• Rawleigh Howe AHRI
  • Zeleke Ayenew
  • Habtamu Biazin
  • Solomon Gebre-Selassie
  • Biruk Yeshitila
  • Abrham Assefa
  • Tamrat Abebe


Background:  Diarrheal disease remains a major public health problem in developing countries including Ethiopia. The current study was designed to isolate medically important bacterial enteric pathogens and assess the antimicrobial susceptibility testing of bacteria causing diarrhea in pediatrics for those antibiotics were prescribing in Integrated Management of Childhood illness (IMCI).

Methods: Across-sectional study to determine bacterial enteric pathogenic microorganisms that cause diarrhea and antimicrobial susceptibility profile was carried out in selected health facilities of Addis Ababa, Ethiopia from November 2016 to May 2017. Stool specimens from pediatric patients aged 0-14 years were collected randomly from two health centers and one specialized hospital to identify bacterial enteric pathogens. Antimicrobial susceptibility tests were performed on all bacterial isolates using the Kirby-Bauer disc diffusion method.

Results: Out of 290 study patients with diarrhea examined, the majority of bacterial enteropahogens isolated in the study were Shigella spp 22(7.6%) followed by enterohemorrgic E.coli O157:H7 13(4.5%), Salmonella spp 7(2.4%).  Bacterial isolates from diarrheal patients showed antimicrobial resistance to ampicillin, Augmentin, trimethoprim-sulphamethoxazole and ciprfloxacillin. Salmonella spp showed resistance to trimethoprim-sulphamethoxazole and chloramphenicol, 42.9% and 14.3% respectively. Another enteric bacteria Shigella spp were resistant to 77.3%ampicillin, 68.2% trimethoprim-sulphamethoxazole and36.4%Augmentin whereas E.coli O157:H7 resistance anti-biogram showed 69.2%ampicillin,46.1% trimethoprim-sulphamethoxazole,38.5%Augmentin, 23.1%ciprfloxacillin and Amikacin, ceftriaxone and gentamycin were resistant with the same rate  of 15.4% .


Key words: Enteric pathogens, diarrhea, antimicrobial susceptibility, pediatrics, Addis Ababa, Ethiopia



WHO /UNICEF. Diarrhea. Available from,2017

WHO. Diarrhea: why children are still dying and what can be done. Geneva: UNICEF/WHO, 2009

Eldaif, W.A.H., Omer, A.A.O. and Saeed, N.S. In-vitro antimicrobial susceptibility testing of bacteria causing diarrhea in children at Khartoum State-Sudan. Indian Journal of Pharmaceutical and Biological Research, 2015; 3(1): 32-35.

Akinnibosun, F.I. and Nwafor, F.C. Prevalence of diarrhea and antibiotic susceptibility test in children below 5 years at University of Benin Teaching Hospital, Nigeria. International Research Journal of Public and Environmental Health, 2015; 2(4):49-55.

Mikoleit, M. Isolation of Salmonella and Shigella from Faecal Specimens. WHO Global Foodborne Infections Network, 2010.

Onyango, D.M. and Angienda, P.O. Epidemiology of waterborne diarrhoeal diseases among children aged 6-36 months old in Busia-Western Kenya. International journal of biological and Life Sciences, 2010; 6(2):1158-1165.

Pavani, G., 2012. Enteric pathogens and their resistance pattern in pediatric diarrhea in AP. Journal of Microbiology and Biotechnology Research, 2012;2(4):595-597.

RonoSalinah, J., Rose, K. and Fabian, E. Prevalence and clinico-demographic characteristics associated with bacterial diarrhea among HIV positive and negative children aged below five years at Moi Teaching and Referral Hospital, Kenya. American Journal of Life Sciences, 2014; 2(5): 1-8.

Central Statistical Agency of Ethiopia. CSA, 2007, preliminary

Balakrishnan, S. and Mohammed, M. Drug Susceptibility Pattern and Associated Factors among Under Five Children in Dire Dawa, Eastern Ethiopia (Doctoral dissertation, Haramaya University).2015.

Monica Cheesbrough. 2009. ''Medical laboratory manual for tropical countries''. Cambridge University Press, 2009; 1:196-198.

