Characterization of non-typhoidal salmonella isolated from patients attending Agona Swedru Municipal hospital
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Date
APRIL, 2016.
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Abstract
Introduction: There is increasing occurance of salmonellosis with observed emergence of
high level resistance to antimicrobial agents leading to the difficulty in treating infected
patients with invasive infections worldwide. The study aims at determining the Salmonella
species causing diarrhoea in Agona Swedru Municipal Hospital, as diarrhoea ranked the
third common complaints in the hospital.
Methods: Clinical samples comprising stool (n=380), blood (n=378) and urine (n=375)
were cultured for Salmonella and other bacteria. The Salmonella isolates were serotyped
based on Kauffmann and White scheme. Antimicrobial susceptibility testing was performed
on all the isolates using the disc diffusion Kirby-Bauer method. Double-disk synergy test
was used to test the isolates for Extended Spectrum -Lactamase production. The
Salmonella isolates were fingerprinted by Pulsed-Field Gel Electrophoresis (PFGE) to
determine their genetic relatedness.
Results: Thirteen (13) Salmonellae were isolated from the diarrhoeal patients stool samples
(n=380). Among the Salmonella serovars identified, Salmonella Enterica (69.2%; n=9/13)
predominated, followed by Salmonella Choleraesuis (23.1%; n=3/13) and Salmonella
Paratyphi B (7.7%; n=1/13). The most common pathogen isolated other than Salmonella
was Escherichia coli (63.6%; n=21/33), followed by Staphylococcus aureus (18.2%;
n=6/33), Citrobacter species (9.1%; n=3/33), Proteus mirabilis (6.1%; n=2/33) and
Pseudomonas aeruginosa (3.0%; n=1/33). Salmonella isolates showed varied resistance to
antimicrobials tested, with resistance proportions being Cotrimoxazole (9/13 (69.2%),
Tetracycline (3/13, 23.1%), Amoxicillin (2/13, 15.4%), Ampicillin (2/13, 15.4). All the
isolates were sensitive to Ceftriaxone, Ciprofloxacin, Amikacin, Gentamicin, Amoxicillin-
Clavulanic acid, Chloramphenicol and Meropenem. None of the Salmonella isolates were
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multidrug resistant (MDR) and none produced Extended Spectrum -Lactamase. Extended
Spectrum -Lactamase production was varied among other isolates. The Salmonella
Choleraesuis isolates though were same species, were of different PFGE types.
Conclusion: Prevalence of Salmonellae among patients attending Agona Swedru
Municipal Hospital was 3.4%. Most of the Salmonellae were non-Typhoidal Salmonellae.
Proportion of isolates resistant to antibiotics was low. There are possibly different S.
Choleraesuis isolates circulating in Agona Swedru and its environs.
Description
A thesis submitted to the Department of Clinical Microbiology, in fulfillment of the requirementsfor the award of the Degree of Master of Philosophy in Clinical Microbiology.