Bacteriological Identication among Patients Attending at Jimma University Veterinary Clinic

Findings of conducted study showed that the predominant bacteria in Jimma University Veterinary Clinic. Among predominant bacteria identied includes; Escherichia coli 46 (34.3%), Klebsiella 23(17.2%), followed by Staphylococcus aureus 40(29.9%) and Streptococcus spp 25(18.7%). Among 4 species of bacteria isolated, 2 were gram negative and 2 of them was gram positive bacteria. Among the antibiotic susceptibility test, Staphylococcus aureus showed the total resistant on penicillin while tetracycline showed to have the highest sensitivity. Escherichia coli showed the total resistant on gentamicin (100%). Veterinary Clinic is at risk of acquiring bacterial infections due to the presence of mentioned bacteria during this study. The big issue is that these infections resist to antibiotics used in treatment according to results of the study. Health care workers in Veterinary Clinic should improve hygiene to control clinic acquired infections and much attention should be done during diagnosis to improve treatment of patients.


Introduction
Veterinary clinics acquired infections are known to be common cause of morbidity and mortality among animal patients. Antibiotic-resistant bacteria as the etiology of infection have been expanding at an alarming rate.These infections are due to Multi-Drug Resistant (MDR) bacteria and seriously lead to health care problem, and a daily challenge among Veterinarians dealing with diagnosis and treatment of patients. Cross-contamination of pathogens among patients of inanimate surfaces around patients in Veterinary clinics has been clearly identi ed in outbreaks; contamination can take place either by microorganisms transfer that contaminated health workers' hands or direct patient shedding of microorganisms while performing their task related to patient care and treatment. Infections crossing from patient to another as well as from Veterinary clinic workers to patients constructed huge hazards in health care especially in developing country. These infections are mostly known to be causes of morbidity and mortality of animals on the worldwide. Contamination due to bacteria in clinics are related directly or indirectly to the use of antibiotics in improper way by number of owners. Haphazard use of antibiotics and absence of knowledge are the most imperative variables for the rise, selection, and spread of antibiotic-resistant organisms in the environment. This improper use of Antibiotics creates opportunities of new strains of bacteria appearance that resist to current used antibiotics. Many of the antimicrobial agents are utilized in feed of animal production for controlling diseases and mostly used as growth promoter that is continuously disseminating in human food chain leads serious health problem in human and animals.Cattle that comes to veterinary clinics were a potential source for the contamination of the environment and farm products by antibiotic-resistant of Staphylococcus aureus, Escherichia coli and Streptococcus spp. present in cow milk, dung/cow urine. The way of how Veterinary clinics environment is in terms of hygiene and other activities related to patient care build the way of spreading various antimicrobial-resistance pathogens. Both gram negative and gram positive bacteria resist to antibiotics and most of them are Staphylococci wide variety of Enterobacteriaceae, Pseudomonas species, Acinetobacter species or Candida species. These pathogens are zoonotic in nature and can transmit to human from animals through contaminated milk, meat, water, and direct contact with animals or their environmental equipment. Salmonella spp. is the most ubiquitous organisms in nature and major food-borne zoonotic pathogen, it is also one of the pathogens listed in the WHO priority pathogen list.
Livestock manure contains microbial constituents, which make it a potential source of pathogenic microorganisms for animals and human.
Despite all effort done by veterinarian care setting to reduce the burden of infections in Veterinary care unit, the rate of these infections continue to be a burden, however, patients in Veterinary clinics are at high risk of various infections due to their health state. However, these Veterinary clinics patients are often at risk of infection due to impairing effects of their diseases and therapies on the immune system as well as some operative treatment consequences. Infection categorization is a very big issue in various infection surveillance, control and management, especially in Veterinary clinics as most of patient in this service are risky to get second infection. Health setting acquired infection especially in Veterinary clinics based on time spent at health setting enough to distinguish bacterial infection from community infections.
Veterinarians have taken this inconsideration and con rmed that infection that can occur after pretreatment clinic is not considered to be nosocomial or Veterinary clinics acquired infection.

