Search

Background: Nosocomial infection is defined as an infection, which is not present or incubating on admission and is usually not manifested in the first 72 hours of hospitalization. Infectious diseases including hospital acquired infections account for 25% of mortality worldwide and 45% in low-income countries Objective: To assess the susceptibility pattern of the bacterial causes of common nosocomial infections and their susceptibility pattern in surgical patients. Methods: A one-year prospective survey of nosocomial infections of surgical patients admitted in 1999-2000 at Tikur Anbesa Hospital (TAH) and Saint Paul Hospital (SPH) was performed. The samples were collected and processed following standard microbiological techniques as part of the routine clinical management of the patient. Antibiotic sensitivity testing was done on pure culture isolates employing the disc-diffusion method for the commonly used antibiotics Results: A total of 133 patients in Tikur Anbesa (69) and Saint Paul (64) were found to have nosocomial infection among surgical patients admitted in the study period making the prevalence 6.19% in TAH and 5.74% in SPH. Wound infection was the leading nosocomial infection 36(52.1%) in TAH and 54(79%) in SPH followed by urinary tract infection 26 (38%) in TAH and 10(15.9%0) in SPH. The most frequently isolated organisms were Escherichia coli 16(25.4%) in TAH and 29(46.0%) in SPH, followed by Klebsiella 22(34%) in TAH, 13 (25.4%) in SPH and Proteus species 5(6.8). The percentage of resistant strains to Gentamycin was found to be 56% in samples taken from Hospital acquired infection at TAH. The resistance level is even higher for the penicillin group such as, crystalline penicillin and ampicillin which is (95%) of isolates from nosocomial infection Conclusions: Most isolates from hospital-acquired infection were found to be resistant to the most frequentl used antibiotics in the setting where the study was conducted., Ethiopian Journal of Health and Biomedical Sciences, Vol. 2 No. 1 (2009): ETHIOPIAN JOURNAL OF HEALTH AND BIOMEDICAL SCIENCES

Samples of 15 different fruit and vegetable types were purchased from five small groceries around Addis Ababa. Enumeration, isolation and identification processes were performed for the microbial flora of each sample before and after 15-30 days of preservation. Both direct and enrichment culture media were used to distinguish these microflora as members of the groups of normal contaminants, indicators, spoilage and foodborne disease causing organisms. The overall result of this work indicates that a total of 25 different organisms, comprising 3 (12%) indicators, 15 (60%) spoilage, 5 (20%) food-borne pathogens and 2 (8%) normal contaminants, were isolated. The predominant isolates of these groups were Escherishia coli type I, among the indicators Bacilli, molds and Enterobacter species among the spoilage and Staphylococcus aureus, Salmonella typhimurium and Bacillus cereus among the pathogens. The direct inoculation method revealed the isolation of more than one indicator organisms from each of 7 (46.7%) fresh or unpreserved fruit and vegetable samples, more than 3 spoilage organisms from each of 8 (53.3%) samples, and, at least, one pathogenic organism from each of another 8 (53.3%) samples. When enrichment culture method was applied, all these results were increased as: >1 indicators in 10 (67%), >3 spoilage organisms in 9 (60%), and pathogens in 9 (60%) of the unpreserved samples. The enumeration values of the indicator/organisms and the spoilage groups of mesophyllic aerobes/anaerobes, molds and/or yeasts were all above the accepted limits for such fruits and vegetable samples. This was shown to be true in 10 (66.7%), 4 (26.7%) and 6 (40%) samples for the indicators, spoilage mesopheles, and mold or yeasts respectively. The preservation processes have proved to be effective in eliminating or reducing the numbers and types of the organisms isolated from each fresh sample. The effectivity of the preservation methods is discussed and its applicability in a simplified and comprehensive manual for a small-scale (household level) preservation of fruits and vegetables has been recommended.

Using the Thin Layer Chromatographic (TLC) methods of the AOAC procedures, the aflatoxin content of 486 samples of six cereal varieties was determined and 71 (14.6%) of these were found to be positive, anging from 9 mcg/kg to 39.0 mcg/kg. Of these, 23 (32.4%) were maize grains followed by the white sorghum, 12 16.9%) and mixed sorghum, 11 (15.5%). The positive numbers of white, mixed and red teff samples were significantly as low as 7 (9.8%),8(11.3%) and 10 (14.1%), respectively. Similarly, out of the 60 injera samples tested only 1 (5%) sample of teff injera was positive at the 7th day of storage, while 5 (25%) and 7 (35%) samples of maize and sorghum respectively, were positive after the 4th day of storage. In all cases, it was observed that some environmental factors like temperature, moisture content and relative humidity have influenced the aflatoxin formation in the examined samples. It was also confinned that poor storage conditions like open sacs in market areas and warehouses were more conducive to aflatoxin formation than the modern silo bin storage systems. Although the maximum level of aflatoxin yield (39 mcg/kg) determined in this study is not much greater than the accepted standard limit (30 ppb ), it is possible to deduce that maize and sorghum are more susceptible to aflatoxin accumulation than teff grains both before and after baking. In view of these results, therefore, we consider it necessary to recommend some essential measures of controlling food materials for aflatoxin contamination.

