Isolation and antimicrobial susceptibility pattern of Staphylococcus aureus in patients with surgical site infection at Debre Markos Referral Hospital, Amhara Region, Ethiopia

BACKGROUND: Staphylococcus aureus, especially Methicillin Resistant Staphylococcus Aureus (MRSA) is a major health problem recognized as the most important nosocomial pathogen, often causing postoperative wound infections. Antibiotic resistance by MRSA has grown to be common, and resistance to almost all antibiotics has been found among these strains. The aim of this study was to determine the prevalence, antimicrobial susceptibility patterns and associated risk factors of S. aureus in patients with surgical site infections in an Ethiopian hospital. METHODS: A cross-sectional study was conducted from December 1, 2011 to March 30, 2012 among patients with surgical site infections at Debre Markos Referral Hospital, Debre Markos, Ethiopia. All wound swabs obtained from patients with surgical site infections during the study period were cultured on mannitol salt agar media which is selective for S. aureus. Isolated strains of S. aureus were tested for antibiotic susceptibility patterns using standard disc diffusion technique, and interpretation of resistance was done based on Clinical and Laboratory Standard Institute criteria. Univariate and multivariable analyses were used to assess the risk factors. RESULTS: Of the 184 surgical patients who had developed surgical site infection, S. aureus was isolated from 73 (39.7%) cases. Out of the 73 isolates of S. aureus, 36 (49.7%) were MRSA. Among the study participants, prevalence of MRSA was found to be 19.6%. The clinical isolates showed >80% level of resistance to ampicillin, amoxicillin, penicillin G, erythromycin, gentamicin and cotrimoxazole whereas <50% level of resistance was observed against clindamycin, oxacillin, tetracycline and vancomycin. MRSA strains showed resistance ranging from 5.6% (vancomycin) to 100% (cotrimoxazole). Of the following risk factors: sex, age, pus consistency, duration of operation, type of surgery, ward and hospital stay, laparotomy type of surgery was identified as a risk factor for infection by S. aureus. CONCLUSION: The prevalence of S. aureus and/or MRSA infection in surgical and gynaecology & obstetrics wards of Debre Markos Referral Hospital was found to be high. The majority of isolates were highly resistant to major antimicrobial agents

Bacteriological profile of burn patients at Yekatit 12 Hospital Burn Center, Ethiopia: A longitudinal study

Introduction: Burn is one of the most common devastating and a very painful form of trauma. Significant thermal injuries induce a state of immune-suppression that predisposes burn patients to infection complications.Materials and methods: A prospective hospital based study was carried out from December 2010 to February 2011 at Yekatit 12 hospital burn center. Periodic wound swabs and blood samples were collected on 1st, 7th, and 14th days of hospital stay and processed with conventional culture and biochemical tests. Isolates were tested against commonly used antibiotics by Modified Kirby-Bauer disc diffusion methods. Data were analyzed by SPSS version 17.0 for Windows.Results: From the total of 104 pus cultures, 101 isolates were identified. At the 1st day of pus culture the dominant isolate was Staphylococcus aureus 15(46.9%). On the 7th day of pus culture S. aureus 21 (46.1%) and Pseudomonas spp 20 (44.4%) were isolated. Similarly, at the 14th day the most frequent isolates were S. aureus 12 (50%) and Pseudomonas spp11 (45.8 %). There was no significant change on time regarding blood culture isolates. Of 92 blood cultures, 15 gram positive isolates were identified the majority being coagulase negative staphylococci (CoNS), 8 (53.3%). Gram negative isolates, mainly Pseudomonas spp were found resistant for most of antibiotics used in the hospital.Conclusions: The nature of periodic microbial wound colonization, flora changes and their antibiotic susceptibility pattern should be taken into consideration in empirical antimicrobial treatment of burned patients

Bacterial Profile and Antimicrobial Susceptibility Pattern of Isolates Among Burn Patients at Yekatit 12 Hospital Burn Center, Addis Ababa, Ethiopia

