Diarrhea is among the leading causes of morbidity and mortality in children aged Escherichia coli (DEC) accounts for 30% - 40% of childhood diarrhea cases. To identify the pathotypes involved in diarrheal outbreaks in...Diarrhea is among the leading causes of morbidity and mortality in children aged Escherichia coli (DEC) accounts for 30% - 40% of childhood diarrhea cases. To identify the pathotypes involved in diarrheal outbreaks in Kenya, we analyzed archived E. coli isolates from children E. coli confirmation and antimicrobial susceptibility testing were done using the VITEK<sup>®</sup>2 instrument. Pathotype identification was performed via conventional polymerase chain reaction. Of 175 E. coli isolates, 48 (27%) were DEC pathotypes, with enteroaggregative E. coli (EAEC) predominating (71%, 34/48). Enterohemorrhagic (EHEC) and enteropathogenic E. coli (EPEC) represented 19% and 10% of isolates, respectively. Enteroinvasive and enterotoxigenic pathotypes were not identified. All DEC isolates were susceptible to amikacin, ertapenem, imipenem, meropenem and tigecycline. Conversely, most (>80%) isolates were resistant to ampicillin, ampicillin-sulbactam and sulfamethoxazole-trimethoprim. Half of all EAEC and EPEC strains were resistant to cefazolin while half of EHEC isolates were resistant to ciprofloxacin and moxifloxacin. In total, 18 resistance phenotypes were identified with “ampicillin-cefazolin-ampicillin/ sulbactam-sulfamethoxazole/trimethoprim” predominating (33%, 16/48). The majority (81%) of DEC isolates were multidrug-resistant, with extended-spectrum beta-lactamase production identified in 8% of these isolates. This study highlights the predominance of Enteroaggregative E. coli and multidrug resistance of DEC pathotypes. Studying the epidemiology of diarrheal disease and antimicrobial resistance surveillance, will aid in identifying dominant etiological agents of diarrhea and newly emerging resistant strains in informal settlements.展开更多
<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:""><span style="font-family:Verdana;"> In the last two deca...<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:""><span style="font-family:Verdana;"> In the last two decades, the treatment of enteric infections has been complicated by the emergence of antimicrobial resistant strains. Occurrence of multidrug resistant Extended Spectrum Beta Lactamase (ESBL) producing </span><i><span style="font-family:Verdana;">Enterobactaeraceae</span></i><span style="font-family:Verdana;"> pose</span></span><span style="font-family:Verdana;">s</span><span style="font-family:""><span style="font-family:Verdana;"> the greatest risk to public health by raising morbidity and mortality by six folds in developing countries. The present study aims to determine the antibiotics resistance patterns of selected</span><i><span style="font-family:Verdana;"> Entero</span><span style="font-family:Verdana;">bacteriaceae</span></i><span style="font-family:Verdana;"> isolated from commercial poultry production systems i</span><span style="font-family:Verdana;">n Kiamb</span><span><span style="font-family:Verdana;">u County. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A laboratory based cross-sectional study was co</span></span><span style="font-family:Verdana;">nducted in six purposively selected Sub-Counties of Kiambu County from October 2020, to February 2021. A total of 437 fecal samples were collected from each household. The antibiotic susceptibility testing using disk diffusion method w</span></span><span style="font-family:Verdana;">as</span><span style="font-family:""><span style="font-family:Verdana;"> used against </span><i><span style="font-family:Verdana;">E.</span></i></span><i><span style="font-family:""> </span></i><i><span style="font-family:Verdana;">coli</span></i><span style="font-family:""><span style="font-family:Verdana;">;</span><i><span style="font-family:Verdana;"> Salmonella spps.</span></i><span style="font-family:Verdana;">;</span><i><span style="font-family:Verdana;"> Shigella spps.</sp展开更多
