Bacterial Causes of Acute Febrile Illnesses and Their Antimicrobial Susceptibility Patterns in Adult Patients Attending Felege-Hiwot Referral Hospital, Northwest Ethiopia: A Cross Sectional Study

Abstract

Background: Bacterial etiologies of acute febrile illnesses (AFIs) are common causes of   hospital admission and death in Africa, including Ethiopia. The very limited resources and the great diversity of etiologies of AFIs in the tropical regions of Africa are critical challenges to establishing definite diagnosis, treatment, prevention and control of infectious diseases.

Objective: The aim of this study was to assess the bacterial causes of AFI and their susceptibility to antimicrobial agents among acute febrile illness patients.

Methods: A cross sectional study was conducted on 137 patients suspected acute febrile illness at Felege Hiwot Referral Hospital, from February1 to May 30, 2013. Data on socio-demography were collected using a pre-tested structured questionnaire. Blood samples were collected and inoculated into brain heart infusion. Blood culture and antimicrobial susceptibility tests were done according to the Clinical Laboratory Standard Institute guideline. Data were entered and analyzed using SPSS version 16.

Results:  Of the total 137 blood cultures, 24 (17.5%) were positive for six different types of bacteria. The isolates were Coagulase negative Staphylococcus 8(5.8%) followed by K. pneumoniae 7 (5.1%) and S. pyogens 5 (3.6%). Enterococcus  species and Enterobacter species accounted 1(0.7%) each. The isolates showed high rates of resistance to most antibiotics tested. The range of resistance rates for Gram positive bacteria was from 0% to 64.3% and for Gram negative from 0% to 100%.  All Gram negative bacteria were multidrug resistant.

Conclusions:  This study showed a high prevalence of bacterial pathogens in acute febrile illness suspected patients with high rate of resistance to most commonly used antibiotics. Therefore, early diagnosis and treatment of bacterial infections based on culture and drug susceptibility are crucial to reduce bacterial causes of acute febrile illness. A rational use of antibiotics should be practiced in order to minimize the spread of drug resistant bacteria.