Identification and antimicrobial resistance patterns of bacterial enteropathogens from children aged 0-59 months at the University Teaching Hospital, Lusaka, Zambia: a prospective cross sectional study.
Bacterial diarrhoeal disease is among the most common causes of mortality and morbidity in children 0-59 months at the University Teaching Hospital in Lusaka, Zambia. However, most cases are treated empirically without the knowledge of aetiological agents or antimicrobial susceptibility patterns. The aim of this study was, therefore, to identify bacterial causes of diarrhoea and determine their antimicrobial susceptibility patterns in stool specimens obtained from the children at the hospital.



This hospital-based cross-sectional study involved children aged 0-59 months presenting with diarrhoea at paediatrics wards at the University Teaching Hospital in Lusaka, Zambia, from January to May 2016. Stool samples were cultured on standard media for enteropathogenic bacteria, and identified further by biochemical tests. Multiplex polymerase chain reaction was used for characterization of diarrhoeagenic Escherichia coli strains. Antimicrobial susceptibility testing was performed on antibiotics that are commonly prescribed at the hospital using the Kirby-Bauer disc diffusion method, which was performed using the Clinical Laboratory Standards International guidelines.



Of the 271 stool samples analysed Vibrio cholerae 01 subtype and Ogawa serotype was the most commonly detected pathogen (40.8%), followed by Salmonella species (25.5%), diarrhoeagenic Escherichia coli (18%), Shigella species (14.4%) and Campylobacter species (3.5%). The majority of the bacterial pathogens were resistant to two or more drugs tested, with ampicillin and co-trimoxazole being the most ineffective drugs. All diarrhoeagenic Escherichia coli isolates were extended spectrum β-lactamase producers.



Five different groups of bacterial pathogens were isolated from the stool specimens, and the majority of these organisms were multidrug resistant. These data calls for urgent revision of the current empiric treatment of diarrhoea in children using ampicillin and co-trimoxazole, and emphasizes the need for continuous antimicrobial surveillance as well as the implementation of prevention programmes for childhood diarrhoea.
Department of Epidemiology and Biostatistics, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Science, Dar es Salaam, Tanzania.|Tanzania Field Epidemiology and Laboratory Management Program, Ministry of Health, Dar es Salaam, Tanzania.
Harriet
H
Chiyangi
Department of Disease Control, School of Veterinary, University of Zambia, Lusaka, Zambia.
John B
JB
Muma
Health Promotions Research Program, Institute of Economic and Social Research, University of Zambia, Lusaka, Zambia. sydneymalama1971@gmail.com.
Sydney
S
Malama
Health Promotions Research Program, Institute of Economic and Social Research, University of Zambia, Lusaka, Zambia.
Joel
J
Manyahi
Tanzania Field Epidemiology and Laboratory Management Program, Ministry of Health, Dar es Salaam, Tanzania.
Ahmed
A
Abade
Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia.
Geoffrey
G
Kwenda
Department of Microbiology and Immunology, School of Medicine, Muhimbili University of Health and Allied Science, Dar es Salaam, Tanzania.
Mecky I
MI
Matee
D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D002167:Campylobacter / Q000302:isolation & purification; D002169:Campylobacter Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D004405:Dysentery, Bacillary / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D015995:Prevalence; D011446:Prospective Studies; D012760:Shigella / Q000302:isolation & purification; D015024:Zambia / Q000453:epidemiology
D000900:Anti-Bacterial Agents
Antimicrobial; Bacteria; Children; Diarrhea; Zambia