Bacterial etiologies of diarrhea and antimicrobial resistance profile of the isolates among under- five years children attending at Mizan-Tepi University Teaching Hospital, Southwest Ethiopia

Abstract

Background: Diarrheal disease remains a leading cause of morbidity and mortality mainly among under five years of children in low and middle income countries. Bacteria, particularly gram-negative enteric bacterial pathogens are the most common cause of infectious diarrhea in children, especially in developing countries. The challenge of antibiotic resistance is other problem that becoming getting increased day by day alarmingly, hence results infections due to enteric pathogens either more difficult to treat or untreatable. Thus the study was designed to determine bacterial etiologies of diarrhoea and antimicrobial resistance profile of the isolates among under-five years children attending at Mizan-Tepi university teaching hospital Method: Cross-sectional study was conducted at Mizan-Tepi university teaching hospital from January to April, 2023. A systematic sampling technique was used to select study participants. Stool samples were collected from selected children under five years of age and inoculated onto MacConkey & SS/XLD media. Those show the growth of microorganisms was identified by biochemical tests, and then antimicrobial sensitivity tests were done by disk diffusion method against selected classes of antimicrobials for the isolated organism. The data was entered into epidata version 4.0.2 and analyzed by SPSS version 26.0. Descriptive statistics, such as frequencies and percentages were computed and the results were presented as text, tables and/or graphs. Results: A total of 344 bacterial isolates were isolated from stool sample of 298 diarrheic under-five year children. Ninety nine percent of cultured stool samples were positive at least for one type of bacterial species. The predominant isolated bacteria were Escherichia coli 119(34.6%), followed by Klebsiella pneumoniae 51(14.8%) and Shigella species 39(11.3%). Salmonella typhi and others Salmonella species accounted for 17(4.9%) and 19(5.5%) respectively. The range of resistance for tested isolates against selected antimicrobial was ranged from 0% to 66.7%. Escherichia coli showed relatively higher resistance against amoxicillin-clavulanate 67/119(56.3%) and doxycycline 66/119 (55.5%). The rate of resistance to cefotaxime was 12/19(63%) for Salmonella species, 8/17(47%) for Salmonella typhi and 16/39 (41%) for Shigella species. The overall prevalence of multidrugresistant isolates was 140/344 (40.7%), of which 109/140/ (77.9%) and 31/140 (22.1%) were MDR and XDR respectively. Conclusion and recommendation: In this study, the isolated enteric bacteria consist of potential pathogens of gastrointestinal tract infections and normal fecal coliforms. The rates of drug resistant bacteria against tested antibiotic in diarrheic under-five year children were high. This highlights the importance of implementing the most effective public measurement to prevent further emergency and spread of multidrug resistant bacteria