Prevalence, associated risk factors and antimicrobial susceptibility pattern of Campylobacter species among under five diarrheic children at Gondar University Hospital, Northwest Ethiopia

BMC Pediatrics

Belay Anagaw²  Chandrashekhar Unakal²  Feleke Moges²  Ayalew Lengerh¹ 

[1] College of Medicine and Health Sciences, University of Gondar Teaching Hospital Laboratory, Bacteriology Section, University of Gondar, Gondar, Ethiopia;Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

关键词: Risk factors;    Under five children;    Campylobacter species;    Antimicrobial susceptibility;   

Others  :  1144835
DOI  :  10.1186/1471-2431-13-82

 received in 2012-12-20, accepted in 2013-05-14,  发布年份 2013

【 摘 要 】

Background

Recent reports indicate that Campylobacter species are becoming one of the leading causes of bacterial diarrhoeal disease worldwide and most of the isolates are resistant to different antibiotics. This study aimed at determining the prevalence, associated risk factors and susceptibility pattern of Campylobacter species in under-five diarrheic children.

Methods

A cross-sectional study was conducted from October 2011 to March 2012. Samples were collected from under five diarrhoeic children who visited University of Gondar Teaching Hospital and seeking medical services during the study period. Stool specimens were aseptically inoculated using selective media and species isolation was further processed following standard procedures. Antimicrobial susceptibility test for Campylobacter species was performed using the standard agar disc diffusion method. The data was entered and analyzed using SPSS version 16 packages. Odd ratio was used to see their association between variables and then logistic regression was used to measure strengths of association. P-values less than 0.05 were taken as statistically significant.

Result

A total of 285 under five children with diarrhoea were included in this study. Of these144 (50.5%) were males and 141(49.5%) were females with the age range of one month to five years and mean age of 2.26 years (25months). Among 285 stool specimens cultured, 44(15.4%) of them were positive for Campylobacter species. Culture positivity for Campylobacter was higher in children below 12 months of age. Latrine usage, water source, boiling drinking water, bottle feeding, nutritional status and exposure to domestic animals had statistically significant association. Highest drug resistance rate were found in ampicillin (68.2%), tetracycline (56.8%) and trimethoprim- sulfamethoxazole (54.5%).

Conclusion

Isolation rate of Campylobacter species were frequent among under five children. The frequency was higher in those children who were malnourished, drinking of unprotected water and direct contact with infected animals (especially cats, dogs, pigeons, hens and their products). The antimicrobial resistance patterns for some of the commonly prescribed antibiotics were high. Therefore, awareness of hand washing and proper boiling of drinking water are probably important in preventing infection with Campylobacter species and childhood diarrhea should not be underestimated and effectiveness of the drugs should be continuously monitored by doing antimicrobial susceptibility test.

