Prevalence and Antimicrobial Resistance of Species and Associated Factors Among Under-Five Children with Diarrhea at Randomly Selected Public Health Facilities in Mekelle, Tigray, Ethiopia.

Background: species are the most predominant bacterial agents to cause diarrhea in under-five children. It poses a serious challenge to public health worldwide with ongoing acquisition of resistance to different antimicrobials with multiple patterns. Thus, this study aimed to determine the prevalence, and antimicrobial resistance of species, and associated factors among under-five children with diarrhea in selected public health facilities.

Methods: A cross-sectional study was conducted among under-five children with diarrhea using convenient sampling. Health facilities were selected using a simple random sampling method. The stool samples collected from 214 study participants were transported and processed following standard microbiological protocols. isolates were identified using Gram staining, biochemical test, serological test, and aerobic growth at 25°C. Antimicrobial susceptibility profiles of isolates were performed using the Kirby-Bauer method. Data were analyzed using SPSS ver. 25.0. Association between variables was assessed using Chi-square test and Logistic regression, with 0.05.

Results: The subject's mean age was 31.3 (±3.9) months. Of the 214 samples cultured, 14 (6.5%) of them were positive for species with 95% CI (3.3-10.3). Out of the isolated species, 12 (85.7%) were / and 2 (14.3%) were other species. Bottle feeding and history of direct contact to domestic animals were associated with Campylobacter species (AOR=5.13, CI=1.21-21.6, p=0.026 and AOR=4.93, CI=1.33-18.17, P=0.016), respectively. isolates were highly resistant to ciprofloxacin 5 (35.7%), and tetracycline 3 (21.4%).

Conclusion: A higher incidence of species was obtained in children who were bottle-fed and who had a history of direct contact with domestic animals. The isolates were highly resistant to ciprofloxacin and tetracycline. These findings indicate that special attention is needed for better management of drug resistance in under-five children. To enhance and support our current findings, further research using molecular techniques is needed to identify the resistant and virulent genes of the bacterial isolates.