Plesiomonas shigelloides diarrhea in Enugu area of south eastern Nigeria: Incidence, clinical and epidemiological features

Abstract

The role of Plesiomonas shigelloides was determined in patients attending health centres and cottage hospitals in parts of Enugu State of Nigeria had diarrhoea. During the 12-month study (March 2012 - Feb 2013), P. shigelloides was isolated from 51 (7.2%) patients who had diarrhoea and none from 500 patients without diarrhoea (p 0,05). A seasonality distribution in favour of rainy season was also observed with the highest cases recruited in the periods June - August (54.9%) and September - October (23.5%). Only 2 (3.9%) were recruited between December and February. Thirty-seven (5.2%) patients had single infection with Plesimonas while 14 (2.0%) were co-infected with other bacterial pathogens. No parasitic agents were detected in the samples analysed. Twenty-seven (73%) of the patients with simple Plesimonas infection had watery diarrhoea; 24 (64.8%) had abdominal pain; 12 (32.4%) had fever, 7 (18.9 %) had visible mucus in stool, 6 (16.2%) had bloody diarrhoea while 5 (13.5%) were vomiting. Of the 5 children up to 5 years of age who had single infection, 3(60%) were clinically dehydrated. Of the 37 who had single infection, 8 (21.6%) had diarrhoea >/- 14 days. The antibiogram shows that the Plesimonas strains were highly resistant to the more available antibiotics in the area, with Ampicillin having a resistivity of 90.2%, Trimetoprim sulphamethoxazole (66.7%) and Tetracycline 51%, while the less available ones like Imipenem (2%), Aztreneonam and Cefotaxime (3.9%) each, and Laevofloxacillin (5.9%), had the least resistance. The findings may be of Public Health importance for creating awareness among physicians about the clinical profile and management strategy of P. shigelloides-diarrhoea in the area.