Microbial aetiology of gastroenteritis, antimicrobial resistance and associated factors among under five children in Addis Ababa, Ethiopia

Abstract

Introduction: Diarrheal diseases are among the most frequent childhood illnesses and leading causes of preventable death, especially among under five years’ children in developing countries. As socioeconomic conditions and living situations are changing, it is important to revisit the bacteriological etiologies and the drug resistance profiles amog children with diarrhoea including those under five years old.

Objective: To identify enteric pathogens and their antimicrobial susceptibility patterns from under five children in Addis Ababa, Ethiopia.

Materials and Methods: A cross-sectional study was conducted from December/2013 – March/ 2014 in selected health facilities of Addis Ababa, Ethiopia. Demographic and clinical data were collected and enteric pathogens were isolated. Antimicrobial susceptibility testing was done following standard bacteriological techniques as recommended by CLIS guideline.

Results: Out of 256 children with diarrhoea, enteric bacteria were isolated in 78 (30.5%) participants.  The most frequently isolated bacterial pathogen was E. coli.  There was no single risk factor significantly associated with the microbial aetiology. Sensitivity of the E.coli isolates were 30 % to ampicillin; 98 % to ciprofloxacin; 50% to Trimethoprim sulphamethoxazole. The high level (72%) of antimicrobial resistance was detected in E.coli, Salmonella and Shigella isolates. The organisms developed complete resistance to ampicillin and amoxicillin.

Conclusion: The first line antimicrobial agents for enteric pathogens are the least susceptible that need culture driven prescription