Prevalence of salmonella Infections in Patients Attending St. Dominic Hospital, (Akwatia)-Eastern Region

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The St. Dominic hospital in Akwatia reports high Salmonella infection with the source of these infections unknown. The prevailing Salmonellae species and their antimicrobial susceptibility pattern are not known. It is also not known if the Salmonellae there produce Extended Spectrum Beta Lactamase (ESBL). This study therefore investigated the prevalence of Salmonella serotypes isolated from both clinical and water samples in Akwatia. Four hundred and sixty four (464) samples comprising 270 Stool and 194 Blood samples were collected from patients attending the St. Dominic Hospital in Akwatia. One hundred and eighty eight (188) water samples were also cultured for Salmonella. Prevalence of Salmonella was 11.6% (54/464) for the clinical samples tested and 2.7% (5/188) for the water samples. Out of the 54 clinical isolates, 31.4% (16/54) were typhoidal Salmonellae while 68.6% (38/54) were non-typhoidal Salmonellae. Salmonella Typhi recording 20.4% (11/54) was the most frequently encountered typhoidal isolate while S. Enterica, 29.6% (16/54) followed by Salmonella Typhimurium 24.1% (13/54) were predominant among the non typhoidal isolates. Abdominal pain and fever were the most common patient complaints. The water samples tested had bacterial count of 2.56 x103-1.2 x 1013 per millilitre. Salmonella were isolated from 9.4% (5/188) of the water samples collected. The Salmonella isolates had high proportions resistant to ampicillin 69.5% (41/59), piperacillin 69.5% (41/59) and Trimethoprim- Sulfamethoxaxole 76.3% (45/59). All the Salmonella isolates were, however, susceptible to cefoxitin (100%), cefotaxime (100%), cefepime (100%), Imipenem (100%), meropenem (100%) and amikacin (100%). No isolate was found to be resistant to norfloxacin and ciprofloxacin. Varying resistance patterns were observed with the other antibiotics. No strain was found to produce ESBL. Salmonella infection can be acquired from the well water. The use of cephalosporins, quinolones, carbapenems and amikacin are recommended as the drug of choice for both typhoidal and non-typhoidal Salmonellosis.
A thesis submitted to the School of Graduate Studies, Kwame Nkrumah University of Science and Technology in partial fulfilment of the requirement for the award of Master of Science degree, January-2014