Department of Medical Microbiology and Immunology

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    Bacterial Urinary Tract Infections, Antimicrobial Susceptibility Patterns and Associated Risk factors Among Fistula patients at Hamlin Fistula Hospital, Mekelle, Tigray, North of Ethiopia
    (Mekelle University, 2025-06-28) KASECH FITSUM TEDLA
    Background: Urinary tract infections (UTIs) are one of the most common bacterial infections in humans, both in the community and hospital. UTIs are a significant cause of hospital admissions, a widespread concern, affecting millions of people worldwide and causing significant morbidity, mortality, and serious healthcare costs. Patients with obstetric fistula usually suffer from urinary and stool incontinence that can predispose them to frequent infections with urinary tract infection. Despite this fact, there is lack of data on the prevalence, causative pathogens, and antimicrobial susceptibility patterns of UTIs, particularly in lower resource settings like Tigray, Ethiopia. Objective: The study aimed to assess the prevalence of bacterial urinary tract infection, evaluate antimicrobial susceptibility patterns and identify associated risk factors among fistula patients at Hamlin Fistula Hospital in Mekelle, Tigray, Ethiopia. Method: A cross-sectional study was conducted from January to May 2025 at Hamlin Fistula Hospital in Mekelle, Tigray. Socio-demographic characteristics and other urinary tract infection related risk factors were collected from study participants using structured questionnaires. The mid-stream urine was collected and cultured on Cysteine lactose electrolyte deficient agar, and MacConkey agar. Bacterial isolates of gram negative and gram positive were characterized using series of biochemical tests. Antimicrobial susceptibility was determined using the disc diffusion method and interpreted according to the Clinical and Laboratory Standards Institute (CLSI2020) guidelines. The data was entered and analyzed using SPSS version 27. Results: Out of the 151 patients sampled, 104 (68.8.6%) were found to have significant bacteria infecting the urinary tract. Isolation of significant bacteriuria was strongly associated with the history of previous UTI and history of catheterization (p=0.01). Eight different species of bacterial uropathogens were identified from the samples. The bacteria isolated were 94.2 % gram negative and 5.8% gram positive. The most predominant bacteria identified were E. coli followed by P.vulgaris. The isolated bacteria had shown the highest resistance rate (72.2%) to Tetracyllin followed by Ampicillin (69.2%) and highest susceptibility to Amikacin (100%) followed by Meropenem (98.1%). Twenty-six of the isolated bacteria (98) were found to be ESBL-producing gram-negative bacteria. Conclusion and recommendation: The overall prevalence of urinary tract infection among fistula patients is high. The predominant pathogen of UTI isolated was E. coli followed by P.vulgaris and K. peumoniae. All the bacterial isolates have shown multiple antibiotic resistance pattern. Based on the findings of the present study, routine screening, urine culture and antimicrobial susceptibility testing are recommended for all fistula patients.
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    Predictors of clinical severity , immunological failure and magnitude of intestinal parasitic infections among HIV Patients on ART in Mekelle General Hospital, Tigray, Ethiopia.
