Aetiology of Acute Infantile Diarrhoea in the south-Eastern Nigeria: An Assessment Of Microbiological And Antibiotic Sensitivity Profile

摘要

An assessment of microbiological profile of enteric pathogens in pediatric stool specimens and antibiotic sensitivity pattern of implicated bacterial agents were performed in Abakaliki, Nigeria. Of the 150 children diagnosed with diarrhoea (cases), at least one enteropathogen was detected in 122(81.3%). Among the 50 children without diarrhoea (controls), 4(8.0%,) had enteropathogen. Rotavirus was detected in 35(23.3%) cases but none in the controls. Bacterial detected among cases included Escherichia coli (15.3%), Salmonella species (11.3%) and Klebsiella species (7.3%). Entamoeba histolytica and Giardia lamblia were detected in 3.3% and 2.7% of the cases respectively. Infants aged 0-12 months old recorded highest frequency of enteropathogens. Enterobacter species, Shigella species and Campylobacter species exhibited a 100% susceptibility to oflaxacin, gentamycin and ciprofloxacin. All bacterial isolates showed 100% resistance to septrin, while E. coli, Salmonella species, Campylobacter species exhibited 100% resistance to augmentin. Immunization/effective childcare programmes, improved personal and environmental hygiene and health-education recommended. Introduction Infections are the major cause of severe morbidity and mortality among children worldwide [1]. Diarrhoeal illness stands, as an important cause of infectious morbidity in children, exceeded only by respiratory tract infections and mortality is currently associated with cases that evolve without proper feeding or rehydration care, invasive diarrhoeas with extraintestinal or systemic involvement, or persistent diarrhoeas that occur especially in infants from low-level socioeconomic groups, who suffer previous deficiencies and develop severe nutritional consequences of enteric infection [2]. Diarrhoea defined as excessive and frequent evacuation of watery faeces, usually indicating gastrointestinal distress or disorder of 3-7 days duration, is a frequent illness in developing countries and contributes to the deaths of 4.6 million to 6 million children annually in Asia, Africa, and South America and it has been estimated that in the very poor countries of these regions each child suffers up to 15 to 19 episodes of diarrhoea per year [2,3]. Despite much progress in the understanding of pathogenesis and of management, diarrhoeal illness still remains one of the most important causes of global childhood mortality and morbidity largely because the aetiology and pathogenesis of persistent diarrhoea are usually multifactorial and sometimes can not be identified [4]. Reports from different parts of the world have implicated various pathogens such as parasites, bacteria and viruses with outbreak of infant diarrhoea disease in children [5,6,7,8,9,10]. However in the developing countries including Nigeria, infantile diarrhoea disease is grossly under-reported and the incidence under-estimated, this is attributed to poverty and ignorance among affected group who usually constitute up to 80% of the population of the area [11]. In Nigeria, available reports indicate that more than 315,000 deaths of preschool age children are recorded annually as a result of diarrhoea disease [12,13]. Nevertheless, despite the public health implications and enormous burden imposed on the primary health care delivery system by infantile diarrhoea illness in the country, there is still paucity of information on the epidemiology and aetiology of infantile diarrhoea in many regions including the South-eastern Nigeria. Since the pathogens responsible for diarrhoea infections employ ingenious mechanisms to establish disease, regional variation in the microbiological profile may exist even in the same country [3,11]. The persistent seasonal outbreak of diarrhoeal disease among children in the South-eastern Nigeria, particularly in Abakaliki and its environs, and the rising trend of resistance to antimicrobial agents used for treating diarrhoeal infections in the area, necessitated this investigation. In E