasitological and bacteriological procedures.

RESULTS

Of the total 220 food handlers included in the study, 38.6%, 9.5%, and 3.2% were positive for intestinal parasites, Salmonella, and Shigella species, respectively. A. lumbricoides (11.4%) was the predominant parasite isolated followed by E. histolytica (7.7%). From the total Salmonella isolates, serogroup D was the most frequent isolate and from the total Shigella species, Shigella flexneri was the predominant isolate. In this study, through irregular medical checkups, those who drunk unpasteurized milk and ate raw meat were significantly associated with intestinal parasites. Both Salmonella and Shigella species were highly resistant to ampicillin (81%) and amoxicillin-clavulanic acid (>70%). Salmonella isolates are highly sensitive to cefotaxime and ceftriaxone, while Shigella is highly sensitive to ciprofloxacin and norfloxacin. MDR was recorded in 71.4% of all bacterial isolates.

CONCLUSION

The presence of a high prevalence of intestinal parasites, Salmonella, and Shigella species that were resistant to the commonly prescribed drugs is a treat to the children and the community at large. Therefore, measures including health education, improvement of safe water supply, sanitation facilities, and continuous monitoring of microbiological and antimicrobial surveillance are crucial.

Prevalence and antimicrobial susceptibility patterns of Salmonella and Shigella isolates among children aged below five years with diarrhea attending Robe General Hospital and Goba Referral Hospital, South East Ethiopia

BACKGROUND

Diarrheal diseases are responsible for high level of morbidity and mortality, particularly in children below 5 years. Salmonella and Shigella spp. are pathogenic microbes responsible for the major diarrheal associated mortality. The purpose of this study was to determine the prevalence, factors associated with Salmonella and Shigella isolates infections and their antimicrobial susceptibility patterns among diarrheic children aged below 5 years attending BRGH and GRH, Ethiopia.

METHODS

A health institution based cross-sectional study was conducted from April to July 2016. One stool samples was collected from 422 diarrheic children under the ages of five and were cultured on to Hektoen Enteric (HE) and Salmonella-Shigella agar. Isolation identification of the Salmonella and Shigella isolates were conducted using standard bacteriological methods. Antibiotic susceptibility was done by Kirby-Bauer disk diffusion method. The isolates were defined as multidrug resistant if it was resistant to two or more antimicrobial agents. Descriptive statistics were employed and logistic regression models were constructed to determine factors associated with Shigella/Salmonella prevalence.

RESULTS

The prevalence of Salmonella and Shigella isolates were 6.9 and 4.3%, respectively. Children aged between 1 to 3 years were significantly associated with Salmonella infection [AOR = 19.08, 95% CI (2.68-135.86)]. The odd of prevalence of Salmonella/Shigella isolates was significantly associated with absence of latrine, absence of hand washing after latrine, and in unimmunized children in adjusted odd ratio. Unimproved water sources and hand washing before meal had also higher odd of prevalence although the difference was not significant. All Salmonella and Shigella isolates were resistant to amoxicillin (100%). In addition, all Shigella isolates were completely resistant to chloramphenicol, and tetracycline, and were multidrug resistant. However, all Salmonella and Shigella isolates were susceptible to ciprofloxacin and ceftriaxone.

CONCLUSION

There was a relatively low prevalence of Salmonella and Shigella species in the study areas and were significantly associated with lack of personal hygiene and environmental sanitation. There were also higher drug resistance and multidrug resistant pattern. Personal hygiene and environmental sanitation, including access to latrine and supply of safe drinking water are suggested. Checking susceptibilities of Shigella and Salmonella isolates causing diarrhea is also suggested.

Prevalence and antimicrobial susceptibility profile of Salmonella and Shigella among food handlers working in food establishment at Hawassa city, Southern Ethiopia

OBJECTIVE

The aim of this study was to determine the prevalence of Salmonella and Shigella, antibiotic susceptibility profile and associated factors among food handlers working in food establishment from June to December 2018 at Hawassa city, Southern Ethiopia.