<b>Introduction:</b> <i>Campylobacter</i> are zoonotic bacteria that cause gastroenteritis worldwide with the species, <i>Campylobacter jejuni</i> and <i>Campylobacter coli<...<b>Introduction:</b> <i>Campylobacter</i> are zoonotic bacteria that cause gastroenteritis worldwide with the species, <i>Campylobacter jejuni</i> and <i>Campylobacter coli</i> commonly associated with human diarrhea. Transmission is mainly through direct contact with farm animals, consumption of chicken and contaminated water. There is paucity of data on the epidemiology of <i>Campylobacter</i> in developing countries despite its global widespread and expansion of poultry farming;hence there is the need to explore and build on the available data. This study aimed at determining prevalence and homestead risk practices associated with <i>Campylobacter</i> infection in diarrheal patients in Busia County. <b>Methods:</b> A cross-sectional study was conducted from February, 2017 to April, 2019. Stool samples were collected from patients of all ages attending Busia County referral Hospital and structured questionnaires on homestead associated risk practices administered. Isolation and identification of <i>Campylobacter</i> species was performed using standard culture method on Modified Charcoal Cefoperazone Deoxycholate medium and confirmed by mPCR. Factors associated with <i>Campylobacter</i> infection were evaluated using logistic regression analysis. <b>Results:</b> A total of 132 (11.6%) <i>Campylobacter</i> comprising 89.2% <i>C. jejuni</i> and 10.8% <i>C. coli</i> were isolated from 1200 diarrhoegenic patients sampled. Isolation rate was higher in children aged < 2 years (13.7%) as compared to 2 - 5 years (10.2%) and >5 years (9.4%). Multilevel logistic models showed that homestead poultry farming was a significant risk associated with <i>Campylobacter</i> infection in <2 years [odds ratio (OR) 9.02;95% CI: 3.19 - 25.47, P < 0.001], 2 - 5 years (OR 6.47, 95% CI: 2.71 - 15.45, P < 0.001) and >5 years (OR 10.05;95% CI: 2.60 - 24.29, P < 0.001). Other homestead risk practices linked to children < 2 years were drinking of pond water (OR 7.43, 95% CI: 1.70 - 16.33, P < 0.001), repeated use of same food cutting board 展开更多
Antimicrobial resistance (AMR) is a global threat to public health and particularly to children. This study aimed to determine the prevalence of multidrug resistance of fecal <i>Klebsiella spp</i> on selec...Antimicrobial resistance (AMR) is a global threat to public health and particularly to children. This study aimed to determine the prevalence of multidrug resistance of fecal <i>Klebsiella spp</i> on selected beta lactam (3<sup>rd</sup> generation cephalosporins and carbapenems) and fluoroquinolone classes of drugs in four health facilities serving the slum communities of Nairobi city in Kenya. Additionally, determine the genetic basis for the multidrug resistance observed. A cross sectional laboratory based study was undertaken where a total of 1171 children below 16 years were selected, from whom stool samples were collected, tested and analyzed. 395 (33.73%) <i>Klebsiella spp</i> were isolated, consisting of 365 (92.4%) <i>Klebsiella pneumoniae</i> and 30 (7.6%) <i>Klebsiella oxytoca</i> were isolated. The proportion of multi-drug resistance (MDR) <i>K. pneumoniae</i> and MDR <i>K. oxytoca</i> was 64.1% (234/365) and 96.67% (29/30) respectively. Third generation cephalosporins, cefotaxime ceftriaxone and ceftazidime showed the highest resistance of 30.7%, 29.9% and 27.4% respectively, whereas carbapenems including imipenem and meropenem had the least resistance of 1.6%, each, to <i>K. pneumoniae</i>. A significant association was observed in diarrheic children (OR = 1.88;p = 0.01) and those below 50 months (OR = 0.43;p = 0.002) and carrying <i>K. pneumoniae</i> resistance to one or more third generation cephalosporins. Genes associated with resistance included <i>bla</i> TEM 100%, <i>bla</i> CTX-M 95.2%, <i>bla</i> SHV 57.1%, <i>bla</i> OXA-1 66.7%, <i>qnr</i>S 54.1%, <i>qnr</i>B 47.6% and <i>bla</i> NDM 7.1%. In conclusion, there’s need for more effective infection control measures, antimicrobial stewardship to reduce emergence of antimicrobial resistance, improved drinking water, sanitation and hygiene (WASH) practices.展开更多
Background: Streptococcus pneumoniae (pneumococcus) is one of the most frequent causes of bacterial infection in children and is a leading cause of otitis, sinusitis, pneumonia, and meningitis worldwide. Nasopharyngea...Background: Streptococcus pneumoniae (pneumococcus) is one of the most frequent causes of bacterial infection in children and is a leading cause of otitis, sinusitis, pneumonia, and meningitis worldwide. Nasopharyngeal colonization is a risk factor for pneumococcal disease, a leading cause of complications and death in infants. HIV-infected persons are at high risk of invasive pneumococcal disease. Method: Nasopharyngeal swabs were collected from 296 HIV infected children below five years recruited from Gertrude’s Children hospital and Nazareth Hospital Nairobi, Kenya. The nasopharyngeal swabs were processed to isolate S. pneumoniae, which were serotyped and tested for drug susceptibility. Results: The carriage prevalence of S. pneumoniae in the study was 30.4% while the isolated serotypes were (in order of decreasing frequency): 35B, 19F, 3, 13, 15A, 11A, 16F, 7C and 23A. Most of the serotypes were resistant to the commonly used antibiotics but all were susceptible to vancomycin and chloramphenicol. Conclusion: Carriage prevalence of nasopharyngeal S. pneumonia in HIV infected children was lower than that of similar prevalence studies in children. Most of the S. pneumoniae isolates were however non pneumococcal vaccine isolates.展开更多
