Selected bacterial etiology of acute diarrhea in under five children at Mulago National Referral Hospital Kampala, Uganda.

Abstract

Background: Diarrhea is understood as the passing of three or more passages of loose or watery stools per day according to WHO and is considered among the major causes of childhood mortality and morbidity. Diarrhea kills close to 1500 children a day globally and is therefore responsible. Children under five experience a very high diarrheal burden which poses a severe public health risk as the second leading cause of infant death In Uganda. Objective: The study aimed to identify bacterial etiology of acute diarrhea in children under five years of age at Mulago Hospital. It also seeks to determine the prevalence of these bacterial pathogens and their susceptibility profiles to common antibiotics, providing critical insights for effective treatment and prevention strategies. Methodology: This cross-sectional study was conducted at Mulago Hospital, involving children under five years presenting with acute diarrhea. A total of 72 stool samples were collected and analyzed using multiplex polymerase chain reaction (PCR) to detect specific bacterial pathogens, including Escherichia coli, Shigella spp., Salmonella spp., and Campylobacter spp. Antibiotic susceptibility testing was performed using the disk diffusion method to assess the resistance profiles of the isolated bacteria. Data analysis was conducted using IBM SPSS appropriate to determine prevalence rates and resistance patterns. Results: The results revealed that bacterial pathogens were detected in 11% of the stool samples analyzed. The most common pathogens identified were campylobacter spps (50%), followed by Shigella spp. (37%), Salmonella spp. (12.5%). Antibiotic susceptibility testing identified a high level of resistance particularly to ampicillin (6mm), trimethoprim/sulfamethoxazole (06) and azithromycin (06) and conversely, the highest susceptibility was seen on ciprofloxacin (24mm) on salmonella species. Recommendation: This study provides valuable data on the bacterial etiology of acute diarrhea in children under five at Mulago Hospital, contributing to the limited body of literature on this critical public health issue in Uganda. The findings underscore the need for regular surveillance of bacterial pathogens and their susceptibility patterns to inform clinical practice and public health interventions effectively