Background: Infection is a common cause of morbidity and mortality in burn patients. Clinical diagnosis of bacteremia and/or sepsis in burn patients is difficult for a number of reasons. It could be symptomatic and/or asymptomatic as a result of immune deficiency secondary to thermal injury.Methods: A cross sectional study was conducted at Yekatit 12 Hospital Burn Center. Blood specimen and wound swab were collected from burn patients and were cultured by conventional method. Sensitivity/susceptibility pattern of the isolates was determined by disc diffusion method. Some of the risk factors of bacteremia like prior antibiotic use and total body surface area burn were also determined.Results: Fifty patients were enrolled in the study of whom 21(42%) were found bacteremic. Five different bacteria were isolated from blood specimen. Coagulase negative Staphylococci, 9(42.8%), S. aureus, 8(38.2%), Bacillus spps, 2(9.52%), K. pneumoniae, 1(4.8%), and P. aeruginosa, 1(4.8%), were frequent isolates. From wound swab, S. aureus, (34.04%), and P. aeruginosa, (31.8%), were predominant. Antimicrobial resistance was observed for Ampicillin, (77.4%), Doxycycline, (74.0), Nalidixic acid, (70.5%), Penicillin G, (68.2%), and tetracycline, (67.5%). Total body surface area of burn ≥ 15% was found as a risk factor for bacteremia.Conclusion: Bacteremia was detected at a rate of 42% among burn patients. Frequent isolates were S. aureus, (34.04%), and P. aeruginosa, (31.8%). About 82.16% of the isolates showed multiple resistances. In light of our findings, regular antibiotic resistance test has to be done for each patient in order to select an appropriate antimicrobial agent.Keywords: Bacteraemia, Burn, Sepsis, Thermal injur

Phenotypic and Allelic Distribution of the ABO and Rhesus Blood Groups among students at Hawassa University, Ethiopia

A prior information on the distribution of ABO and Rh groups is important for management of blood bank and transfusion, genetic counseling, anthropological studies, to study the association of blood groups and diet; to investigate the association between blood and diseases. This study aimed to determine the frequency of ABO and Rh bloods and investigate gene diversity at both loci among students in Ethiopia.  A descriptive cross-sectional survey was employed involving randomly selected two thousand thirty nine (2039) university students (1054 males and 985 females) with an age range of 18–29 years. Blood groups were determined based on agglutination reaction. The most common blood group was found to be O (42.47%), followed by A (27.86%), B (21.87%), and AB (7.80 %). The frequency of Rh+ and Rh- were 90.88% and 9.12 %, respectively. The combined blood types showed O+, A+, B+ and AB+ were: 38.60 %, 25.20%, 20.10%  and 7.00%, respectively. A slightly different distribution pattern of ABO blood group was observed among females from Amhara region (O> B> A>AB). The distribution of ABO phenotypes from Addis Ababa and Amhara did not differ significantly from those expected under the Hardy Weinberg Equilibrium. A high level of gene diversity was observed for both loci. In general, the O blood type is most frequent and followed by A, B and AB. A similar pattern of distribution of the ABO and Rh blood groups was found in male and female study subjects. The present study will generate baseline data that could be used in blood bank management and transfusion, genetic counseling, population genetic and anthropological studies, and for disease management

Prevalence of Neisseria gonorrhea and their antimicrobial susceptibility patterns among symptomatic women attending gynecology outpatient department in Hawassa Referral Hospital, Hawassa, Ethiopia

