Characterization and antimicrobial susceptibility pattern to commonly prescribed antimicrobials of diarrheagenic <i>Escherichia coli</i> in patients attending Thika district Hospital - Kenya, 2014.

Abstract

Background: Diarrheagenic E. coli (DEC) are associated with outbreaks of severe diarrhea and multiple drug resistance. We characterize DEC among diarrhoeal patients attending Thika Hospital and determine their antimicrobial susceptibility patterns. Methods: A cross-sectional study was conducted among patients of all ages seeking diarrhea treatment. Stool samples were collected, inoculated on bacterial differential media for growth of enteric pathogens, characterized and antimicrobial susceptibility of DEC isolates determined. Results: A total of 402 stool samples were cultured. E. coli was isolated from 269, of which 72 (27%) were DEC; 60 (83.3%) enteroaggregative E. coli (EAEC), 6 (8.3%) enteropathogenic E. coli (EPEC) and 6 (8.3%) enterotoxigenic E. coli (ETEC). Of the 72, 58% were female, median age was 8 (IQR: 2-28) years, 75% did not boil water and 100% did not treat water. Twenty five (35%) patients with DEC were under-five years. Drinking un-boiled water (OR: 2.51, 95% CI: 1.36-4.61) was associated with having DEC. All DEC isolates were sensitive to cefoxitin, meropenem, amikacin, gentamicin and ciprofloxacin. They were resistance to ampicillin (92%), trimethoprim-sulfamethoxazole (92%) and amoxicillin-clavulanic acid (85%). Conclusion: The predominant DEC strain was EAEC. High resistant to ampicillin, trimethoprim-sulfamethoxazole and amoxicillin-clavulanic acid were observed. All isolates were sensitive to ciprofloxacin and gentamicin.