文摘Diarrhea is among the leading causes of morbidity and mortality in children aged Escherichia coli (DEC) accounts for 30% - 40% of childhood diarrhea cases. To identify the pathotypes involved in diarrheal outbreaks in Kenya, we analyzed archived E. coli isolates from children E. coli confirmation and antimicrobial susceptibility testing were done using the VITEK<sup>®</sup>2 instrument. Pathotype identification was performed via conventional polymerase chain reaction. Of 175 E. coli isolates, 48 (27%) were DEC pathotypes, with enteroaggregative E. coli (EAEC) predominating (71%, 34/48). Enterohemorrhagic (EHEC) and enteropathogenic E. coli (EPEC) represented 19% and 10% of isolates, respectively. Enteroinvasive and enterotoxigenic pathotypes were not identified. All DEC isolates were susceptible to amikacin, ertapenem, imipenem, meropenem and tigecycline. Conversely, most (>80%) isolates were resistant to ampicillin, ampicillin-sulbactam and sulfamethoxazole-trimethoprim. Half of all EAEC and EPEC strains were resistant to cefazolin while half of EHEC isolates were resistant to ciprofloxacin and moxifloxacin. In total, 18 resistance phenotypes were identified with “ampicillin-cefazolin-ampicillin/ sulbactam-sulfamethoxazole/trimethoprim” predominating (33%, 16/48). The majority (81%) of DEC isolates were multidrug-resistant, with extended-spectrum beta-lactamase production identified in 8% of these isolates. This study highlights the predominance of Enteroaggregative E. coli and multidrug resistance of DEC pathotypes. Studying the epidemiology of diarrheal disease and antimicrobial resistance surveillance, will aid in identifying dominant etiological agents of diarrhea and newly emerging resistant strains in informal settlements.
文摘<b><span style="font-family:Verdana;">Introduction:</span></b><span style="font-family:""><span style="font-family:Verdana;"> In the last two decades, the treatment of enteric infections has been complicated by the emergence of antimicrobial resistant strains. Occurrence of multidrug resistant Extended Spectrum Beta Lactamase (ESBL) producing </span><i><span style="font-family:Verdana;">Enterobactaeraceae</span></i><span style="font-family:Verdana;"> pose</span></span><span style="font-family:Verdana;">s</span><span style="font-family:""><span style="font-family:Verdana;"> the greatest risk to public health by raising morbidity and mortality by six folds in developing countries. The present study aims to determine the antibiotics resistance patterns of selected</span><i><span style="font-family:Verdana;"> Entero</span><span style="font-family:Verdana;">bacteriaceae</span></i><span style="font-family:Verdana;"> isolated from commercial poultry production systems i</span><span style="font-family:Verdana;">n Kiamb</span><span><span style="font-family:Verdana;">u County. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A laboratory based cross-sectional study was co</span></span><span style="font-family:Verdana;">nducted in six purposively selected Sub-Counties of Kiambu County from October 2020, to February 2021. A total of 437 fecal samples were collected from each household. The antibiotic susceptibility testing using disk diffusion method w</span></span><span style="font-family:Verdana;">as</span><span style="font-family:""><span style="font-family:Verdana;"> used against </span><i><span style="font-family:Verdana;">E.</span></i></span><i><span style="font-family:""> </span></i><i><span style="font-family:Verdana;">coli</span></i><span style="font-family:""><span style="font-family:Verdana;">;</span><i><span style="font-family:Verdana;"> Salmonella spps.</span></i><span style="font-family:Verdana;">;</span><i><span style="font-family:Verdana;"> Shigella spps.</sp
