Antimicrobial susceptibility patterns of Streptococcus pneumoniae over 6 years at Gondar University Hospital, Northwest Ethiopia

Objective:To assess the magnitude and antimicrobial susceptibility patterns ofStreptococcus pneumoniaeisolates from various clinical specimens.Methods:A record based on retrospectivestudy was conducted at Gondar University Teaching Hospital from September 2007 to January 2012.All patients who visited Gondar University Hospital and provided clinical specimens(body fluids,discharge,swab and blood)for routine bacteriological culturing and antimicrobial susceptibilitytesting were taken for analysis.Clinical specimens were processed for bacterial culture accordingto the standard procedures.Antimicrobial susceptibility test for isolated organisms was doneusing agar disk diffusion method.The data were entered and analyzed using SPSS software version16 package.Results:One hundred and fifty threeStreptococcus pneumoniaewere isolated frompatients who visited Gondar University Teaching Hospital bacteriology laboratory for culture.Majority of the pneumococcal isolates were from inpatients[111(72.5%)],and 74(48.4%)were frombody fluids.Out of the total isolates,93(61%)were found to be resistant to at least one antibioticused for susceptibility testing.Forty eight(43.2%)of the isolates were multi-drug resistant(resistantto two or more drugs).The resistance rate noted for both ciprofloxacin 17(11.1%)and ceftriaxone15(9.8%)were alarming.Conclusions:High proportions of the isolates tend to be increasinglyresistant to the commonly prescribed drugs.The recommended drug of choice like ciprofloxacinand ceftriaxone were found to be less susceptible in the study area.Based on the findings,wetherefore recommend that antimicrobial agents should be inspected for acceptable activity beforethey are prescribed and administered empirically.Further study with a better design and surveyof antimicrobial susceptibility at large scale shoule be performed to draw advanced information.

Tuberculosis Lymphadenitis in Northwest Ethiopia: Implications for Public Health

Objective: In Ethiopia where there are limited diagnostic facilities, the actual burden of tuberculosis (TB) lymphadenitis is not well known. Therefore, we conducted this study to determine the proportion of TB lymphadenitis (TBL) in childhood and adults in Northwest Ethiopia. Materials and Methods: A prospective cross sectional study was conducted from April to May 2012. Fine needle aspiration cytology (FNAC) for cytological diagnosis of TBL was used. The diagnosis of TBL was established when cytological features from lymph node aspirates are strongly suggestive of TB. Descriptive and multivariate analysis was done using SPSS version 16. Results: Out of 1070 patients attending the cytological diagnosis in the study sites 437 (41%) were positive for TBL. Of the 437 registered TBL, 59 (13.5%) were pediatric patients and 378 (86.5%) were adults. There were more females than males with a male to female ratio of 0.8:1. The cervical region had the most common group of TBL with 321 (73.2%) patients. Most of all these patients 314 (75.3%), were matted with a majority of (250/314) being in the cervical region. Individuals who had contact history with TB patients (P = 0.046) were more likely to have TBL. Conclusions: In the studied region high prevalence of TBL was documented. Screening of TBL particularly for those who had contact with TB patients is recommended. Most patients in our study presented with matted lymph nodes, indicating that late arrival of patients to health institutions. Thus continuous and intensified public health strategies on health education and early referral system have to be done in order to link them to health institutions earlier than at present.

Smear positive pulmonary tuberculosis among diabetic patients at the Dessie referral hospital, Northeast Ethiopia

Background:Tuberculosis(TB)is an infectious disease which is still a major cause of morbidity and mortality throughout the world.People with diabetes mellitus(DM)have a three times higher risk of developing active TB than people without diabetes.However,there is not enough credible information on the burden of pulmonary tuberculosis(PTB)among DM patients in Ethiopia,in general,and in the city of Dessie,in particular.Therefore,this study aims to determine the prevalence and associated risk factors of smear positive PTB among diabetic patients at a referral hospital in Dessie.Methods:A cross-sectional study was conducted from February 2012 to April 2012.Patient demographic characteristics were collected using a pre-tested standard questionnaire format.Spot-morning-spot sputum specimens were collected from the study participants and examined for acid-fast bacilli using direct microscopy by the Ziehl-Neelsen staining technique.Data was entered and analyzed using the SPSS version 16 statistical software and p-value<0.05 was considered as statistically significant.Results:Out of 225 TB suspected diabetic patients,52%were males and 48%were females.Their ages ranged from 12 to 82 years,with a mean age of 47.2 years.Urban residence(AOR:5.5;95%CI:1.07-28.20),history of TB(AOR:13.4;95%CI:2.74-65.73),contact with TB patients in the family(AOR:9.4;95%CI:1.822-48.50),and long duration of DM(AOR:8.89;95%CI:1.88-58.12)were independently associated with the development of active TB in people living with DM.Conclusions:The prevalence of smear positive PTB was 6.2%in TB suspected diabetic patients,which is higher compared with the general population(0.39%).Patients with a previous history of contact with TB patients,as well as those who had prolonged diabetes,were more prone to have PTB.Therefore,screening of diabetic patients for PTB infection during follow-up is necessary.