BACKGROUND: gonorrhoeae, a sexually transmitted disease caused by Neisseria gonorrhea for which humans are the only natural host. The causative organism is highly adapted to the genital tract and often causing asymptomatic and undetected infection in females in which Acquisition of gonococcal infection late in pregnancy can adversely affect labor and delivery as well as the well-being of the fetus. The aims of this study were to determine the prevalence and drug susceptibility pattern of Neisseria gonorrhea among symptomatic women in Hawassa Referral Hospital.METHODS: A cross-sectional study was conducted from December 1 2010 to February 30, 2011 at Hawassa Referral Hospital. All women who visited gynecology outpatient department (OPD) with suspected gonococcal infection were included. Endocervical swab was collected by the attending physician. The presence of gonorrhea was confirmed by culture, gram staining and biochemical tests. Antimicrobial sensitivity test was performed using disc diffusion method and the result was interpreted accordingly. RESULTS: Of the total 215 cases examined, 11 (5.1%) were confirmed to have gonococcal infection. Although not statistically significant, most of the cases 5/11 (45.5%) were in age group of 20-24 years and the identified organism had low level susceptibility to quinolones (ciprofloxacin 55%, ofloxacin 64% & lomefloxacin 64%).CONCLUSION: Despite low rates of gonorrhea infection, it is important to focus on high-risk populations (reproductive age group) because of the great physical and emotional costs of the disease. A high resistance for quinolones, the commonly used antibiotics was observed for this laboratory-based diagnosis is recommended. Keywords: Neisseria gonorrhea, drug susceptibility, symptomatic women, Southern Ethiopi

Internationalisation and Globalisation of Higher Education: Implications for Africa's Higher Education System

While governments are responsible for ensuring that their national education systems adequately meet the human resource needs of their countries, the provision of education -- especially higher education -- is gradually shifting to the private domain and is increasingly commoditised. Amidst these global trends, the higher education sector in Africa remains poorly developed and unable to cope with increasing demand; the reason is partly caused by a focus on primary and secondary education in earlier times, and a lack of focus on the development of a tertiary education sector. Despite excess demand, Sub-Saharan Africa has, on a global basis, the lowest higher education participation rate; preventing the region from providing the specialist knowledge and skills required to support its development. This paper explores global developments in higher education in order to assess opportunities that the global higher education market can provide to Africa to help it overcome low domestic higher education opportunities

Wound trauma mediated inflammatory signaling attenuates a tissue regenerative response in MRL/MpJ mice

<p>Abstract</p> <p>Background</p> <p>Severe trauma can induce pathophysiological responses that have marked inflammatory components. The development of systemic inflammation following severe thermal injury has been implicated in immune dysfunction, delayed wound healing, multi-system organ failure and increased mortality.</p> <p>Methods</p> <p>In this study, we examined the impact of thermal injury-induced systemic inflammation on the healing response of a secondary wound in the MRL/MpJ mouse model, which was anatomically remote from the primary site of trauma, a wound that typically undergoes scarless healing in this specific strain. Ear-hole wounds in MRL/MpJ mice have previously displayed accelerated healing and tissue regeneration in the absence of a secondary insult.</p> <p>Results</p> <p>Severe thermal injury in addition to distal ear-hole wounds induced marked local and systemic inflammatory responses in the lungs and significantly augmented the expression of inflammatory mediators in the ear tissue. By day 14, 61% of the ear-hole wounds from thermally injured mice demonstrated extensive inflammation with marked inflammatory cell infiltration, extensive ulceration, and various level of necrosis to the point where a large percentage (38%) had to be euthanized early during the study due to extensive necrosis, inflammation and ear deformation. By day 35, ear-hole wounds in mice not subjected to thermal injury were completely closed, while the ear-hole wounds in thermally injured mice exhibited less inflammation and necrosis and only closed partially (62%). Thermal injury resulted in marked increases in serum levels of IL-6, TNFα, KC (CXCL1), and MIP-2α (CXCL2). Interestingly, attenuated early ear wound healing in the thermally injured mouse resulted in incomplete tissue regeneration in addition to a marked inflammatory response, as evidenced by the histological appearance of the wound and increased transcription of potent inflammatory mediators.</p> <p>Conclusion</p> <p>These findings suggest that the observed systemic inflammatory response of a severe thermal injury undoubtedly has an adverse effect on wound healing and tissue regeneration.</p

From farm to table: exploring food handling and hygiene practices of meat and milk value chain actors in Ethiopia

