Abstract:
Background: Children under the age of 5 years continue to suffer the
ravaging effects of microbial resistance. Majority of the infections
associated with this age are of bacterial and viral nature. Highest
mortalities in this age group are those associated with enteric and
diarrheal diseases. Diarrheagenic Escherichia coli (DEC) is among the
leading causes of these diseases due to their ubiquitous nature.
Methods: The study adopted a case-control design and aimed at
investigating antibiotic utilization and resistance in DEC strains
isolated from children under 5 years in Nakuru County. A total sample
size of 384 children were considered. Stool samples from anal swabs
were obtained and cultured on Eosin Methylene Blue (EMB).
Antimicrobial susceptibility testing was done using the Kirby-Bauer
disk diffusion method to segregate the resistant DEC isolates against
amoxicillin, ampicillin, erythromycin, cefoxitin and nalidixic acid.
Results: All the DEC (n=192, 100%) strains were resistant to
amoxicillin, n=168, 87.5% were resistant to ampicillin, n=156, 81.3% to
erythromycin n=72, 37.5% to cefoxitin and only n=64, 33.3% to
nalidixic acid. Based on demographic factors, it was that observed
self-medication leads among factors contributing to the observed
trend in antimicrobial resistance (AMR). Other factors such the length
of antibiotic use did not show any level of significance (p<0.05).
Conclusions: Thus, we conclude that a conglomerate of several
factors is associated with the rising cases of AMR among the DEC
strains. Notably, the use of first-line antibiotics especially the βlactams poses a critical health concern being the most resisted class
of antibiotics. Therefore, the current study unravels the need to
remediate the effects of AMR among the DEC strains through proper
formulation and implementation of guidelines on antibiotic usage.
