ANTIBIOTIC PROFILES OF ENTEROBACTERIACEAE ISOLATED FROM DIARRHOEIC STOOL OF CHILDREN BELOW FIVE YEARS AT MUKURU SLUMS, NAIROBI- KENYA

Abstract

Diarrhoea in young children continues to be a major public health concern in developing countries, including Kenya. Poor sanitation among other factors can predispose a child to diarrhoea. Faecal carriage of bacteria with antibiotic resistant traits greatly affects treatment outcome. The main objective of this study was to determine the aetiological causes of diarrhoea and response of bacterial isolates to selected antibiotics from children presenting with diarrhoea in the government health facility at Mukuru Slums, Nairobi- Kenya. It employed a cross-sectional design targeting children below 5 years of age. Stool specimens were obtained asceptically and cultured on MacConkey agar and Salmonella Shigella agar. Biochemical tests were used to identify the isolated bacteria to genus and species using biochemical characterization scheme and the Analytic Profile Index 20E. Drugs sensitivity tests were done using standard techniques. Escherichia coli ATCC 25922 was included as a control strain. The study showed that there was no statistical significant association (p>0.05) between the gender and areas of residence in relation to diarrheoea. Age of the participants showed significant association with the prevalence of diarrhoea (p=0.00).The E.coli isolates from Mukuru Kwa Njenga showed a higher percentage of pathogens (35.2%) from female children,while 29.4% were from male children. Salmonella spp isolates (4.9%) were isolated from female children and the least was Shigella sonnei (3.2%) from female children from Mukuru Kwa Reuben and Sinai respectively. More than 33.3% of all the isolates from both male and female in all the slums were resistant to Amoxicillin/ Clavulanic Acid. Above 93.4% of E.coli, 100% of Salmonella spp, Salmonella typhi, Shigella sonnei and Shigella dysenteriae were sensitive to Ceftazidime. 52.4% of E. coli, 100% of S. typhi, 66.7% of S. dysenteriae were sensitive while 33.3% of S. dysenteriae and 37.5% of S. sonnei were resistant to Sulphamethoxazole/ trimethoprim. Also 63.9% of E. coli, 80.0% of S. typhi, 66.7% of S. dysenteriae and 25.0% of S. sonnei were sensitive to Tetracycline. 59.6% of E. coli, 100% of Salmonella sp, 20% of S. typhi, 33.3% of S. dysenteriae and 87.5% of S. sonnei were resistant to Ampicillin. 89.8% of E. coli, 100% of Salmonella sp and S. dysenteriae, 80% of S. typhi and 87.5% of S. sonnei were sensitive to Ciprofloxacin. 86.1% of E. coli, 100% of Salmonella sp and S. dysenteriae, 80.0% of S. typhi and 87.5% of S. sonnei were sensitive to Nalidixic acid. Likewise 91.0% of E.coli, 87.5% of Salmonella sp, 100% of S. typhi and S. dysenteriae and 87.5% of S. sonnei were sensitive to Chloramphenicol. All the isolates were above 90.0% sensitive to gentamicin and ceftriaxone. There were isolates which showed multidrug resistance in this study. The E. coli isolate was resistant to Amoxicillin/ Clavulanic Acid and Ampicillin, Salmonella sp was resistant to Amoxicillin/ Clavulanic Acid (100%), Ampicillin (100%) and Tetracycline (87.5%). The S. dysenteriae isolate was resistant to Amoxicillin/ Clavulanic and streptomycin (66.7%), Ampicillin, tetracycline and kanamycin (33.3%). Shigella sonnei isolate was resistant to Amoxicillin/ Clavulanic Acid (50.0%), Ampicillin (87.5%), tetracycline (75.0%), Sulphamethoxazole/ trimethoprim (37.5%). The findings showed that, although there are a number of causative agents of diarrheal diseases, bacteria still remain one of the major causes with Shigella, Salmonella and Escherichia coli being the most prevalent and are usually waterborne. Emphasis should therefore be placed on primary preventive measures such as ensuring good sewerage management and safe supply of drinking water in the study area.