RESULTS

Out of the 236 food handlers screened for stool culture, 5 (2.12%) were positive for Salmonella species and all of them were negative for Shigella species. All Salmonella species isolated were susceptible to ciprofloxacin and ceftriaxone but among the five isolated Salmonella species, 4 (80%), 3 (60%), 2 (40%), 2 (40%), and 2 (40%) were resistant to tetracycline, ampicillin, amoxicillin-clavulanic acid, cotrimoxazole, and chloramphenicol respectively. Only food handlers hand washing the habit after toilet had a significant association with the prevalence of Salmonella species (P = 0.03).

Antibiotic Use and Resistance Pattern in Ethiopia: Systematic Review and Meta-Analysis

BACKGROUND

In the last decades, medicines have had an unprecedented positive effect on health, leading to reduced mortality and disease burden and consequently to an improved quality of life. The rapid and ongoing spread of antimicrobial-resistant organisms threatens our ability to successfully treat a growing number of infectious diseases. In the absence of the development of new generations of antibiotic drugs, appropriate use of existing antibiotics is needed to ensure the long-term availability of effective treatment for bacterial infections. Irrational use of antibiotics is an ongoing global public health problem that deserves more attention. This review is conducted to evaluate the prevalence of inappropriate antibiotic utilization and resistance to antibiotics in Ethiopia.

METHODS

Electronic search in PubMed/MEDLINE and Google was used to find published literature with reference lists of relevant articles searched manually. Titles and abstracts were initially screened for eligibility. The full texts of articles judged to be eligible were reviewed if they meet the inclusion criteria. Data were extracted on important variables like the sample size, region of the study, the inappropriate antibiotic use, bacterial detection rate, multidrug resistance pattern, and more other variables. Microsoft Excel was used for data extraction. Quantitative analysis was performed using STATA version 11.

RESULTS

The electronic searches identified 193 articles of which 33 were found eligible. The random-effects model was used to provide point estimates (with 95% confidence interval (CI)) of bacterial detection rate, inappropriate antibiotic use, and multidrug resistance rate to account for heterogeneity. The pooled bacteria detection rate was 29.1 with 95% CI (16.6-41.7). The pooled prevalence of multidrug resistant strains identified was 59.7% (95% CI: 43.5-75.9). The pooled estimate of inappropriate antibiotic use was 49.2% (95% CI: 32.2-66.2). The pooled proportion of self-antibiotic prescription was 43.3% (95% CI: 15.7-70.9). Other reasons for inappropriate antibiotic use included a wrong indication, wrong duration, improper route of administration, use of leftover antibiotics from a family member, and immature discontinuation of antibiotics.

CONCLUSION AND RECOMMENDATIONS

Inappropriate antibiotic use is a huge problem in Ethiopia, and many bacteria were resistant to commonly used antibiotics and similarly, multidrug-resistant bacterial strains are numerous. Appropriate antibiotic use should be ensured by prohibiting over-the-counter sale of antibiotics and strengthening antimicrobial stewardship.

Prevalence of enteric bacteria and their antimicrobial susceptibility patterns among food handlers in Gondar town, Northwest Ethiopia

Background

Enteric bacterial pathogens are the major causes of food-borne gastroenteritis in humans and remain important public health problems worldwide. The emergence of antimicrobial resistance is a global concern, particularly in developing countries. The aim of this study was to determine the prevalence of enteric bacteria pathogens and their antimicrobial susceptibility patterns among food handlers in Gondar town, Northwest Ethiopia.

Methods

A cross-sectional study was conducted from February 4 to April 16, 2018. A total of 257 food handlers were selected using a multistage sampling technique. Data on socio-demographic characteristics were collected using a structured questionnaire. Stool samples were collected and inoculated into appropriate media. Enteric bacterial pathogens were identified using standard microbiological methods. Antimicrobial susceptibility tests were performed using the disk diffusion technique as per the standard Kirby-Bauer method. Data were entered and analyzed using SPSS version 20 software.

