Abstract
BackgroundBacterial 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.MethodsThis 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.ResultsOf 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.ConclusionFive 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.
Highlights
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
The aim of this study was to identify bacterial pathogens in stool samples obtained from children aged 0–59 months admitted with diarrhea to the University Teaching Hospital (UTH) in Lusaka, Zambia
All cultures were incubated at 35–37 °C for 12–18 h except for the modified Charcoal-Cefoperazone Deoxycholate Agar plates (Himedia, Mumbai, India), which were incubated at 42 °C for 72 h in a candle jar sealed with parafilm (Parafilm M, Pechiney Plastic Packaging, Chicago, USA)
Summary
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. Infectious diarrhoea is a significant cause of illness and death among children under 5 years of age in lowresource countries. It accounts for 9% of all deaths globally in this age group, and ranks only second to pneumonia [1]. Interventions that target the main causes of diarrhoea should focus on the most susceptible children, and this should further accelerate decline of diarrhoeal cases. Guiding these efforts requires identification of aetiological agents and understanding the risk factors associated with diarrhoea. Several pathogens have been implicated as important causes of diarrhoea, and these include a variety of bacteria, parasites and viruses [4, 6, 7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