The distribution and frequency of some Sills among 282 female sex workers in Addis Ababa randomly selected out of a larger group subjected to HIV serosurvey was studied. Demographic and social information, clinical examination including use of speculum and laboratory detection of Sill pathogens were performed following an informed consent of all participants. An alarmingly high prevalence of Sills was found in the study population. Gonorrhoea was detected in 78 subjects (30.1%), trichomoniasis in 62 (23.9% ), vaginal candidiasis in 51 (19.7% ) and out of 203 sera studied 76 (37.4% ) were positive for syphilis. The duration in sex work was found to have a significant association with seropositivity for syphilis (p < 0.001). Neither the marital status nor regular intake of oral pills influenced the prevalence of Sills. Further laboratory investigation on a broader panel of STDs along with KAPB studies for assessment and evaluation of social and behavioral determinants related to sex work are recommended.

Cervical and vaginal discharge samples, collected from282 randomly selected prostitutes of Addis Ababa, were examined for Sill causative agents. The subjects represented 900 females included in the 1990 sero-survey-for HIV infection. The results of the laboratory tests indicated that 117 (41.5%) of the examined females had a single infection by one of the five organisms tested for, while the others 18.1 % had experienced mixed infections of two organisms, and 4.2% of three organisms. The five organisms included Neisseria gonorrhoea isolated from 78 subjects (28.1 %), Trichomonas vaginalis -from 56 (20.6%), Candida albicans -from 40 (14.7%), and Gardnerella vaginosis -associated clue cells -from 27 individuals (9.9%). The presence of syphilis infection was indicated by the TPHA test in 72 subjects, representing 37.3% of the study samples. Among the N. gonorrhea isolates, PPNG strains comprised 57 (73.0%). Resistant strains were obtained to penicillin in 100.0%, ampicillin in 96.0%, bactrim (sxt) in 80.7%, among the PPNG strains; 19.1% of the NPPNG strains to penicillin, 38.1% to kanamycin, 66.6% of a bactrim and 66.7% of ampicillin. Both groups were, however, sensitive to erythromycin, tetracycline, chloramphenicol, norfloxacin, spectinomycin and ceftriaxone. Significant correlation was observed between these results and the MIC values obtained for each drug.

This study was conducted to investigate a reported diarrhoeal diseaseboutbreak among higher education students recruits in Bilate Military Training Centre, Sidamo Administrative Region, Out of the total patients of 5,248 who visited at the out-patient department 1,616 (30.1% ) were patients with diarrhoea. There were 99 patients admitted to the hospital out of which 27 (27.2 % ) were diarrhoeal patients. There ere no deaths reported. A total of 965 (75.6%) were treated with antimicrobial, mainly Tetracyclines, Chloramphenicol, Metronidazole and Chloroquine. Only 114 (8.9% ) were treated with Oral Rehydration Salts (ORS) while 86 (7.11 % ) with Anti-diarrhoeal (Charcoal) and ORS. There was no proper excreta disposal and the water source was found to be bacteriologically non-potable. Among the 34 stool specimens collected for culture and sensitivity tests, the genus Shigella was isolated in 6 patients; where 4 were higellaflexneri (Group B) and 2 were Shigella dysenteriae (Group A) one type 1 (Shiga's Bacillus) and the other type 2 (Schmittz's Bacillus). Shigella dysenteriae serogroups 1 and 2 showed resistance to eight and seven drugs including Trimethoprim Sulpha-Methoxazole (TSM) respectively. This study highlights the importance of safe water and improvement of general hygiene and environmental sanitation for prevention and control of epidemics and indicates the importance of continuous surveillance of drug resistant Shigella for the control of outbreaks of Shigellosis.

We report methods used to characterize an outbreak of food-borne acute toxicity among the labour force of a cotton plantation in Middle Awash Agricultural Development Enterprise in July and August 1984. Among 1492 patients seen at the Enterprise and Ministry of Health clinics during this period, 688 (46.1% ) exhibited unusual sign and symptoms. Thirty three patients required hospitalization for intensive medical care while nine patients were reported to have died due to this condition. Contamination of corn flour with pesticides was initially suspected and laboratory animal tests were carried out which failed to show any signs of acute toxicity. Investigation of the source of the corn and its processing was simultaneously conducted and revealed the contamination of the corn with seeds of an indigenous plant identified as Daturastramoniwn, an antimuscarinic alkaloid. These alkaloids contain hyoscine and hyoscyamine which is known to have toxic effect on the exocrine glands, heart, and the autonomic nervous system in man. Signs and symptoms observed in the patients and preventive measures implemented are discussed.

