Explore the vast range of titles available.

Neonatal omphalitis is a true medical emergency that can rapidly progress to sepsis and even death if not promptly diagnosed and treated appropriately. Empirical therapy is widely practised in this case, too, in low-income countries like Ethiopia, paving the way for severe drug resistance and posing serious challenges. To determine the magnitude, bacterial profile, antibiotic susceptibility patterns, and associated factors of omphalitis among clinically suspected neonates attending four government health institutions in Arba Minch, southern Ethiopia, during the second half of 2023. A facility-based multi-centred cross-sectional study was conducted among 379 clinically suspected neonates who attended the inpatient/outpatient departments and intensive care units of four government health institutes of Arba Minch from June 1 to December 28, 2023. Study participants were consecutively recruited, and their demographic and clinical data were collected using a pre-tested questionnaire. Samples were aseptically collected and inoculated onto a series of bacterial culture media, namely MacConkey agar, mannitol salt agar, chocolate, and blood agar, and different species were identified by means of several biochemical tests. Antibiotic susceptibility tests were performed through the Kirby–Bauer disc diffusion technique. Bivariable and multivariable logistic regression models (SPSS version 25) were utilized to analyze the association between dependent and independent variables; P -values ≤ 0.05 were considered statistically significant. The overall number of clinically suspected and culture-confirmed cases of omphalitis, respectively, were 379 and 130 per 1000 live births. Gram-positive (GPB) and Gram-negative bacteria (GNB) were detected in 50.4% ( n  = 71) and 49.6% ( n  = 70) of cases, respectively. The often isolated bacteria were S. aureus , 53.5% ( n  = 38), and E. coli , 47.1% ( n  = 33); GNB were highly resistant (> 60%) to tetracycline, sulfamethoxazole-trimethoprim, and ampicillin. The overall multi-drug resistance was 34.7% ( n  = 49); methicillin-resistant S. aureus was 34.1% ( n  = 14). The GNB isolates comprised extended-spectrum beta-lactamase, 15.7% ( n  = 11), and carbapenemase, 10% ( n  = 7) producers. The lack of hand washing practices [AOR = 2.08, (95% CI 1.26–3.41), P value = 0.004] and lower gestation period (< 37 weeks) [AOR = 2.3, (95% CI 1.33–3.93), P value = 0.003] were statistically associated. The overall prevalence of omphalitis was higher; WHO-prioritised drug-resistant bacterial pathogens were also detected. This study underscores the importance of factors such as maternal/caregiver hand hygiene and antenatal care. Thus, a more comprehensive approach towards the management of omphalitis employing precise diagnostic tools and an antimicrobial stewardship program is essential in all the four study settings.

Typical pneumonia is a pressing issue in the treatment of human immunodeficiency virus (HIV) patients, especially in Sub-Saharan Africa, where it remains a significant menace. Addressing this problem is crucial in improving health outcomes and the reduction of the burden of diseases in this vulnerable category of patients. To determine the prevalence of community-acquired typical pneumonia among HIV patients in Public Hospitals in southern Ethiopia. A cross-sectional study was done among 386 HIV patients clinically suspected of typical pneumonia attending the anti-retroviral therapy (ART) clinics of two hospitals from March to September 2022. A pretested structured questionnaire was employed to collect the demographic, clinical, and behavioral data. Sputum samples were collected and inspected for bacteria following standard procedures, and antimicrobial susceptibility testing was performed employing the Kirby-Bauer disk diffusion method. Besides, extended-spectrum β-lactamase (ESβL) and carbapenemase-producing Gram-negative bacteria were inspected by the double disk synergy test and modified carbapenem inactivation method. Descriptive and inferential statistical analyses were also done. Overall, 39.1% (151/386) of sputum cultures (95% Confidence Interval: 32.4-44) were bacteriologically positive. A total of 151 bacteria were identified, comprising 72.8% (n = 110) of Gram-negative bacteria. The predominant isolate was Klebsiella pneumoniae (25.8%, n = 39), followed by Staphylococcus aureus (17.9%, n = 27); 59.6% (n = 90) of the entire isolates were multidrug-resistant (MDR). Forty percent (11/27) of S. aureus were methicillin-resistant S. aureus (MRSA), and 28.1% (n = 31) and 20.9% (n = 23) of Gram-negative bacteria were extended-spectrum beta-lactamases (ESBL) and carbapenemase producers, respectively. Occupational status, alcohol consumption, cluster of differentiation4 (CD4) Thymocyte cell count < 350, interruption of trimethoprim-sulfamethoxazole prophylaxis and antiretroviral treatment, and recent viral load ≥ 150 were found statistically significant. The higher rates of MDR, MRSA, ESBL, and carbapenem-resistant Enterobacterales (CRE) indicate that bacterial pneumonia is a vexing problem among HIV patients and therefore it is advisable to implement an antimicrobial stewardship program in the study area.