Results

The overall prevalence of enteric bacteria was 34/257 (13. 2%, [95% CI, 8.9-17.5%]). Shigella species was the leading isolate that accounted for 26/257 (10.1%) followed by Enterohemorrhagic Escherichia coli (EHEC) O157: H7 5/257 (1.9%) and Salmonella species 3/257 (1.2%). Shigella spp. was susceptible to ciprofloxacin 26 (100%), ceftriaxone 25 (96.1%), chloramphenicol 24 (92.3%), nalidixic acid 24 (92.3%), and gentamicin 20 (76.9%). Escherichia coli O157: H7 and Salmonella spp. showed the maximum (100%) susceptibility results to ceftriaxone, chloramphenicol, ciprofloxacin, and gentamicin. The overall prevalence of Multidrug resistance (MDR) in the current study was 14/34 (41.2%).

Conclusion

Our study showed high prevalence of enteric bacterial pathogens among food handlers. All isolates were susceptible to ciprofloxacin. However, a substential number of isolates were resistant to commonly prescribed antibiotics and the prevalence of MDR was high.

Prevalence of Shigella species and its drug resistance pattern in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Shigella species are a major cause of dysentery and may attribute for death worldwide. Currently antibiotic resistance became the critical challenges for management of infectious disease. The aim was to conduct a systematic review and meta-analysis of Shigella species and its drug resistance pattern in Ethiopia.

METHODS

A comprehensive literature search was conducted through internet searches using database of MEDLINE, PubMed, Google scholar, EMBASE, HINARI, Cochrane Library and reference lists of previous prevalence studies from January 1999 to November 2018. Results were presented in forest plot, tables and figures with 95% CI. The Cochrane Q test and I2 test statistic were used to test heterogeneity across studies. The Pooled estimate of Shigella species and its drug resistance pattern was computed by a random effects model.

RESULTS

The pooled prevalence of Shigella species in Ethiopia was 6.6% (95% CI 4.7-8.8). In the subgroup analysis, the highest prevalence was observed among patients in Health facility (8.5%, 95% CI 6.2-11.5) whereas the lowest prevalence was observed in Community based studies (1.6%, 95% CI 0.8-3.4). In addition, Shigella species were highly resistant to ampicillin, amoxicillin, erythromycin and multi-drug resistant (MDR) with the pooled resistance proportions of 83.1% (95% CI 75.7-88.6), 84.1% (95% CI 75.6-90.1), 86.5% (95% CI 70.9-94.4) and 83.2% (95% CI 77.1-87.9), respectively. On the other hand, comparably low resistance pattern was reported for ciprofloxacin 8.9% (95% CI 6.0-12.8), ceftriaxone 9.3% (95% CI 3.9-20.5), and norfloxacin 8.2% (95% CI 3.8-16.6) and gentamycin 17.3% (95% CI 11.2-25.9). Subgroup analyses indicated that study years were associated with a decreasing Shigella prevalence over time (p = 0.002).

CONCLUSION

The pooled estimate showed high burden of Shigella infection and its high proportion of drug resistance pattern to ampicillin, amoxicillin and erythromycin in Ethiopia. Therefore, initiating and scale up of performing drug susceptibility test for each shigellosis case, educate the community and health care providers on appropriate use of antibiotics need to be considered and strengthened.

Salmonella and Shigella Among Asymptomatic Street Food Vendors in the Dire Dawa city, Eastern Ethiopia: Prevalence, Antimicrobial Susceptibility Pattern, and Associated Factors

BACKGROUND

Salmonella and Shigella infections are a common public health problem throughout the world. The risk of getting infections is high, where asymptomatic street food vendors are preparing foods and vending. Current knowledge of antimicrobial susceptibility pattern is essential for appropriate treatment and management of these infections.

OBJECTIVE

This study was aimed to determine the prevalence, antimicrobial susceptibility pattern, and associated factors of Salmonella and Shigella among asymptomatic street food vendors in the Dire Dawa city, Eastern Ethiopia.

METHODS

A cross-sectional study was conducted among 218 randomly selected asymptomatic street food vendors in the Dire Dawa city, Eastern Ethiopia from May to July 2017. Data on the sociodemographic and associated factors were collected using a pretested structured questionnaire. The stool specimens collected were examined for Salmonella and Shigella using recommended culture methods. The antimicrobial susceptibility test was done using the disk diffusion technique. Data were described using descriptive statistical tools. Logistic regression models were used to identify the factors associated with Salmonella and Shigella infections. A P-value ⩽ .05 was considered statistically significant.