    (Mekelle University, 2025-06-28) GIRMAY ALEMSEGED
    Background: Untreated intestinal parasitic co-infections appeared to hasten the progression of HIV-1 disease. However, there had been few studies to ascertain the interference and their induced severity of intestinal parasitic infections among on ART HIV/AIDS patients in resource-limited settings such as Ethiopia, where HIV/AIDS management largely depended on CD4+ T cells counts, viral load, and WHO clinical staging. Objective: To assess predictors of clinical severity, immunological failure and magnitude of intestinal parasitic infections in HIV Patients on ART in Mekelle General Hospital, Tigray, Ethiopia. Methods: A health facility based cross-sectional study was carried out from December 2024 to March 2025 among adult HIV/AIDS patients on ART. Data on socio-demographic, clinical and risk factors were gathered using a pre-tested structured questionnaire. Intestinal parasite were detected using direct microscopic examination, the formal ether concentration methods, and the Modified Ziehl–Neelsen technique, CD4 cell quantification was performed using the BD FACS Count System, while viral load measurement was conducted with the 2000rt Abbott machine. Multivariable logistic regression analysis determined the association between predictors and outcomes. P-value ≤ 0.05 was considered statistically significant. Results: The prevalence of intestinal parasites among HIV/AIDS patients was found to be 31.5% (100/318), of these 92.0 % (92/100) protozoans and 8.0% (8/100) helminthes. Among the identified parasites, Entamoeba histolytica/dispar had the highest prevalence 13.8% (44/318), followed by Giardia lamblia 10.4% (33/318) and Isospora belli was detected in 3.5% (11/318). The overall magnitude of clinical severity and immunological failure were 33.3% (106/318) among on ART patients, of these 26.7% (85/318) clinical severity and 29.3% (93/318) immunological failure. Among these, 72.3% (64 /85) had disclosed their HIV status, while 69.4% (59/85) demonstrated fair or poor adherence to antiretroviral therapy (ART). The prevalence of clinical and immunological failure among patients with parasitic infections was 53% (53/100). Significant association was observed between parasite infection and CD4+ T cell counts below 200/µl (AOR: 3.4, 95% CI: 1.5-8.5, p=0.005) as well as viral load levels equal to or greater than 1000 copies/ml (AOR: 3.2, 95% CI: 1.7-5.9, p=0.000). Several factors were associated with an increased likelihood of clinical severity and immunological failure, including smoking habits, occupational status, low BMI and an ambulatory or bedridden functional status at the last ART visit. Conclusions: The prevalence of intestinal parasites was higher among HIV patients on ART of these, E. histolytica, G.lambelia and Isospora belli were the leading causes of clinical severity and immunological failure on those individuals who were their CD4 count less than 200 cells/mm3, viral load greater than 1000 copies/µl. The overall severity of clinical conditions and immunological failure was significantly high among patients on ART who had smoking habits, occupational status, low body mass index, and an ambulatory or bedridden functional status.
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    Prevalence and Antimicrobial Susceptibility Pattern of Extended Spectrum Betalactamase Producing Bacterial Species From Catheterized Pat Ayder Comprehensive Specialized Hospital and Mekelle General Hospitals,Northen Ethiopia
    (Mekelle University, 2025-06-28) GEBREGIORGIS ASSEFA
    Background: Extended spectrum beta –lactamase (ESBL) producing bacteria are a public health problem globally, more than700000 deaths occur every year by multi-drug resistance. Patients catheter associated urinary tract infection and among the most affected by ESBL producing bacteria which results in increases the cost of medical care, extend hospital stay and mortality which needs to undergo regular surveillance and intervention. Objectives: To determine the prevalence of extended spectrum beta –lactamase producing bacteria and their antimicrobial susceptibility pattern among catheterized patients at Ayder compressive specialist Hospital and Mekelle General Hospital. Methods:A hospital based cross-sectional study was conducted on 310catheterized patients from October1/2023 to February30, 2024.Urine specimen (5-10mL) from patients catheterized with indwelling urinary catheters were collected in to a sterile labeled container. Urine specimens were delivered to the laboratory immediately and processed within 2hours.Each urine sample was inoculated onto MacConnkey agar and incubated at 37°C for 24 hours. Extend spectrum beta lactamace producing bacteria detection were done using biochemical and culture characteristics method and antimicrobial susceptibility tests to isolated bacterial pathogens was done using the disc diffusion technique. The data was entered and analyzed using Epidata version 3 and SPSS version 20, Chi-square was used to assess association between variables and then logistic regression was used to measure strengths of association, p-values less than 0.05 was considered statistically significant. RESULT: The results show that 37/310(11.9%) of the participants had bacteria. Of these,Escherichia Coli 32/37 (86.5%), K.pnuemoniae 3/37(8.1%) and mixed (E.coli and K.pnuemoniae) 2/37(5.4%). ESBL was seen in 13/37(35.1%) of the bacterial isolated and was all seen on Escherichia coli, 13/13 (100%) isolates. Altogether 100% (n=37) isolates were sensitive to meropnem, 83.8% (n=31) to nitrofurantoin, and 59.5% (n=22) to gentamicin. 64.8% (n=24) isolates were resistant to antibiotic ampicillin while 29.7% (n=11) were found as multidrug resistant (MDR). Conclusion:Most ESBL-producing bacteria were E.coli, The prevalence of ESBL producing bacteria were on patients who admitted at medical ward. Microbiological-based therapy for patients with UTIs is essential at my study site due to high rates of ESBL production with concomitant high rates of drug resistance to several antibiotics.