Wayne, PA., CLSI. Performance standards for antimicrobial susceptibility testing; 26th informational supplement. Clinical and Laboratories Standards Institute. CLSI document M100-S26, 2016.

Eguale T, Gebreyes AW, Asrat D, Alemayehu H, John S. Gunn SJ and Ephrem Engidawork E. Non-typhoid Salmonella serotypes, antimicrobial resistance and co-infection with parasites among patients with diarrhea and other gastrointestinal complaints in Addis Ababa, Ethiopia. BMC Infectious Diseases, 2015; 15:497.

Beyene, G. and Tasew, H. Prevalence of intestinal parasite, Shigella and Salmonella species among diarrheal children in Jimma health center, Jimma southwest Ethiopia: a cross sectional study. Annals of clinical microbiology and antimicrobials, 2014; 13(1):10.

Getamesay, M., Getenet, B. and Ahmed, Z. Prevalence of Shigella, Salmonella and Campylobacter Species and Their Susceptibility Patters among Under Five Children withdiarrhea in Hawassa Town, South Ethiopia. Ethiopian Journal of Health Sciences, 2014; 24(2): 101-108.

Reda, A.A., Seyoum, B., Yimam, J., Fiseha, S. and Jean-Michel, V. Antibiotic susceptibility patterns of Salmonella and Shigella isolates in Harar, Eastern Ethiopia. Journal of Infectious Diseases and Immunity, 2011; 3(8): 134-139.

Gebrekidan, A., Dejene, T.A., Kahsay, G. and Wasihun, A.G. Prevalence and antimicrobial susceptibility patterns of Shigella among acute diarrheal outpatients in Mekelle hospital, Northern Ethiopia. BMC research notes, 2015; 8(1): 611.

Saeed, A., Abd, H. and Sandstrom, G. Microbial etiology of acute diarrhea in children under five years of age in Khartoum, Sudan. Journal of medical microbiology, 2015; 64(4): 432-437.

Mikhail, I.A., Fox, E., Haberberger, R.L., Ahmed, M.H. and Abbatte, E.A. Epidemiology of bacterial pathogens associated with infectious diarrhea in Djibouti. Journal of clinical microbiology, 1990; 28(5), 956-961.

Samie, A., Guerrant, R.L., Barrett, L., Bessong, P.O., Igumbor, E.O. and Obi, C.L. Prevalence of intestinal parasitic and bacterial pathogens in diarrhoeal and non-diarroeal human stools from Vhembe district, South Africa. Journal of Health, Population and Nutrition, 2009:739-745.

TeshaleWorku, Ayalew Jejaw, Subbaram Kannan, Beyene Wondafrash. Isolation and Antimicrobial Sensitivity Patterns of Enteric Bacterial Pathogens from Asymptomatic Food Handlers, Jimma, Ethiopia. American Journal of Health Research,2015; 3(6):399-406.

Beyene, G. and Tasew, H. Prevalence of intestinal parasite, Shigella and Salmonella species among diarrheal children in Jimma health center, Jimma southwest Ethiopia: a cross sectional study. Annals of clinical microbiology and antimicrobials, 2014; 13(1):10.

Beyene, G. and Haile-Amlak, A. Antimicrobial sensitivity pattern of Campylobacter species among children in Jimma University Specialized Hospital, southwest Ethiopia. Ethiopian Journal of Health Development, 2004; 18(3): 185-189.

Mengistu, G., Mulugeta, G., Lema, T. and Aseffa, A. Prevalence and antimicrobial susceptibility patterns of Salmonella serovars and Shigella species. J. Microb. Biochem. Technol. S, 2014; 2: 006.

Shah, M., Kathiiko, C., Wada, A., Odoyo, E., Bundi, M., Miringu, G., Guyo, S., Karama, M. and Ichinose, Y. Prevalence, seasonal variation, and antibiotic resistance pattern of enteric bacterial pathogens among hospitalized diarrheic children in suburban regions of central Kenya. Tropical Medicine and Health, 2016; 44(1): 39.

Qu, M., Lv, B., Zhang, X., Yan, H., Huang, Y., Qian, H., Pang, B., Jia, L., Kan, B. and Wang, Q. Prevalence and antibiotic resistance of bacterial pathogens isolated from childhood diarrhea in Beijing, China (2010–2014). Gut Pathogens, 2016; 8(1):31.