Background. Listeriosis, a bacterial disease in humans and animals, is mostly caused by ingestion of Listeria monocytogenes via contaminated food and/or water, or by a zoonotic infection. Globally, listeriosis has in general a low incidence but a high case fatality rate. Objective. The objective of this study was to investigate the occurrence, antimicrobial profiles, and genetic relatedness of L. monocytogenes from raw meat and dairy products (raw milk, cottage cheese, cream cake), collected from the capital and five neighboring towns in Ethiopia. Methods. Two hundred forty food samples were purchased from July to December 2006 from food vendors, shops, and supermarkets, using a cross-sectional study design. L. monocytogenes were isolated and subjected to molecular serotyping. The genetic relatedness and antimicrobial susceptibility patterns were investigated using pulsed-field gel electrophoresis (PFGE) and minimum inhibitory concentration determinations. Results. Of 240 food samples tested, 66 (27.5%) were positive for Listeria species. Of 59 viable isolates, 10 (4.1%) were L. monocytogenes. Nine were serotype 4b and one was 2b. Minimum inhibitory concentration determination and PFGE of the 10 L. monocytogenes isolates showed low occurrence of antimicrobial resistance among eight different PFGE types. Discussion and Conclusions. The findings in this study correspond to similar research undertaken in Ethiopia by detecting L. monocytogenes with similar prevalence rates. Public education is crucial as regards the nature of this organism and relevant prevention measures. Moreover, further research in clinical samples should be carried out to estimate the prevalence and carrier rate in humans, and future investigations on foodborne outbreaks must include L. monocytogenes.

The aerobic gram-negative microbiota and virulence properties of Escherickia coli were studied in 157 rectal biopsy specimens from 50 patients with a first attack of inflammatory bowel disease (IBD) and in 56 such specimens from 20 patients with infectious colitis or infectious-type colitis (non-relapsing colitis, NRC). E. coli strains that produced both haemolysin, enterohaemolysin or colicin were found to a similar extent in IBD and NRC. E. coli strains carrying recognised virulence factors, such as enterotoxins and adhesins, were rarely isolated from patients of either group. No property was found more often in active than in inactive phases of the disease. In addition, the properties of E. coli were evenly distributed between ulcerative colitis and Crohn’s disease. E. coli strains belonging to classical enteropathogenic or enteroinvasive serotypes were not isolated. Non-motile E. coli lacking H antigen were isolated to a similar extent in IBD and NRC. Repeated isolation of the same serotype of E. coli was more common in IBD (P

Escherichia coli strains were isolated as the dominating organism of faecal cultures from 65 children with acute diarrhoea, 13 with persistent diarrhoea and from 35 healthy controls in whom Salmonella sp, Shigella sp or Campylobacter jejuni were not isolated. Nor were parasites detected. Enterotoxigenic E. coli were the most commonly detected enterovirulent organism. Enteroaggregative E. coli were also isolated more frequently from cases than controls ( p

No Abstract. Keywords : Antibiotic resistance; Ethiopia; Prevalence; Shingella Ethiop. J. Bio. Sci. Vol. 3 (2) 2004: pp. 191-235

Objective: To determine antimicrobial susceptibility and resistance of Yersinia enterocolitica, Shigella, E.coli and Salmonella isolated strains from diarrhoeal out-patients. Design: A cross-sectional study.Setting: Ethiopian Health and Nutrition Research Institute (EHNRI) in Addis Ababa Ethiopia. Subjects: Fifty one strains of enteric pathogenic bacterial isolates from 205 diarrhoeal out-patient cases. Results: All fifty one strains of enteric pathogenic bacterial isolates were sensitive to nalidixic acid, norfloxacin, and polymyxin B and 46 strains were resistant to cephalothin. Sensitivity to gentamycin, nalidixic acid, norfloxacin and polymyxin B is greater than 90% for the tested strains, while resistance to cephalothin, ampicillin and tetracycline was greater than 50%. All strains of Yersinia enterocolitica were sensitive to carbenicillin, chloramphenicol, gentamycin, kanamycin, nalidixic acid, norfloxacin, polymyxin B, streptomycin, sulphadiazene and trimethoprim-sulphamethoxazole. All strains of Yersinia enterocolitica were resistant to ampicillin. All of the 12 strains of Shigella were sensitive to nalidixic acid, norfloxacin, polymyxin B, gentamycin and kanamycin. Ampicillin, carbenicillin, cephalothin, streptomycin sulphadiazene, tetracycline and trimethoprimsulphamethoxazole were sensitive against