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    PREVALENCE AND ASSOCIATED RISK FACTORS OF PLUMONARY TUBERCULOSIS AMONG PRISONERS IN SHIRE, AXUM AND ADWA PRISON CENTRS
    (Mekelle University, 2025-06-28) GIRMASLASIE FISEHA
    Background: Pulmonary Tuberculosis is a contagious airborne disease caused by Mycobacterium tuberculosis and remains a significant global public health problem. Prisons, due to overcrowding, poor ventilation, and limited healthcare services, present a high-risk environment for TB transmission and progression. In the Tigray region of Ethiopia, challenges such as inadequate diagnostic capacity and insufficient data hinder effective TB control among incarcerated populations. Objective: This study was aimed to determine the prevalence of pulmonary tuberculosis and identify its associated risk factors among prisoners in Shire, Axum, and Adwa correctional facilities in Tigray, Ethiopia, over the period from December, 2024 to May, 2025. Methodology: An institutional-based cross-sectional design was employed to enroll 265 prisoners presenting with TB symptoms. Structured questionnaires were collected socio-demographic and clinical information, including HIV status, history of smoking, and incarceration-related exposures. Sputum samples were collected and analyzed using Ziehl-Neelsen staining and the Gen-expert MTB/RIF assay. Results: A total of 265 prisoners were enrolled in this study, drawn from a total incarcerated population of 3,180 inmates across the three prison centers in Shire, Axum, and Adwa, located in northern Ethiopia. The study identified 5 bacteriologically confirmed TB cases, yielding a point prevalence of 1.9% (95% CI: 0.6%–4.3%) among the study participants. Occupation prior to imprisonment was significantly related to TB status: prisoners who had been governmentemployed or self-employed had significantly lower odds of TB infection compared to those who had been daily laborers or unemployed (exact AOR = 0.119, 95% CI: 0.000–0.946, p = 0.0432). Prisoners who were HIV-negative or whose HIV status was unknown had significantly lower odds of TB compared to HIV-positive individuals (exact AOR = 0.033, 95% CI: 0.001–0.722, p = 0.0281). Conclusions and Recommendations: The prevalence of PTB was high in these prison centers. There should be an intensified implementation of TB screening among high-risk inmates, particularly those with a history of unemployment, HIV infection, smoking, or TB symptoms.
