Emerging Antimicrobial Resistance Patterns of Enteric Pathogens Isolated from Children under 5 years of age in five EAPHLNP Satellite Sites in Kenya.

Abstract

The emergence of resistance to antimicrobial agents in bacterial pathogens is a worldwide problem that has been associated with inappropriate use in human and veterinary medicine. Between 12th February 2013 and 30th July 2014 from a total of 420 children under 5 years of age with diarrhea were analyzed for bacterial enteric pathogens of which E. coli isolates were characterized by Polymerase Chain Reaction for the presence of virulence genes.

Patients from whom bacterial enteric pathogens were isolated and identified from the 5 satellite sites were 145, Wajir (21), Malindi (42), Kitale (34), Machakos (18) and Busia (30) County Referral Hospitals. Antibiotic susceptibility testing was done on all isolates: pathogenic E. coli (55), Salmonella (22) and Shigella (72) using disk-diffussion methods containing Ampicillin, Cefotaxime, Tetracycline, Erythromycin Gentamicin, Chloramphenicol, Trimethoprim/Sulphamethoxazole, Ciprofloxacin, Furasolidine and Nalidixic acid. E. coli, Shigella and Salmonella isolates showed up to 100% level of resistance to ampicillin, trimethoprin/sulphamethoxazole and erythromycin.

Furthermore, pathogenic E. coli revealed tetracycline resistance ranging from 67% to 76% in all sites. Emerging resistance to ciprofloxacin ranged from 14.3% in Wajir to 50.0% in Machakos and gentamycin resistance ranged from 20% in Kitale to 100% in Wajir. Salmonella isolates showed levels of resistance ranging from 25% to 100% in Busia and 14% to 100% in Wajir for all the antimicrobials tested.