【 授权许可】

   
2013 Lengerh et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Kassa T, Gebre-selassie S, Asrat D: The prevalence of thermo tolerant Campylobacter species in food animals in Jimma Zone, southwest Ethiopia. Ethiop J Health Dev 2005, 19(3):225-229.
• [2]Fernández H, Vera F, Villanueva PM, García A: Occurrence of campylobacter species in health well-nourished and mal-nourished children. Brazilian Journal of Microbiology 2008, 39:56-58.
• [3]Solomon EB, Hoover DG: Campylobacter jejuni: a bacterial paradox. J Food Safety 1999, 19:121-136.
• [4]Sean FA, Norman JS, Patricia IF, David LS: Centers for Disease Control and Prevention, Atlanta, Georgia USA. Emerg Infect Dis 1999, 5(1):27-30.
• [5]Aboderin AO, Smith SI, Oyelese AO, Onipede AO, Zailani SB, Coker AO: Role of Campylobacter jejuni/coli in diarrhoea in Ill-Use, Nigeria. East Afr Med J 2002, 79:423-426.
• [6]Mackenjee MK, Coovadia YM, Coovadia HM, Hewitt J, Robins-Browne RM: Etiology of diarrhoea in adequately nourished young African children in Durban, South Africa. Ann Trop Paediatr 1984, 4:183-187.
• [7]Obi CL, Bessong PO: Diarrheagenic bacterial pathogens in HIV-positive patients with diarrhoea in rural communities of Limpopo province, South Africa. J Health Popul Nutr 2002, 20:230-234.
• [8]Kaba M, Ayele F: Ethnographic study of diarrhoeal diseases among under-five children in Mana district, Jimma Zone, Southwest Ethiopia. Ethiop J Health Dev 2000, 14(1):77-83.
• [9]Meseret E: Analysis of pediatric admission to Jimma Hospital pediatric ward: A three year retrospective study. Bull JIHS: 1994, 4:1-11.
• [10]National Committee for Clinical Laboratory Standards: Performance standards for Antimicrobial Disk and Dilution Susceptibility Tests for bacterial isolated from animals. Wayne, PA: Approved standard M31-A-19, 11; 1999.
• [11]National Committee for Clinical Laboratory Standards: Performance Standards for Antimicrobial Disk Susceptibility Tests. 7th edition. Wayne, PA USA: Approved standard M2–A7. National Committee for Clinical Laboratory Standards; 2000.
• [12]Gedlu E, Assefa A: Campylobacter enteritis among children in Northwest Ethiopia: a one-year prospective study. Ann Trop Paediat 1996, 16:207-212.
• [13]Mitike G, Kassu A, Genetu A, Nigussie D: Campylobacter enteritis among children in Dembia district Northwest Ethiopia. East Afr Med J 2000, 77(12):654-657.
• [14]Ewunetu D, Mihert A: Prevalence and antimicrobial resistance of Campylobacter isolates from humans and chickens in Bahir Dar, Ethiopia. Foodborne Pathog Dis 2010, 7(6):667-670.
• [15]Beyene G, Haile-Amlak A: Antimicrobial sensitivity pattern of Campylobacter species among children in Jimma University Specialized Hospital, Southwest Ethiopia. Ethiop J Health Dev 2004, 18(3):185-189.
• [16]Koulla-Shiro S, Loe C, Ekoe T: Prevalence of Campylobacter enteritis in children from Yaounde (Cameroon). Cent Afr J Med 1995, 41:91-94.
• [17]Simango C, Nyahanana M: Campylobacter enteritis in children in an urban community. Cent Afr Med J 1997, 43:172-175.
• [18]Rao MR, Naficy AB, Savarino SJ, Abu-Elyazeed R, Wierzba TF, Peruski LF: Pathogenicity and convalescent excretion of Campylobacter in rural Egyptian children. Am J Epidemiol 2001, 154:166-173.
• [19]Wren BW, Linton D, Dorrell N, Karlyshev AV: Post genome analysis of Campylobacter jejuni. J Appl Microbiol 2001, 90:36-44.
• [20]Coker AO, Adefeso AO: The changing patterns of Campylobacter jejuni/ coli in Lagos, Nigeria after ten years. East Afr Med J 1994, 71:437-440.
• [21]Lindblom GB, Ahren C, Changalucha J, Gabone R, Kaijser B, Nilsson LA: Campylobacter jejuni/coli and enterotoxigenic Escherichia coli (ETEC) in faeces from children and adults in Tanzania. Scand J Infect Dis 1995, 27:589-593.
• [22]Akitoye OC, Raphael D, Isokpehi , Bolaji N, Akitoye OC, Raphael D, Isokpehi WW, Thomas BN, Amisu KO, Larry Obi C: Human Campylobacteriosis in Developing Countries. Emerg Infect Dis 2000, 8(3)):237-241.
• [23]Ashraful H, Rahman KM: Campylobacter jejuni as a cause of acute diarrhoea in children: a study of an urban hospital in Bangladesh. J Trop Med Hyg 1991, 94:50-54.
• [24]David NT, Martin JB, Peter EP, Bodhidatta L, Wang WLL: Erythromycin- Resistant Campylobacter Infections in Thailand. Antimicrob Agents Chemother 1987, 31:438-442.
• [25]Mehdi M, Dallal S: Diarrhea Caused by Enteropathogenic Bacteria in Children. Arch Iran Med 2001, 4:201-206.
• [26]Grados O, Bravo N, Black RE, Butzler JP: Pediatric Campylobacter diarrhea from household exposure to live chickens in Peru Lima. Bulletin of WHO 1998, 66(3):369-374.
• [27]Asrat D, Hathaway A, Ekwall E: Studies on enteric Campylobacteriosis in Tikur Anbessa and Ethio-Swedish children's hospital, Addis Ababa, Ethiopia. Ethiop Med J 1999, 37:71-84.
• [28]Hassan A, Abdualbaki A, Khald A: Epidemiology, clinical features and antibiotic susceptibility of Campylobacter infections in Sanaa, Yemen. Journal of Chinese Clinical Medicine 2007, 2(8):445-463.
• [29]Calva J, Palacios GM, Lopez-Vidal A: Cohort study of intestinal infection with Campylobacter in Mexican children. Lancet 1988, 1:503-506.
• [30]Richard S, Hopkins MD, Olmsted BS, Gregory R, Istre MD: Endemic Campylobacter jejuni Infection in Colorado: Identified Risk Factors. Am J Public Health 1984, 74:249-250.