Determining rates of dysentery and salmonellosis among patients hospitalized for intestinal infections

Abstract

Background: According to health statistics, intestinal infectious diseases in Mongolia have increased three times in 2022 and 7 times in 2023 compared to 2021. In countries around the world, the problem of treatment of intestinal infections caused by antibiotic-resistant bacteria is becoming acute. However, in our country, the system for monitoring the state of antibiotic resistance is weak, and more detailed studies in this direction are still needed. Therefore, it is necessary to study the prevalence of common intestinal infections and antibiotic resistance. Aim: To determine the prevalence of salmonellosis and shigellosis among patients hospitalized for diarrhea at the National Center for Communicable Diseases and to determine antibiotic resistance. Materials and Methods. The survey was carried out using snapshot research and included the patients who went to the National Health Center with symptoms of intestinal infection between 07/01/2023 and 09/29/2023. Pathogenic bacteria were cultured from the samples, sensitivity was determined by Vitek 2 compact (BioMerieux, France), antibiotic sensitivity was determined by Vitek 2 compact (BioMerieux, France), and disk permeation method (HiMedia, India), STARMag 96 ProPrepC, Allplex performed PCR analysis. ™ GI-Bacteria Assay I, II (Seegene, Korea) was used. Statistical analysis was performed with the SPSS-22 program. Results: In the study, 225 (91.8%) Ulaanbaatar patients, 20 (8.1%) local patients, and a total of 245 patients who were admitted to the NCCD were enrolled. The mean age of the study participants was 15 (95% CI 13–17). Of the respondents, 43.7% (n=107) were female and 56.3% (n=138) were male. Of the 245 patients studied, 21/8.5% (CI 95% 5.6-12.8%) had salmonellosis, 186/75.9% (CI 95% 70.1-80.9%) had shigellosis, and 38/15.5% (CI 95% 11.5-20.6%) ) other intestinal infections were diagnosed. Salmonella, shigellosis, and other infections are analyzed by univariate analysis and for shigellosis the results of intestinal infection treatment, age, sex, and region was statistically significantly different (p<0.05). In determining the antibiotic resistance of Shigellosis, ampicillin was 92.3% (CI 95% 80.7-97.25), ampicillin-sulbactam 80.8% (CI 95% 67.3-89.6), ciprofloxacin 69.2% (CI 95% 55.0-80.5), levofloxacin 63.5% (CI 95% 49.2-75.7), 61.5% (CI 95% 47.3-74.0) for trimethoprim-sulfometaxazole, and 80.8% (CI 95% 67.3-89.6) for gentamicin. But for piperacillin-tazobactam 98.1% (86.8-99.7), cefazolin 50% (29.7-70.3), ceftriaxone 82.7% (69.4-90.9), ceftazidime 98.1% (86.8-99.7), cepifime 100%, imipenem 97.7% (84.2-99.7), 97.7% (84.2-99.7) to meropenem, 100% to ertapenem, 95.8% (72.6-99.5) to tobramycin, and 100% to amikacin. Conclusions: 1. Of the 245 patients surveyed, 21 or 8.5% (CI 95% 5.6-12.8%) had salmonellosis, 186 or 75.9% (CI 95% 70.180.9%) had shigellosis, 38 or 15.5% (CI 95% 11.5 - 20.6%) had other intestinal infections. 2. 61.5-92.3% resistance to ampicillin, ampicillin-sulbactam, ciprofloxacin, trimethoprim-sulfamethoxazole, levofloxacin, gentamicin, piperacillin-tazobactam, ceftriaxone, ceftazidime, cefepime, imipenem, meropenem, ertapenem, tobramycin, amikacin 82.7-10 0% sensitivity.