Study design and sample collection
This study was conducted from January to July 2020 to December 2020 and 134 animal patients comes pus, swab 30 and 14 urine. Inclusion criteria were all patients who diagnosed clinically have bacterial infection.The study was carried out using cross section method to collect the different samples from the patients in aseptic condition and transferred to laboratory on bacteriology service and using Ice box.
Specimen was collected from Veterinary clinics and tested on Microbiology and Bacteriology unit of laboratory. All specimens were registered when collected.

Bacterial identi cation techniques
Different techniques were used for bacterial identi cation. Bacterial identi cation techniques used during the study including gram staining for gram positive and gram negative bacterial differentiation, catalase test to differentiate staphylococci and streptococcus, coagulase test to differentiate staphylococcus aureus (positive) from coagulase negative staphylococci, Mac-Conkey agar was used to identify enterobacteriaceae, however all samples were incubated in Incubators to maintain the growth of bacteria.

Antibiotic susceptibility tests
Antibiotic susceptibility test of bacteria was conducted regarding criteria of clinical and performed laboratory standard institute, using the Kirby-Bauer disc diffusion on Mueller Hinton agar. Isolates were grown in peptone water at 37 0 C turbidity was matched with 0.5 McFarland standards. The placement of various types of antibiotic on culture was taken place on Mueller Hinton agar plate and incubated for 24hr on 37 0 C both the sensitivity and resistance were con rmed by means of measuring the diameter of inhibition zone.     According to Figure 5 above, Streptococcus is also among isolated bacteria, and their frequency was 25(18.7%). In this study the antibiotic susceptibility test for isolate on Streptococcus, showed the total resistance on amoxicillin 25(100%) and moderately resist on cipro oxacin 15(60%) and cefotaxime 13(52%) while imipenem showed sensitivity on 17 (68%). The same study was conducted in Nigeria where Results showed the general resistance to ceftriaxone, cefuroxime, amoxicillin, ampicillin, and cipro oxacin and augmentin which are the drugs of choice to treat thyroid fever in the area of study. Although, sensitivity was seen to o oxacin and chloremphenicol, despite stopping these drugs in treatment of thyroid fever in the area. The antibiotic susceptibility test on E.Coli isolated whose frequency were 46 showed the total resistance on gentamicin 17(100%) moderately resist on ceftazidime 20(23%) and chloremphenicol 9(47%  8%).The very low percentage of the two microorganisms; Klebsiella and Streptococcus spps were also isolated, however, Streptococcus spps was seen in pus and Klebsiella was seen in cow dung and urine specimen. Klebsiella was seen to be resistant to gentamicin and tetracycline; and high sensitivity to penicillin. Streptococcus spps was resistant to Imipenem but sensitive to cefotaxime.

Discussion
The study was carried out for identifying common bacteria in affected animals that were comes to Veterinary Clinics at Jimma University. As shown on the Taking care of patients with much hygiene, and avoiding simple contacts of them will reduce the spread of these kind of infection in veterinary clinic.

Limitation
The study was conducted at Jimma University Veterinary Clinics to identify common bacteria in Veterinary clinics; however, a little sample has taken due to limitation of budget to work with all Veterinary clinics in and around Jimma area.
The second limitation is that only Jimma University Veterinary clinics has clinical microbiology laboratory with techniques of bacterial identi cation like bacterial culture and others in and around Jimma area Veterinary Clinics.

Conclusion And Recommendations
The patients comes to Veterinary clinics are more susceptible to bacterial infections. They are frequently resistant to various used antibiotics; the predominant infecting bacteria in Veterinary clinics were staphylococcus aureus and Streptococcus which are gram positive bacteria, Klebsiella and Escherichia coli which is gram negative bacteria and showed a high resistance to number of antibiotics used during this study. The high increase in resistance of microbes to previous and recent antibiotics is a factor for health facilities to control the spread of infections in terms of improving treatments system as well as providing hygiene to health settings environments and infrastructures.
Based on the above conclusion the following recommendations are forwarded: The ministry of Livestock and Fisheries in collaboration with researchers should plan researches related to antibiotic susceptibility to know if used antibiotics are effective to treat infections in veterinary Clinics.