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    PREVALENCE OF METHICILLIN RESISTANT Staphylococcus aureus, AND ASSOCIATED FACTORS, FROM RAW MILK OF LACTATING COWS, AND NASAL AND HAND SWABS OF MILKING PERSON IN SELECTED DAIRY FARMS OF MEKELLE CITY, TIGRAY NORTHERN ETHIOPIA. A ONE HEALTH PERSPECTIVE
    (Mekelle University, 2025-06-28) ABRHAM GEREZIHER
    Background: Staphylococcus aureus causes subclinical mastitis in dairy cows, leading to severe economic losses. MRSA is responsible for over 70,000 severe infections and 9,000 deaths per year. MRSA causes many infections, including skin & wound infections, pneumonia, and bacteremia in humans. In animals, it is commonly associated with mastitis. Therefore, the study aimed to determine the prevalence of methicillin-resistant S. aureus and associated factors from raw milk of lactating cows, and nasal and hand swabs of milking person in selected dairy farms in Mekelle City, Northern Ethiopia. Methods and Materials: A cross-sectional study was conducted in selected dairy farms in Mekelle, from December 2024 to April 2025. Background information about the dairy farms, lactating cows and milking personnel was collected using a structured questionnaire. Raw milk, hand swabs, and nasal swabs were cultured on Mannitol salt agar, and identification of S. aureus done following standard procedures. The antimicrobial susceptibility testing and MRSA screening were performed based on the Clinical Laboratory Standards Institute’s recommendations. A logistic regression model was applied to measure the association between variables using SPSS version 27 for analysis. A significant association between the independent and dependent variables was declared at p ≤ 0.05 and a corresponding 95% confidence interval. Results: The prevalence of S. aureus from raw milk, nasal swab and hand swabs milking persons were 17.2%, 18.9% and 15.6% respectively. The prevalence of MRSA in lactating cows and milking person were 2.2% and 2.8% respectively. The prevalence of S. aureus and MRSA among the CMT positive lactating cows were54.4% and 7% respectively. Among the S. aureus isolates 119.4%, 17.6% and 10.7% were MDR from raw milk, nasal and hand swab samples respectively. The variable MRSA positivity in human and history of hand lesion of milking person were showed a significant association with the prevalence of MRSA in lactating cows and the prevalence of MRSA in milking person respectively. Conclusion: The prevalence of MRSA in lactating cows was lower from the pooled prevalence of MRSA in mastitic cows in Ethiopia. The prevalence of MRSA in milking persons was lower from the pooled prevalence of MRSA in Ethiopia.
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    Sero-prevalence of hepatitis B virus and human immunodeficiency virus, and associated factors among pregnant women attending antenatal care in selected general hospitals of Mekelle and Eastern zone of Tigray region, Northern Ethiopia
    (Mekelle University, 2025-06-28) SENAIT KEBEDE
    Background: Hepatitis B virus (HBV) and Human Immunodeficiency Virus (HIV) share common transmission risk factors and represent significant global public health challenges. They are major contributors to morbidity and mortality among pregnant women, especially in low and middle-income countries. However, there is limited local data on the burden of these infections among pregnant women in the study area collectively. Hence, this study was aimed to assess the sero-prevalence of hepatitis B viruses (HBV) and human immunodeficiency viruses (HIV), and associated factors among pregnant women attending antenatal care in selected general hospitals of Mekelle and Eastern Zone of Tigray, Northern Ethiopia. Method: A hospital based cross sectional study was conducted from December 2024 to April 2025 in selected general hospitals of Mekelle and Eastern zones of Tigray. Socio-demographic risk factors data and blood sample were collected from the 238 pregnant women. Rapid diagnostic tests were used to detect HBV and HIV. HBV confirmation with Enzyme linked immune sorbent assay (ELISA) was also performed. Data was entered and analyzed using SPSS version 27. Descriptive and Logistic regression analysis was used to assess associations between variables. A p-value of ≤0.05 was considered as statistical significant. Result: The overall seroprevalence of HBV and HIV were 9.7% and 4.2% respectively. However, no cases of HBV/HIV co-infection were identified. Among the three sites the seroprevalence of HBV and HIV were 8.9% & 3.7%, 8% & 2.7% and 11.9% & 6% in Adigrat, Wukro and Mekelle respectively. Variables like older age (AOR = 3.10, 95% CI: 1.01–9.46, P = 0.047), history of liver disease (AOR = 23.67, 95% CI: 3.55–158.01, P = 0.001), history of abortion (AOR: 0.23, 95% CI: 0.05-0.96; p=0.043), nose piercing (AOR: 4.01, 95% CI: 1.35, 11.92; p=0.013) and history of sexually transmitted infection(AOR: 5.94, 95% CI: 1.41-24.99; p=0.015) were revealed significant association with seroprevalence of HBV while knowledge about transmission of HIV (Exact OR = 0.10, 95% CI: 0.02–0.72, p = 0.0219) was the only variable significantly associated with of HIV infection. Conclusion: The overall seroprevalence of HBV among pregnant women attending antenatal care was high according to WHO classification. The current HIV prevalence lies within the range of the pooled HIV prevalence among pregnant women in Ethiopia