Prevalence and Antimicrobial Susceptibility Testing of Salmonella and Shigella Species among Children with Diarrhea in Khartoum and Al Jazeera States, Sudan

Abstract
Abstract: Background: It has been estimated that in low and middle-income countries (LMICs) each child suffers up to 15 to 19 episodes of diarrhea per year. Diarrhea kills more young children than Malaria, AIDS, and Measles combined a large proportion of which were attributed to Salmonella and Shigella spices. In developing countries, Salmonella and Shigella species remain major contributors to acute enteric infection in children. Objectives: To detect the prevalence of Salmonella and Shigella species and antibiotic susceptibility testing among children with diarrhea in Khartoum and Al Jazeera states, Sudan (2022). Methods: A descriptive, prospective cross-sectional study was carried out from July to October 2022 among 120 children with diarrhea aged 3-14 years in Khartoum and Al Jazeera states. Information about patient demographics and clinical status was obtained from each patient using a written questionnaire. Stool specimens from diarrheic children were collected and processed for wet mount examination and isolation of Salmonella and Shigella using conventional microbiology procedures. Antibiotic susceptibility patterns were determined by using the Kirby-Bauer disc diffusion method through culturing the isolates on Mueller- Hinton agar. The collected data and laboratory results were analyzed using SPSS version 26. Results: In this study; only 2/120 (1.7%) of the specimens showed growth of Shigella sonnei and Shigella species both were isolated from patients from Al Jazeera state (Al Sameer village), both Shigella isolates were sensitive to ciprofloxacin, gentamicin, cefotaxime, amikacin and only resistant to amoxicillin. G. lamblia and E. histolytica were detected in wet mount examination in stool specimens with a prevalence of (8.3%) and (4.2%) respectively. In our study, there was no association between positive stool culture and type and duration of diarrhea, symptoms with diarrhea, hospitalization, household income, source of drinking water, and hand washing. Conclusion: In this study, only Shigella was detected 2/120 (1.7%) among children aged 3-14 years suggesting the dominance of other causes of diarrhea including intestinal parasites. A further study targeting other causes of diarrhea should be conducted to establish the major causes of diarrhea in children in the study areas
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