Objectives: To examine the impact of sexually transmitted diseases (STD) syndromic treatment on genital shedding of HIV and the impact among women in whom STD treatment was not successful. Design: Seventy-one HIV-infected women were included; 60 had symptomatic STD [72% with genital discharge syndrome (GDS) and 28% with genital ulcer syndrome (GUS)] and 11 controls did not have symptomatic STD. Cervical HIV load in 94% women was measured at baseline and after STD treatment. Results: Cervical HIV load at entry was significantly higher in women with symptomatic STD than in controls [median, 3.15; interquartile range (IQR), 1.90-3.34 versus median, 1.90; IQR, 1.90-2.19 log 10 RNA copies/swab, respectively; P=0.024]. Women with STD were also more likely to have detectable cervical HIV RNA (68% versus 27%; P= 0.016). Cervical HIV load was significantly higher in women with GUS than in those with GDS (median 3.46; IQR, 2.84-4.18 versus median, 2.83; IQR, 1.90-3.31 log 10 copies/swab; P = 0.019). There was no significant reduction in genital HIV shedding after syndromic treatment of GDS or GUS. However, significant decreases were limited to only those with clinical improvement (median, 2.91; IQR, 1.90-3.45 versus median, 2.25; IQR, 1.90-3.08 log 10 RNA copies/swab, respectively; P= 0.006). GUS was significantly associated with treatment failure, independent of plasma HIV RNA load and CD4 T-cell count (odds ratio, 4.79; 95% confidence interval, 1.32-17.46). Conclusions: The fact that STD syndromic treatment impacts very little in reducing genital HIV shedding underscores the need for appropriate validation of STD syndromic diagnosis and management to control heterosexual transmission of HIV.

In 1992, HIV/AIDS researchers in Amsterdam, the Netherlands, were invited to work in partnership with researchers in Ethiopia to build an HIV/AIDS research infrastructure in Addis Ababa. This project, which began in 1994, was envisioned to contribute meaningfully to fighting the HIV pandemic in the decades to come. Its immediate objective was to establish an HIV research laboratory to serve international partnerships pursuing HIV vaccine research in Ethiopia and to support national health authorities fighting the HIV epidemic in Ethiopia. The overall goal was to develop research capacity at the Ethiopian Health and Nutrition Research Institute (EHNRI) by improving facilities, training technical and academic personnel (at PhD, MSc, and MPH level), establishing cohort studies to study HIV infection progression, and helping the government to implement a national HIV surveillance program. In the period 1994-2002, the projected HIV/AIDS research laboratory was built and several existing sections of EHNRI were renovated and upgraded. An active HIV-research program was established. Staff grew to more than 60, including three Ethiopian and three expatriate research/managers. Two PhD. students have graduated in immunology and virology (University of Amsterdam, 2000), and five are currently in training. Several technical persons were trained and over 19 MSc/MPH-programs were supported at Addis Ababa University (AAU). The first Ethiopian PhD graduate became the national program manager for ENARP. Two ENARP cohort studies and several HIV-prevalence studies have helped to document the severity of the HIV epidemic in Ethiopia, assisting national authorities in formulation of national and regional policies to prevent HIV transmission. Initial funding for ENARP from the Netherlands government was projected for eight years, to end by 2003. It was expected that management responsibilities would then be transferred from expatriate to Ethiopian staff and all ENARP activities integrated into EHNRI.

The anti bacterial activity of polar and non-polar extracts prepared from the roots of Plumbago zeylanica L. (Plumbaginaceae), a plant widely used in Ethiopian traditional medicine for various ailments were investigated using hole plate diffusion method against some pneumonia causing pathogens. The aqueous extract did not exhibit any activity while petroleum ether extract was found to have strong anti-bacterial effects as compared to the ethanol extract which showed a significant activity. Activity guided chromatographic purification of the petroleum ether extract led to the isolation of three compounds, of which the compound identified as 5-hydroxy-2-methyl-1, 4-naphthoquinone, plumbagin, found to be the active component on the tested microorganisms. Minimum inhibitory concentration value of this particular compound showed comparative activity resembling the commonly used broad spectrum antibiotic, tetracycline. The strong antibacterial effect of the petroleum ether extract is discussed to show that it was attributable to this compound rather than the other two that were found to have trace of activities. Key words/phrases: Anti-bacterial activity, Minimum inhibitory concentration, Plumbago zeylanica, pneumonia SINET: Ethiopian Journal of Science Vol.25(2) 2002: 285-294