Typical pneumonia is a pressing issue in the treatment of human immunodeficiency virus (HIV) patients, especially in Sub-Saharan Africa, where it remains a significant menace. Addressing this problem is crucial in improving health outcomes and the reduction of the burden of diseases in this vulnerable category of patients. To determine the prevalence of community-acquired typical pneumonia among HIV patients in Public Hospitals in southern Ethiopia. A cross-sectional study was done among 386 HIV patients clinically suspected of typical pneumonia attending the anti-retroviral therapy (ART) clinics of two hospitals from March to September 2022. A pretested structured questionnaire was employed to collect the demographic, clinical, and behavioral data. Sputum samples were collected and inspected for bacteria following standard procedures, and antimicrobial susceptibility testing was performed employing the Kirby-Bauer disk diffusion method. Besides, extended-spectrum [beta]-lactamase (ES[beta]L) and carbapenemase-producing Gram-negative bacteria were inspected by the double disk synergy test and modified carbapenem inactivation method. Descriptive and inferential statistical analyses were also done. Overall, 39.1% (151/386) of sputum cultures (95% Confidence Interval: 32.4-44) were bacteriologically positive. A total of 151 bacteria were identified, comprising 72.8% (n = 110) of Gram-negative bacteria. The predominant isolate was Klebsiella pneumoniae (25.8%, n = 39), followed by Staphylococcus aureus (17.9%, n = 27); 59.6% (n = 90) of the entire isolates were multidrug-resistant (MDR). Forty percent (11/27) of S. aureus were methicillin-resistant S. aureus (MRSA), and 28.1% (n = 31) and 20.9% (n = 23) of Gram-negative bacteria were extended-spectrum beta-lactamases (ESBL) and carbapenemase producers, respectively. Occupational status, alcohol consumption, cluster of differentiation.sub.4 (CD.sub.4) Thymocyte cell count < 350, interruption of trimethoprim-sulfamethoxazole prophylaxis and antiretroviral treatment, and recent viral load [greater than or equal to] 150 were found statistically significant. The higher rates of MDR, MRSA, ESBL, and carbapenem-resistant Enterobacterales (CRE) indicate that bacterial pneumonia is a vexing problem among HIV patients and therefore it is advisable to implement an antimicrobial stewardship program in the study area.

