Prevalence, associated risk factors and antimicrobial susceptibility patterns of Shigella infections among diarrheic pediatric population attending at Gondar town healthcare institutions, Northwest Ethiopia

Abstract

Background Diarrhea caused by Shigella species remains a major public health threat especially in the pediatric population. A regular surveillance system needs to be in place, in order to explore the burden, antimicrobial resistance patterns and associated risk factors for Shigella infections. Therefore, the aim of this study was to assess the prevalence, antimicrobial susceptibility patterns and associated risk factors of Shigella infections among diarrheic pediatric population attending at selected healthcare institutions in Gondar town. Methods A cross-sectional study was conducted in Gondar town healthcare institutions from January to March 2018. A simple random sampling technique was used to enroll 272 study participants. Structured questionnaires were used to gather socio-demographic, environmental and associated risk factors data. Stool samples were collected from diarrheic pediatric patients and inoculated onto MacConkey media, salmonella-shigella agar, and xylose-lysine deoxy-cholate agar. Identification of the bacterial species was carried out by using biochemical tests. The disc-diffusion method was used to determine the antimicrobial susceptibility of the isolates by standardizing the bacterial suspension with a 0.5 McFarland solution. A statistical analysis was done using SPSS version 20 statistical package and P -value < 0.05 was considered as statistically significant. Results From the total study participants, 29(10.7%) of the patients were culture positive for Shigella species. The habit of eating raw food and nutritional status of children were statistically significant with shigellosis ( p < 0.05). Shigella species were found highly resistant to amoxicillin and tetracycline but susceptible to nitrofurantoin and norfloxacin. Conclusion High prevalence of Shigella species were detected in this study. Through in-vitro drug susceptibility testing, norfloxacin and nitrofurantoin were found to be effective against the isolates, while high resistance rates were observed for tetracycline, and amoxicillin. The findings highlighted the need for regular drug resistance information for the best management of infections.

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

“…Children whose parents did not wash their hands before serving food to them and after toilet had higher odd of prevalence of Salmonella and Shigella spp. in concordance with several studies [8, 9, 15–17]. This was a result of fecal-oral transmission of these bacteria from the parents to their children during feeding and/or handling [3, 4].…”

“…The resistance to amoxicillin in our study (100%) was very high and in conformity with previous studies in Ethiopia [6, 7]. The resistance of Shigella isolates to tetracycline in our study (100%) was also higher than earlier studies in Addis Ababa (97.3%) [18], in Bahir Dar (93.8%) [19], in Gonder (89.7%) [17] and in Mozambique 66% [28]. Similarly, the resistance of Shigella isolates to chloramphenicol (100%) was higher than studies in Arba Minch (62.5%) [9], and in Gonder (67.8%) [14].…”

“…and it is a worldwide problem although more prevalent in developing countries [10–12]. Shigellosis is common in areas where living standards are very low and access to safe and adequate drinking water and proper waste disposal systems are often very limited, or even absent [6–9, 13–17]. Shigella spp.…”

Existence of virulence genes in clinical Shigella sonnei isolates from Jiangsu Province of China: a multicenter study

“…Shigellosis is an acute invasive enteric infection caused by any of the four species of Shigella (S. dysenteriae, S. flexneri, S. boydii, and S. sonnei). S. flexneri is the most commonly isolated species in many developing countries (1,2), but S. sonnei in developed countries (3,4). With the development in China, S. sonnei plays an increasingly important part in Shigellosis (5).…”

Shigella and Salmonella, Antibiotics Susceptibility Pattern and Associated Risk Factors among Diarrheic Children in Southern Ethiopia: a cross sectional study

“…Most of these deaths due to diarrhea is in South Asia and sub-Saharan Africa [4]. Studies in Ethiopia from different regions reported that 4.3-17-45% [5][6][7][8] Shigella and 1-12.6 %[6-8] Salmonella infection was confirmed.…”