RESULTS

The overall prevalence of Salmonella and Shigella was 8.7% (95% confidence interval: 5.6, 10.3). The most common isolates were Salmonella (6%). Most of the isolates were resistant to amoxicillin (97.7%), ampicillin (89.5%), and tetracycline (68.4%). Almost half (47.4%) of Salmonella isolates were multidrug resistant. Food vendors who did not wash hands with soap after the use of the toilet (adjusted odds ratio: 3.3, 95% confidence interval: 1.2, 7.9), and who had untrimmed fingernails (adjusted odds ratio: 4.4, 95% confidence interval: 1.5, 9.3) had higher odds of Salmonella and Shigella compared with their counterparts.

CONCLUSIONS

The carrier rate of Salmonella and Shigella was relatively low. Most isolates have developed resistance to amoxicillin, ampicillin, and tetracycline. The odds of Salmonella and Shigella was high among those who lack a habit of hand washing with soap after the use of the toilet and with untrimmed fingernails. Regular screening and appropriate hygienic control measures are needed in place to reduce the risk of infections.

Prevalence, Serotypes, and Antimicrobial Resistance Profiles Among Salmonella Isolated from Food Catering Workers in Nantong, China

Salmonella is a worldwide foodborne pathogen causing human disease. Food handlers, who are potential carriers of Salmonella, may transmit the pathogen to consumers through food. To determine the prevalence of Salmonella enterica serovars among food handlers working in the catering industry in Nantong, China, a total of 214,542 food handlers' fecal samples were tested for Salmonella in the Nantong CDC (Centers for Disease Control) from 2012 to 2017. Among those tested, 193 (0.09%) were identified to be positive for Salmonella, and the highest detection rate was 0.16% during the period of July to September. Serotyping analysis showed that Salmonella enterica serovar Typhimurium was the predominant serotype (16.1%), followed by Salmonella Derby (13.5%), Salmonella Enteritidis (11.4%), and Salmonella London (11.4%). The high detection rate of Salmonella Derby was probably closely related to its high prevalence of the serotype in pork, which is the primary meat consumed by the Chinese. Antibiotic susceptibility analysis demonstrated that 73.4% of the isolates were multidrug-resistant (MDR) strains with predominant resistance to ampicillin (AMP, 64.6%), followed by resistance to sulfisoxazole (SUL, 58.1%), nalidixic acid (55.8%), and tetracycline (TET, 44.5%). Therefore, MDR Salmonella strain carriage among food handlers working in the catering industry might be a potential source of human salmonellosis, especially for the predominant MDR genotype isolates (32.3%) with resistance to AMP, SUL, and TET.

Burden of intestinal pathogens and associated factors among asymptomatic food handlers in South Ethiopia: emphasis on salmonellosis

Objective

The study aims to assess the burden of intestinal parasites and Salmonellosis among asymptomatic food handlers at meal serving facilities in Sodo town. Antibiotic resistance was also common and increasing among Salmonella isolates with multidrug resistance as current concern.

Result

Community based cross-sectional study was carried out from 387 food handlers working in meal serving facilities. Food handlers, 159(41%) had one or more intestinal parasites. A. lumbricoides was the most prevalent parasite 30(7.8%), followed by Taenia species 26(6.7%) and Hook worm 23(5.9%). A total number of 35 Salmonella isolates were found of which Sero-group D was the most frequent, 17(48.5%) followed by Sero-group C, 12(34.3%), and B 6(17.1%). Ten (2.5%) isolates were Salmonella typhi. Raw meat eating, hand washing after toilet and after touching dirty materials showed significant association with intestinal pathogens. Salmonella isolates were highly resistant to ampicillin (85.7%), amoxicillin and tetracycline 74.3% each. Multidrug resistance prevalence of 81.8% was identified. Periodic screening of food handlers is important in order to prevent the transmission of intestinal parasites and Salmonellosis. Treatment needs to be based on accurate laboratory detection to mitigate the spread of drug resistant Salmonella strains.

Electronic supplementary material

The online version of this article (10.1186/s13104-018-3610-4) contains supplementary material, which is available to authorized users.