The Ecology and Antibiotic Resistance Patterns of Gastrointestinal Tract Infections in A Tertiary Care Hospital in Oman

Asma Ahmed Sulaiman Alsalmi,Said A Al-Busafi,Mohamed Mabruk,Ruwaida Naseer Abdullah Al-Lamki

doi:10.22207/jpam.15.3.60

Asma Ahmed Sulaiman Alsalmi, Said A Al-Busafi + Show 2 more

Open Access

https://doi.org/10.22207/jpam.15.3.60

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Abstract

A wide range of gastrointestinal (GI) illnesses is caused by foodborne bacteria that can arise from either a direct bacterial infection or bacterial toxin ingestion. The treatment of these infections has been hampered by the appearance of resistant strains. This current study aims to investigate the prevalence of Gastrointestinal tract (GIT) infections in Omani patients and their resistance pattern against commonly used antibiotics. Seven hundred and ninety fresh stool samples were obtained from Omani patients attending Sultan Qaboos University Hospital with GI manifestation from the 1st of June to the 30th of November 2019. Bacterial identification in stool samples was carried out by inoculation in culture media, microscopical examination and biochemical tests confirmed by MALDI. BD PhoenixTM. The antibiotics sensitivity testing was carried out by the Manual disk diffusion method and by MALDI. BD PhoenixTM. Out of 790 stool samples, 49 samples were positive for GIT bacterial infections. Salmonella spp. was the most prevalent isolate and more associated with children less than ten years old. Out of the 49 bacterial isolates, 3 (6.1%) were Clostridium difficili, 4 (8.2%) were Shigella flexneri, 5 (10.2%) were Campylobacter jejuni, and different Salmonella spp. serotypes were detected such as Salmonella Kentucky (8.2%), Salmonella enteritidis (6.1%), Salmonella infantis (4.1%), Salmonella welteverden (4.1%), Salmonella typhimurium (4.1%), Salmonella anatum (2.0%), Salmonella tesvia (2.0%), Salmonella Uganda (2.0%), Salmonella Arizona (2.0%) and (40.8%) of other Salmonella spp. serotypes. Eighty percent of isolated Campylobacter jejuni were resistant to Ciprofloxacin and Tetracycline. Salmonella spp. and Shigella flexneri were highly resistant to Amikacin, Gentamicin, and Cefuroxime. The low level of bacterial infection detected among screened patients in the present study indicates the excellent hand washing hygiene practice in reducing GIT infections among patients in Oman. This good hand washing hygiene practice is of great help in the efforts of controlling the spread of other severe diseases like COVID-19. However, detecting the emerging of antibiotic-resistant of GIT bacterial pathogens among patients in Oman, such as Salmonella and Shigella to a commonly used antibiotic such as Gentamicin, is alarming.

Highlights

Diarrhoea resulting from Gastrointestinal tract (GIT) infections is a major health burden worldwide
Out of the 49 bacterial isolates, 3 (6.1%) were Clostridium difficili, 4 (8.2%) were Shigella flexneri, 5 (10.2%) were Campylobacter jejuni, and different Salmonella spp. serotypes were detected such as Salmonella Kentucky (8.2%), Salmonella enteritidis (6.1%), Salmonella infantis (4.1%), Salmonella welteverden (4.1%), Salmonella typhimurium (4.1%), Salmonella anatum (2.0%), Salmonella tesvia (2.0%), Salmonella Uganda (2.0%), Salmonella Arizona (2.0%) and (40.8%) of other Salmonella spp. serotypes
Detecting the emerging of antibiotic-resistant of GIT bacterial pathogens among patients in Oman, such as Salmonella and Shigella to a commonly used antibiotic such as Gentamicin, is alarming

Summary

Introduction

Diarrhoea resulting from GIT infections is a major health burden worldwide. Almost 4% of South Africa deaths during the year 2000 were deaths attributable to infectious diarrhoea, the fifth leading cause of death in this African country[1]. Among children under the age of five, diarrhea ranks as the second leading cause of preventable illness[2]. Diarrhoea resulting from ingesting contaminated food or water. Person to person transmission can be the source of infection of various pathogenic bacteria, including Escherichia coli, Shigella spp., non-typhoidal Salmonella spp., Staphylococcus aureus, enterotoxigenic Bacteroides fragilis, and Campylobacter spp. and Enterococci faecalis[1]. Enterococci faecalis have rapidly appeared as critical nosocomial pathogens, with increasing resistance to most, and some cases to all currently approved antibiotics[3]

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