Background Antimicrobial resistance represents a significant public health challenge, resulting in an estimated 4.95 million deaths annually. In response to the global escalation of antimicrobial resistance in prevalent hospital-acquired infections such as surgical site infections (SSIs), the World Health Organization (WHO) has identified critical and priority pathogens necessitating research and development. Nevertheless, there remains a paucity of data from numerous developing nations. Therefore this study was conducted to evaluate the prevalence of SSIs, examine the microbial profile, and identify factors associated with SSIs, with a particular emphasis on WHO-priority pathogens during the COVID-19 pandemic at a general hospital in southern Ethiopia. Methods A cross-sectional study was conducted on 207 adult patients clinically suspected of SSIs from September 1, 2019, to November 2022. Demographic data, clinical characteristics, and surgery-related variables were collected using pre-tested, structured, interviewer-administered questionnaires and patient chart reviews. Wound samples (swabs and/or pus) were collected aseptically from each participant following standard microbiological procedures and processed for isolation and identification of pathogens by conventional culture and biochemical testing. Bacterial isolates subjected to antimicrobial susceptibility testing, including the detection of extended-spectrum beta-lactamase (ESBL) and methicillin-resistant Staphylococcus aureus (MRSA), by the standard Kirby-Bauer disk diffusion method in accordance with Clinical and Laboratory Standards Institute (CLSI) guidelines. Data were analyzed by Statistical Packages for Social Science (SPSS) version 25, and bivariable and multivariable logistic regression was done to determine the associations between dependent and independent variables. Adjusted odds ratio with 95% confidence interval (CI) was reported, and P–value < 5% was considered statistically significant. Results The overall prevalence of culture-confirmed SSIs among adult patients who underwent major surgery was 76.8% (95% CI: 71.0, 82.6). Among the 178 pathogens recovered, 58.5% were Gram-negative, 40.4% were Gram-positive, and 1.1% were Candida spp. The ESKAPE pathogens comprised 65.3% of the isolates, with S. aureus being the most common species, accounting for 43.5%, followed by K. pneumoniae (33.9%). Multidrug resistance (MDR) was observed in 84.37% of ESKAPE pathogens, with ESBL-producing and MRSA-producing isolates accounting for 88% and 76.5%, respectively. A. baumannii showed the highest MDR rate at 100%, followed by MRSA (90%) and K. pneumoniae (88.23%). Amikacin, meropenem, and piperacillin-tazobactam were effective agents against Gram-negatives, while linezolid, clindamycin, and gentamicin were most effective against Gram-positive bacteria. SSIs was significantly associated with emergency surgery ( P  < 0.001), prolonged surgery waiting time ( P  = 0.004), and clean-contaminated surgery ( P  = 0.008). Conclusion The high prevalence of MDR-ESKAPE pathogens is concerning, highlighting the need for improved infection prevention practices and antimicrobial stewardship programs.

Currently extended-spectrum β-lactamase (ESβL) and carbapenemase producing gram-negative bacteria are the greatest concern among the neonatal population with very limited therapeutic options. The aim of this study was to assess the prevalence of ESβL and carbapenemase producing gram-negative bacilli, associated factors and antimicrobial resistance patterns among neonates in intensive care units. An institutional-based cross-sectional study was conducted from February to June 2021 on 212 neonates in intensive care units. Risk factors data were collected by using a well-designed questionnaire. A rectal swab sample was collected using a sterile cotton swab and inoculated on MacConkey agar. Bacterial isolates were identified using various biochemical tests. ESβL and carbapenemase were first screened by indicator cephalosporins (cefotaxime (30µg) and ceftazidine (30µg)) and carbapenem (meropenem and ertapenem), respectively. ESβL and carbapenemase were confirmed by a double-disk synergy test and modified carbapenem inactivation methods, respectively. SPSS version 21.0 was used for data analysis. A P-value ≤ 0.05 was considered as statistically significant. The overall prevalence of ESβL-producing gram-negative bacilli was 72/212 (34%). The predominant ESβL-producing isolate was 23/72 (31.9%) followed by 17/72 (23.6%). Five (2.4%) carbapenemase-producing gram-negative bacilli were isolated. ESβL-producing isolates showed a high resistance against ampicillin 72/72 (100%), augmentin 69/72 (95.8%) and gentamycin 57/72 (79.2%). The majority 63/72 (87.5%) of isolated ESβL-producing gram-negative bacilli were multi-drug resistant (MDR). Rectal carriage of ESβL by neonates showed a statistically significant association with endotracheal intubation (p = 0.001; AOR = 4.2; 96% CI = (1.8-9.5)), treatment with ampicillin+gentamycin (p = 0.004; AOR = 3.3; 95% CI = (1.5-7.6)) and staying in a neonatal intensive care unit (NICU) between 11 and 20 days (p = 0.042; AOR = 2; 95% CI = (1.0-4.5)). A high prevalence of ESβL-producing bacterial isolates was observed for commonly used antibiotics which needs further attention. Therefore, continuous and regular follow-ups of drug resistance patterns is important for the proper treatment and management of ESβL and carbapenemase producing gram-negative bacilli.