Jomezadeh, N., Babamoradi, S., Kalantar, E. and Javaherizadeh, H. Isolation and antibiotic susceptibility of Shigella species from stool samples among hospitalized children in Abadan, Iran. Gastroenterology and Hepatology from bed to bench, 2014; 7(4): 218.

Mamuye, Y., Metaferia, G., Birhanu, A., Desta, K. and Fantaw, S. Isolation and Antibiotic Susceptibility Patterns of Shigella and Salmonella among under 5 Children with Acute Diarrhoea: A Cross-Sectional Study at Selected Public Health Facilities in Addis Ababa, Ethiopia. Clinical Microbiology: Clin Microbiol, 2015; 4: 186.

Manikandan, C. and Amsath, A. Antimicrobial resistance of enteric pathogens isolated from children with acute diarrhea in pattukkottai, Tamil Nadu, India. International Journal of Pure and Applied Zoology, 2013; 1(2): 139-145.

Chiyangi, H., Muma, J.B., Malama, S., Manyahi, J., Abade, A.,Kwenda, G. and Matee, M.I. Identification and antimicrobial resistance patterns of bacterial enteropathogens from children aged 0–59 months at the University Teaching Hospital, Lusaka, Zambia: a prospective cross sectional study. BMC infectious diseases, 2017; 17(1):117.

YEMANE, G., MULAW, G. and GAIM, T. Prevalence and Antimicrobial Susceptibility of Salmonella Species in Diarrheal Children under Five-Years of Age in Bahir Dar Town, Ethiopia. Int.J.Int sci. Inn. Tech. Sec. A, 2014; 3(2): 12-17.

Rathaur, V.K., Pathania, M., Jayara, A. and Yadav, N. Clinical study of acute childhood diarrhoea caused by bacterial enteropahogens. Journal of clinical and diagnostic research: JCDR, 2014; 8(5): PC01.

Huruy, K., Kassu, A., Mulu, A., Worku, N., Fetene, T., Gebretsadik, S., Biadglegne, F., Belyhun, Y., Muche, A., Gelaw, A. and Anagaw, B. Intestinal parasitosis and shigellosis among diarrheal patients in Gondar teaching hospital, northwest Ethiopia. BMC research notes, 2011; 4(1): 472.

Hines, J. and Nachamkin, I., 1996. Effective use of the clinical microbiology laboratory for diagnosing diarrheal diseases. Clinical infectious diseases: 1996; 1292-1301.

Effler, E., Isaäcson, M., Arntzen, L., Heenan, R., Canter, P., Barrett, T., Lee, L., Mambo, C., Levine, W., Zaidi, A. and Griffin, P.M. Factors contributing to the emergence of Escherichia coli O157 in Africa. Emerging infectious diseases, 2001; 7(5): 812-819.

Lim, J.Y., Yoon, J.W. and Hovde, C.J. A brief overview of Escherichia coli O157: H7 and its plasmid O157. Journal of microbiology and biotechnology, 2010; 20(1):5-14.

Adugna A., Kibret M., Abera B., Nibret E., Adal M., 2015. Antibiogram of E. coli serotypes isolated from children aged under five with acute diarrhea in Bahir Dar town. African Health Sciences, 2015;15 (2):657-664.

TeshaleWorku, Ayalew Jejaw, Subbaram Kannan, Beyene Wondafrash. Isolation and Antimicrobial Sensitivity Patterns of Enteric Bacterial Pathogens from Asymptomatic Food Handlers, Jimma, Ethiopia. American Journal of Health Research, 2015; 3(6):399-406.

Ogunsanya I.T, Rotini O.V and Adenugaf.A. 1994. A study of the etiological agents of childhood diarrhea in Lagos, Nigeria. J. Med. Microbial. 1994;40.

Yismaw G., Negeri C., Kassu A. A five-year antimicrobial resistance pattern observed in Shigella species isolated from stool samples in Gondar University Hospital, northwest Ethiopia. Ethiop J Health Dev.2006; 20(3):194-198.

Asrat, D. Shigella and Salmonella serogroups and their antibiotic susceptibility patterns in Ethiopia. Eastern Mediterranean Health Journal, 2008; 14(4):760-765.






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