Inappropriate Use of Antibiotics and Its Associated Factors among Urban and Rural Communities of Bahir Dar City Administration,Northwest Ethiopia

Background

Inappropriate use of antibiotics in the community plays a role in the emergence and spread of bacteria resistant to antibiotics which threatens human health significantly. The present study was designed to determine inappropriate use of antibiotics and its associated factors among urban and rural communities of Bahir Dar city administration.

Methods

A comparative cross sectional study design was conducted in urban and rural kebeles of Bahir Dar city administration from February 1 to March 28, 2014. A total of 1082 participants included in the study using a systematic random sampling technique. Data was collected using pre-tested and structured questionnaire. Data was coded and entered into SPSSS version 16 for statistical analysis. Bivariate and multivariate logistic regression model were used to identify factors associated with inappropriate use of antibiotics.

Results

Inappropriate use of antibiotics was 30.9% without significant difference between urban (33.1%) and rural (29.2%) communities. From the inappropriate antibiotic use practice, self-medication was 18.0% and the remaining (12.9%) was for family member medication. Respiratory tract symptoms (74.6%), diarrhea (74.4%), and physical injury/wound (64.3%) were the three main reasons that the communities had used antibiotics inappropriately. Factors associated with inappropriate use of antibiotics were low educational status, younger age, unsatisfaction with the health care services, engagement with a job, and low knowledge on the use of antibiotic preparations of human to animals.

Conclusions

Inappropriate use of antibiotic exists in the study area with no significant difference between urban and rural communities. The study indicated an insight on what factors that intervention should be made to reduce inappropriate use of antibiotics in the community. Interventions that consider age groups, educational status, common health problems and their jobs together with improvement of health care services should be areas of focus to reduce inappropriate use of antibiotics.     

Role of Flagella in Virulence of the Coral Pathogen Vibrio coralliilyticus

A recently available transposition system was utilized to isolate a nonmotile mutant of the coral-bleaching pathogen Vibrio coralliilyticus. The mutation was localized to the fhlA gene, and the mutant lacked flagella. The flhA mutant was unable to exhibit chemotaxis toward coral mucus or to adhere to corals and subsequently cause infection.Coral reefs have been described as the rain forests of the sea due to their enormous biodiversity. Unfortunately, during the past few decades nearly 30% of the worldwide coral population has been severely damaged by various diseases (9). Coral bleaching is a disruption of the Symbiodinium-coral symbiosis and results in “whitening” of the coral due to the loss of the Symbiodinium symbiont or its pigment. On a global scale, bleaching is one of the major coral diseases (5) and tends to correlate with increased seawater temperatures (10). Thermal stress is the generally accepted hypothesis to explain the mechanism of the disease. In the last several years, bacterial bleaching of corals has been suggested as an alternative hypothesis to explain some coral bleaching episodes (21, 22). Vibrio shiloi was the first bacterium shown to be a causative agent of coral bleaching in the Mediterranean coral Oculina patagonica (13, 14). More recently, Vibrio coralliilyticus has been reported to be the causative agent of temperature-induced bleaching of Pocillopora damicornis (3, 4) and white syndrome in Indo-Pacific corals (25). Thus, infections by V. coralliilyticus could have an impact on global coral health.Chemotaxis and flagellum-mediated motility allow bacteria to pursue nutrients and to reach and maintain their preferred niches for colonization (7, 8). Several Vibrio species (both pathogens and symbionts) require functional flagellum-mediated motility to invade their hosts and establish successful colonization (17, 18, 27, 28).In this study, we utilized a recently available Tn5-based transposition system to isolate a nonmotile mutant of the coral-bleaching pathogen V. coralliilyticus. The mutation was localized to the gene flhA. Here we demonstrate that the flagellum is critical for chemotaxis toward coral mucus, adhesion to the corals, and infection by V. coralliilyticus.     

Changes in Microbial Communities Associated with the Sea Anemone Anemonia viridis in a Natural pH Gradient

Ocean acidification, resulting from rising atmospheric carbon dioxide concentrations, is a pervasive stressor that can affect many marine organisms and their symbionts. Studies which examine the host physiology and microbial communities have shown a variety of responses to the ocean acidification process. Recently, several studies were conducted based on field experiments, which take place in natural CO₂ vents, exposing the host to natural environmental conditions of varying pH. This study examines the sea anemone Anemonia viridis which is found naturally along the pH gradient in Ischia, Italy, with an aim to characterize whether exposure to pH impacts the holobiont. The physiological parameters of A. viridis (Symbiodinium density, protein, and chlorophyll a+c concentration) and its microbial community were monitored. Although reduction in pH was seen to have had an impact on composition and diversity of associated microbial communities, no significant changes were observed in A. viridis physiology, and no microbial stress indicators (i.e., pathogens, antibacterial activity, etc.) were detected. In light of these results, it appears that elevated CO₂ does not have a negative influence on A. viridis that live naturally in the site. This suggests that natural long-term exposure and dynamic diverse microbial communities may contribute to the acclimation process of the host in a changing pH environment.