Antimicrobial resistance of Campylobacter isolates from small scale and backyard chicken in Kenya

Background Thermophilic Campylobacter species are a major cause of bacterial foodborne diarrhoea in humans worldwide. Poultry and their products are the predominant source for human campylobacteriosis. Resistance of Campylobacter to antibiotics is increasing worldwide, but little is known about the antibiotic resistance in Campylobacter isolated from chicken in Kenya. In this study, 35 suspected Campylobacter strains isolated from faeces and cloacal swabs of chicken were tested for their susceptibility to seven antibiotics using a broth microdilution assay and molecular biological investigations. Results Overall, DNA of thermophilic Campylobacter was identified in 53 samples by PCR (34 C. jejuni, 18 C. coli and one mix of both species) but only 35 Campylobacter isolates (31 C. jejuni and 4 C. coli) could be re-cultivated after transportation to Germany. Isolates were tested for their susceptibility to antibiotics using a broth microdilution assay. Additionally, molecular biological detection of antibiotic resistance genes was carried out. C. jejuni isolates showed a high rate of resistance to nalidixic acid, tetracycline and ciprofloxacin of 77.4, 71.0 and 71.0 %, respectively. Low resistance (25.8 %) was detected for gentamicin and chloramphenicol. Multidrug resistance in C. jejuni could be detected in 19 (61.3 %) isolates. Resistance pattern of C. coli isolates was comparable. Resistance to ciprofloxacin was confirmed by MAMA–PCR and PCR–RFLP in all phenotypically resistant isolates. The tet(O) gene was detected only in 54.5 % of tetracycline resistant C. jejuni isolates. The tet(A) gene, which is also responsible for tetracycline resistance, was found in 90.3 % of C. jejuni and in all C. coli isolates. Thirteen phenotypically erythromycin-resistant isolates could not be characterised by using PCR–RFLP and MAMA–PCR. Conclusions To the best of our knowledge, this study is the first report about resistance to antibiotics in thermophilic Campylobacter originating from chicken in Kenya. Campylobacter spp. show a high level of resistance to ciprofloxacin, nalidixic acid and tetracycline but also a remarkable one to chloramphenicol and gentamicin and they are multidrug resistant. Resistance to antibiotics is a global public health concern. In Kenya, resistance surveillance needs further attention in the future. Efforts to establish at least a National Laboratory with facilities for performing phenotypic and genotypic characterization of thermophilic Campylobacter is highly recommended

Maternal Outcomes among Grand Multiparous and Multiparous Women in Mulago Hospital, Uganda

Objective: To compare the incidence of intrapartum and immediate post-partum complications among grand multiparous (para 5-9) and multiparous (para 2-4) delivering at Mulago hospital, Uganda.Design: Prospective cohort study.Setting: Mulago hospital, Uganda.Subjects: One hundred and fifty six grand multiparous and multiparous women were recruited on admission in labour ward and followed up through labour and immediate post partum period. Maternal complications among the two groups were collected and analysed.Results: Women with grandmultiparity were significantly older and had a lower educational profile than multiparous women. The overall incidence of intrapartum and immediate post-partum complications for grandmultiparous women was 13.5% compared with 9.6% in the multiparous group RR 1.19 (0.88-1.61). Grand multiparous (GMP) women were more likely to have PPH than the multiparous (MP) women 6.4% vs. 1.9% RR l.61 (1.20-2.17).Conclusion: Post-partum haemorrhage (PPH) was higher among the GMPs when compared to MPs