Livestock value chains constitute a source of livelihood for meat and milk value chain actors in Ethiopia, from dairy farmers to other associated value chain actors such as milk traders, abattoir workers, public health officials, veterinarians, butcheries selling meats, milk cooperatives, artisanal milk processors, and transporters. The development of these livestock value chains, however, is constrained by poor food safety and quality, while consumers are also exposed to public health risks due to milk and meat value chain actors’ food handling and hygiene practices. This study used Photovoice and participant observation to explore meat and milk value chain actors’ food handling and hygiene practices in suburban areas of Addis Ababa and neighbouring Oromia in Ethiopia. The results of this study reveal that milk and meat value chain actors’ food handling practices are not aligned with the recommended Ethiopian food safety and quality standards. Low compliance with food safety and quality standards reflected a combination of factors such as lack of incentives, poor road infrastructure and low enforcement of food safety standards. Participatory and visual research methods enable a researcher to collect context-aware data that can lead to the development of policies and intervention strategies that reflect local needs and priorities. The results of this study affirm the need to identify socially acceptable and economically viable policies and intervention strategies that are acceptable to all chain actors; and suggest there is an imperative to train milk and meat value chain actors on good hygiene handling practices, improve road infrastructure, and facilitate access equipment such as fridges and freezers that can contribute to maintaining food safety and quality

Antimicrobial resistance through the lens of one health in Ethiopia: a review of the literature among humans, animals, and the environment

OBJECTIVES: We aimed to review and describe antimicrobial resistance (AMR) prevalence in humans, animals, and the environment in Ethiopia. METHODS: We conducted a structured review of the literature on AMR in humans, animals, and the environment in Ethiopia from 2016 to 2020. We reported the pooled prevalence of AMR of bacterial pathogens in all three sectors. RESULTS: We included 43 articles in our review. Only five studies evaluated AMR across multiple sectors. The most common bacteria in humans were Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus. High prevalence of resistance to third-generation cephalosporins, fluoroquinolones, and sulfamethoxazole-trimethoprim were seen in gram-negative organisms, often with >50% prevalence of resistance. Highest resistance rates were seen in humans, followed by environmental isolates. Salmonella spp. exhibited higher rates of resistance than previously reported in the literature. We found methicillin-resistant S. aureus (MRSA) in approximately half of S. aureus from the environment and a third from human isolates. Few studies evaluated AMR across all three sectors. CONCLUSION: Our review demonstrated high prevalence of AMR among bacteria in humans, animals, and the environment in Ethiopia. Integrating a One Health approach into AMR surveillance as part of Ethiopia's national surveillance program will inform future implementation of One Health interventions

Implementing a one health approach to strengthen the management of zoonoses in Ethiopia

In East Africa, a region with many endemic and emerging zoonoses, and in countries such as Ethiopia in particular, One Health (OH) approaches are increasingly seen as effective ways, to mitigate the risk of zoonoses at the interface between human, animal and the environment. The OH approach promotes interdisciplinary cooperation and collaboration between researchers and practitioners from the disciplines of human, animal and environmental health. Moreover, it advocates for the establishment of a public health sector model which recognises the imperative to holistically address diseases that occur in the human, animal and environmental health arena. Key informant interviews were conducted with human and animal health practitioners and academic researchers in Ethiopia to collect data on the implementation of the OH approach to manage zoonotic diseases at the human and animal health interface. Participants' observations were undertaken within animal and human health clinics and government laboratories to gather additional data. Environmental health was not considered in this study as it is not yet fully integrated into the OH approach in Ethiopia. The results reveal a lack of interdisciplinary cooperation, collaboration, and coordination between animal and human health practitioners in operationalising the OH framework in Ethiopia. Professionals in academic and non-academic institutions and organisations are interested in implementing the OH approach, however, an organisational “silo” culture constrains collaboration between institutions dealing with animal and human health. Understaffing and underfunding of institutions were also cited as major challenges to the implementation of a OH approach. Lack of interdisciplinary training for animal and human health practitioners hinders collaboration in the management of zoonoses. Policymakers need to go beyond the rhetoric to a genuine focus on reform of health management and implement policies that bridge human, animal and environmental health. There is a need for multidisciplinary and transdisciplinary training in human, animal and environmental health and collaborative research for the management of zoonoses