Typical pneumonia is a pressing issue in the treatment of human immunodeficiency virus (HIV) patients, especially in Sub-Saharan Africa, where it remains a significant menace. Addressing this problem is crucial in improving health outcomes and the reduction of the burden of diseases in this vulnerable category of patients. To determine the prevalence of community-acquired typical pneumonia among HIV patients in Public Hospitals in southern Ethiopia. A cross-sectional study was done among 386 HIV patients clinically suspected of typical pneumonia attending the anti-retroviral therapy (ART) clinics of two hospitals from March to September 2022. A pretested structured questionnaire was employed to collect the demographic, clinical, and behavioral data. Sputum samples were collected and inspected for bacteria following standard procedures, and antimicrobial susceptibility testing was performed employing the Kirby-Bauer disk diffusion method. Besides, extended-spectrum [beta]-lactamase (ES[beta]L) and carbapenemase-producing Gram-negative bacteria were inspected by the double disk synergy test and modified carbapenem inactivation method. Descriptive and inferential statistical analyses were also done. Overall, 39.1% (151/386) of sputum cultures (95% Confidence Interval: 32.4-44) were bacteriologically positive. A total of 151 bacteria were identified, comprising 72.8% (n = 110) of Gram-negative bacteria. The predominant isolate was Klebsiella pneumoniae (25.8%, n = 39), followed by Staphylococcus aureus (17.9%, n = 27); 59.6% (n = 90) of the entire isolates were multidrug-resistant (MDR). Forty percent (11/27) of S. aureus were methicillin-resistant S. aureus (MRSA), and 28.1% (n = 31) and 20.9% (n = 23) of Gram-negative bacteria were extended-spectrum beta-lactamases (ESBL) and carbapenemase producers, respectively. Occupational status, alcohol consumption, cluster of differentiation.sub.4 (CD.sub.4) Thymocyte cell count < 350, interruption of trimethoprim-sulfamethoxazole prophylaxis and antiretroviral treatment, and recent viral load [greater than or equal to] 150 were found statistically significant. The higher rates of MDR, MRSA, ESBL, and carbapenem-resistant Enterobacterales (CRE) indicate that bacterial pneumonia is a vexing problem among HIV patients and therefore it is advisable to implement an antimicrobial stewardship program in the study area.

Antimicrobial resistance represents a significant public health challenge, resulting in an estimated 4.95 million deaths annually. In response to the global escalation of antimicrobial resistance in prevalent hospital-acquired infections such as surgical site infections (SSIs), the World Health Organization (WHO) has identified critical and priority pathogens necessitating research and development. Nevertheless, there remains a paucity of data from numerous developing nations. Therefore this study was conducted to evaluate the prevalence of SSIs, examine the microbial profile, and identify factors associated with SSIs, with a particular emphasis on WHO-priority pathogens during the COVID-19 pandemic at a general hospital in southern Ethiopia. A cross-sectional study was conducted on 207 adult patients clinically suspected of SSIs from September 1, 2019, to November 2022. Demographic data, clinical characteristics, and surgery-related variables were collected using pre-tested, structured, interviewer-administered questionnaires and patient chart reviews. Wound samples (swabs and/or pus) were collected aseptically from each participant following standard microbiological procedures and processed for isolation and identification of pathogens by conventional culture and biochemical testing. Bacterial isolates subjected to antimicrobial susceptibility testing, including the detection of extended-spectrum beta-lactamase (ESBL) and methicillin-resistant Staphylococcus aureus (MRSA), by the standard Kirby-Bauer disk diffusion method in accordance with Clinical and Laboratory Standards Institute (CLSI) guidelines. Data were analyzed by Statistical Packages