Bacterial isolates from the stools of children aged less than 5 years with acute diarrhea in Kaduna, Northwestern Nigeria

Abstract

Background: Diarrhea is a significant cause of morbidity and mortality among children aged less than 5 years in sub-Saharan Africa. Bacterial organisms are important etiological agents and their identification is vital to effective management. Objective: To identify characteristics of bacterial isolates in the stools of children aged less than 5 years with acute diarrhea. Materials and Methods: The stools of children aged less than 5 years presenting with acute diarrhea were cultured using deoxycholate citrate agar and Salmonella-Shigella agar. Data were analyzed using Epi Info version 3.5.3 and P values <0.05 were regarded as significant. Results: Stool samples were obtained from 270 children aged 0.2 to 4.9 years (mean: 1.6 ΁ 1.4 years). Majority of the children were males (156, 57.8%) and aged <2 years (64.1%). Diarrhea was bloody in 28 (11.8%) children. Antibiotic therapy was instituted in 185 (68.7%) children before presentation and mostly prescribed by caregiver (87, 47%). Metronidazole (154, 83.2%) was the commonest antibiotic prescribed. Bacteria were isolated in 175 (64.8%) samples. The commonest isolate was Escherichia coli (105, 60%). Bacteria were isolated from 7 (25%) of bloody diarrhea stools and the isolates were E. coli (2, 28.6%) and Shigella spp. (5, 71.4%). Isolates were most sensitive to ciprofloxacin (167, 95.4%). Bacterial isolation was significantly (P < 0.05) associated with age <2 years, nonuse of antibiotics, and bloody diarrhea. Conclusion: Enterobacteria are still important etiological agents of acute diarrhea among children. The study highlights the need for appropriate treatment of children with diarrhea and promotion of its prevention.