文摘<b>Introduction:</b> <i>Campylobacter</i> are zoonotic bacteria that cause gastroenteritis worldwide with the species, <i>Campylobacter jejuni</i> and <i>Campylobacter coli</i> commonly associated with human diarrhea. Transmission is mainly through direct contact with farm animals, consumption of chicken and contaminated water. There is paucity of data on the epidemiology of <i>Campylobacter</i> in developing countries despite its global widespread and expansion of poultry farming;hence there is the need to explore and build on the available data. This study aimed at determining prevalence and homestead risk practices associated with <i>Campylobacter</i> infection in diarrheal patients in Busia County. <b>Methods:</b> A cross-sectional study was conducted from February, 2017 to April, 2019. Stool samples were collected from patients of all ages attending Busia County referral Hospital and structured questionnaires on homestead associated risk practices administered. Isolation and identification of <i>Campylobacter</i> species was performed using standard culture method on Modified Charcoal Cefoperazone Deoxycholate medium and confirmed by mPCR. Factors associated with <i>Campylobacter</i> infection were evaluated using logistic regression analysis. <b>Results:</b> A total of 132 (11.6%) <i>Campylobacter</i> comprising 89.2% <i>C. jejuni</i> and 10.8% <i>C. coli</i> were isolated from 1200 diarrhoegenic patients sampled. Isolation rate was higher in children aged < 2 years (13.7%) as compared to 2 - 5 years (10.2%) and >5 years (9.4%). Multilevel logistic models showed that homestead poultry farming was a significant risk associated with <i>Campylobacter</i> infection in <2 years [odds ratio (OR) 9.02;95% CI: 3.19 - 25.47, P < 0.001], 2 - 5 years (OR 6.47, 95% CI: 2.71 - 15.45, P < 0.001) and >5 years (OR 10.05;95% CI: 2.60 - 24.29, P < 0.001). Other homestead risk practices linked to children < 2 years were drinking of pond water (OR 7.43, 95% CI: 1.70 - 16.33, P < 0.001), repeated use of same food cutting board
文摘Antimicrobial resistance (AMR) is a global threat to public health and particularly to children. This study aimed to determine the prevalence of multidrug resistance of fecal <i>Klebsiella spp</i> on selected beta lactam (3<sup>rd</sup> generation cephalosporins and carbapenems) and fluoroquinolone classes of drugs in four health facilities serving the slum communities of Nairobi city in Kenya. Additionally, determine the genetic basis for the multidrug resistance observed. A cross sectional laboratory based study was undertaken where a total of 1171 children below 16 years were selected, from whom stool samples were collected, tested and analyzed. 395 (33.73%) <i>Klebsiella spp</i> were isolated, consisting of 365 (92.4%) <i>Klebsiella pneumoniae</i> and 30 (7.6%) <i>Klebsiella oxytoca</i> were isolated. The proportion of multi-drug resistance (MDR) <i>K. pneumoniae</i> and MDR <i>K. oxytoca</i> was 64.1% (234/365) and 96.67% (29/30) respectively. Third generation cephalosporins, cefotaxime ceftriaxone and ceftazidime showed the highest resistance of 30.7%, 29.9% and 27.4% respectively, whereas carbapenems including imipenem and meropenem had the least resistance of 1.6%, each, to <i>K. pneumoniae</i>. A significant association was observed in diarrheic children (OR = 1.88;p = 0.01) and those below 50 months (OR = 0.43;p = 0.002) and carrying <i>K. pneumoniae</i> resistance to one or more third generation cephalosporins. Genes associated with resistance included <i>bla</i> TEM 100%, <i>bla</i> CTX-M 95.2%, <i>bla</i> SHV 57.1%, <i>bla</i> OXA-1 66.7%, <i>qnr</i>S 54.1%, <i>qnr</i>B 47.6% and <i>bla</i> NDM 7.1%. In conclusion, there’s need for more effective infection control measures, antimicrobial stewardship to reduce emergence of antimicrobial resistance, improved drinking water, sanitation and hygiene (WASH) practices.
文摘Background: Streptococcus pneumoniae (pneumococcus) is one of the most frequent causes of bacterial infection in children and is a leading cause of otitis, sinusitis, pneumonia, and meningitis worldwide. Nasopharyngeal colonization is a risk factor for pneumococcal disease, a leading cause of complications and death in infants. HIV-infected persons are at high risk of invasive pneumococcal disease. Method: Nasopharyngeal swabs were collected from 296 HIV infected children below five years recruited from Gertrude’s Children hospital and Nazareth Hospital Nairobi, Kenya. The nasopharyngeal swabs were processed to isolate S. pneumoniae, which were serotyped and tested for drug susceptibility. Results: The carriage prevalence of S. pneumoniae in the study was 30.4% while the isolated serotypes were (in order of decreasing frequency): 35B, 19F, 3, 13, 15A, 11A, 16F, 7C and 23A. Most of the serotypes were resistant to the commonly used antibiotics but all were susceptible to vancomycin and chloramphenicol. Conclusion: Carriage prevalence of nasopharyngeal S. pneumonia in HIV infected children was lower than that of similar prevalence studies in children. Most of the S. pneumoniae isolates were however non pneumococcal vaccine isolates.
