BACTERIAL ETIOLOGY OF DIARRHEAL SYNDROME AND SUSCEPTIBILITY PROFILE OF ENTEROPATHOGENS AMONG PATIENT ATTENDING MTHATA GENERAL HOSPITAL

Abstract

The population of the Eastern Cape is largely non−urban and poor with inadequate water supply infrastructure (Mthata river systems 2008). Mthatha has only 10% flushing toilet systems in the households and 90% is either a bucket system or pit latrines with a majority of 60% using the bushes around. Diarrheal infections have thus been shown to cause 20% of all deaths in children under 5 years of age living in settlements with no access to clean water.

Objectives: To determine the frequency of isolation of Enteropathogens and emerging enterobacteria and their susceptibility profile to antibiotics.

Methods: All stool samples submitted to the National health laboratory service Mthata general hospital from March-August 2012 from patients with acute ƒchronic diarrhea. Bacteria were isolated using standard microbiological procedures. Sensitivity testing was done on all isolates against a panel of 10 antibiotics while Campylobacter and Enterococcus against the panel of Six antibiotics.

Results: Of the 150 stools, Escherichia coli was the most predominant with 32% isolates, 21% of these produced þ−lactamase enzyme and 42% were Enteropathogenic E coli . The isolates were resistant to most of the antibiotics and were only susceptible to meropenem, imipenem, ciprofloxacin, and gentamicin. Enterobacter species followed at 20%, then 13% Enterococcus, 7% Citrobacter freundii, 5% Serratia marcesens, 4% Yersinia enterocolitica, while Campylobacter, Salmonella, Shigella, Morganella morganii were at an insignificant level of 1.3% respectively and were sensitive to all the antibiotic profiles while of the 150 patients, 40% were from 0−10 years patient and 60% from 11−80 years and 37% of this group were HIV positive.

Conclusion: In the examined samples, E coli was the most predominant, with notable resistance to þ−lactams and yet it is only considered in children less than 10 years and not considered as a pathogen in adults. The outcome, therefore, points at the need to assess patients individually to determine whether E Coli is a cause for worry or not before ruling out an infection.

KEYWORDS: þ−lactams, Diarrheal infections, Enteropathogens, Enterobacteria