for Social Science (SPSS) version 25, and bivariable and multivariable logistic regression was done to determine the associations between dependent and independent variables. Adjusted odds ratio with 95% confidence interval (CI) was reported, and P-value < 5% was considered statistically significant. The overall prevalence of culture-confirmed SSIs among adult patients who underwent major surgery was 76.8% (95% CI: 71.0, 82.6). Among the 178 pathogens recovered, 58.5% were Gram-negative, 40.4% were Gram-positive, and 1.1% were Candida spp. The ESKAPE pathogens comprised 65.3% of the isolates, with S. aureus being the most common species, accounting for 43.5%, followed by K. pneumoniae (33.9%). Multidrug resistance (MDR) was observed in 84.37% of ESKAPE pathogens, with ESBL-producing and MRSA-producing isolates accounting for 88% and 76.5%, respectively. A. baumannii showed the highest MDR rate at 100%, followed by MRSA (90%) and K. pneumoniae (88.23%). Amikacin, meropenem, and piperacillin-tazobactam were effective agents against Gram-negatives, while linezolid, clindamycin, and gentamicin were most effective against Gram-positive bacteria. SSIs was significantly associated with emergency surgery (P < 0.001), prolonged surgery waiting time (P = 0.004), and clean-contaminated surgery (P = 0.008). The high prevalence of MDR-ESKAPE pathogens is concerning, highlighting the need for improved infection prevention practices and antimicrobial stewardship programs.

Background: Currently extended-spectrum [beta]-lactamase (ES[beta]L) and carbapenemase producing gram-negative bacteria are the greatest concern among the neonatal population with very limited therapeutic options. The aim of this study was to assess the prevalence of ES[beta]L and carbapenemase producing gram-negative bacilli, associated factors and antimicrobial resistance patterns among neonates in intensive care units. Methods: An institutional-based cross-sectional study was conducted from February to June 2021 on 212 neonates in intensive care units. Risk factors data were collected by using a well-designed questionnaire. A rectal swab sample was collected using a sterile cotton swab and inoculated on MacConkey agar. Bacterial isolates were identified using various biochemical tests. ES[beta]L and carbapenemase were first screened by indicator cephalosporins (cefotaxime (30 [micro]g) and ceftazidine (30 [micro]g)) and carbapenem (meropenem and ertapenem), respectively. ES[beta]L and carbapenemase were confirmed by a double-disk synergy test and modified carbapenem inactivation methods, respectively. SPSS version 21.0 was used for data analysis. A P-value [less than or equal to] 0.05 was considered as statistically significant. Results: The overall prevalence of ES[beta]L-producing gram-negative bacilli was 72/212 (34%). The predominant ES[beta]L-producing isolate was Klebsiella pneumoniae 23/72 (31.9%) followed by Escherichia coli 17/72 (23.6%). Five (2.4%) carbapenemase- producing gram-negative bacilli were isolated. ES[beta]L-producing isolates showed a high resistance against ampicillin 72/72 (100%), augmentin 69/72 (95.8%) and gentamycin 57/ 72 (79.2%). The majority 63/72 (87.5%) of isolated ES[beta]L-producing gram- negative bacilli were multi-drug resistant (MDR). Rectal carriage of ES[beta]L by neonates showed a statistically significant association with endotracheal intubation (p = 0.001; AOR = 4.2; 96% CI = (1.8-9.5)), treatment with ampicillin+gentamycin (p = 0.004; AOR = 3.3; 95% CI = (1.5-7.6)) and staying in a neonatal intensive care unit (NICU) between 11 and 20 days (p = 0.042; AOR = 2; 95% CI = (1.0-4.5)). Conclusion: A high prevalence of ES[beta]L-producing bacterial isolates was observed for commonly used antibiotics which needs further attention. Therefore, continuous and regular follow-ups of drug resistance patterns is important for the proper treatment and management of ES[beta]L and carbapenemase producing gram-negative bacilli. Keywords: extended-spectrum [beta]-lactamase, carbapenemase, gram-negative bacilli