4 research outputs found
Antimicrobial Resistance Patterns of bacterial Septicaemia infecting infants in Mbita Subcounty, Western region of Kenya
Background: Gram positive bacteria such Escherichia coli, Group B Streptococcus coagulase-negative staphylococci, Staphylococcus aureus, and Gram-negative bacteria such as Klebsiella and Pseudomonas species are listed as some of the bacteria etiologies for pediatric septicemia. These bacteria are rapidly becoming multi drug resistant to penicillin (or aminopenicillin), gentamicin, the pragmatic antibiotic treatment regimens. Further, the ever-increasing burden of bacteria septicemia infection due to extended-spectrum β-lactamase (ESBL) producing Gram negative bacteria cumulatively presents a major health concern in the management and treatment of bacterial septicemia. In this study we present data on the prevalence and type of antimicrobial resistant patterns among children with bacterial septicemia in Mbita Sub county Hospital, Western region of Kenya. Methods: Blood samples were obtained from 248 children whose parents/guardian consented. The bacterial isolation and characterization were done using the automated BACTEC 9240 system, conventional culture using morphology, Gram stain and biochemical identification. Further identification and resistant gene detection were determined using Polymerase Chain Reaction (PCR). Descriptive statistics were used to present data. Results: Eighty-four (33.9%) patients had septicemia where Staphylococcus epidermidis (28.6%), S. aureus (13.1%), Escherichia coli (13.1%) and single Salmonella Paratyphi B, Citrobacter freundii, Gemella morbillorum, Klebsiella pneumoniae, Lactococcus lactis cremoris, Pantoea spp, and Pseudomonas putida were implicated. The majority of gram-negative bacteria were resistant to penicillin (Ampicillins) 100%, 96.1% to tetracyclin, 84.6% to sulphonamides (Trimethoprim/sulfamethoxazole), 73.1% Aminoglycosides (Gentamicin) 73.1% and 19.2% to Quinolone (Ciprofloxacin). For gram positive bacteria majority 96.7% were resistant to sulphonamides (Trimethoprim/sulfamethoxazole) followed by tetracycline 76.7%, penicillin (Oxacilline) 73.3% and least resistant to Quinolone (Ciprofloxacin) 30%. Various antimicrobial resistant genes mecA, SulII, blaTEM, TetA aac (3) were identified. Conclusion. In this geographically defined region of Kenya, of the 33.9% children with septicemia, gram positive bacteria were the leading cause septicemia. High level resistance due to various resistant genes were seen all type of antibiotics by both Gram positive and negative bacteria. Rapid antibiotic resistant testing is encouraged for appropriate treatment and management of septicemia infection. Keywords: bacterial Septicemia, Epidemiology, Children under five, South Nyanza, Kenya DOI: 10.7176/JNSR/10-10-07 Publication date:May 31st 202
Epidemiology of bacterial Septicemia among children under five in Mbita Subcounty, South Nyanza, Kenya
Background: Septicaemia is a major cause of mortality and morbidity, especially in sub-Saharan Africa leading to complications marked by bodily inflammation referred as sepsis. This is a systemic disease associated with presence of pathogenic microorganisms (viral, parasitic and bacterial) or their toxins in the blood. Bacterial septicaemia is the most fatal and prevalent in hospitalised cases. Globally, 76% of children under five years die due to septicaemia. In East Africa a mortality rate of 40% have been reported. In Kenya, South Nyanza regions have reported higher morbidity and mortality cases among children. We hypothesis that apart from immunosuppressive diseases, septicaemia could contribute significantly to this prevalence in the region. Methods: Blood samples were obtained from 248 children whose guardian consented and a detailed sociodemographic questionnaire was administered. Bacterial isolation and characterization were done using the automated BACTEC 9240 system. Results: The mean age of the participants was 27.9 (SD ±20.7) months. The majority (30.6%) were aged between 1 to 12 months, 50.8% were males, 58.9% had body temperatures above 37.6 OC while only 8.1% were HIV seropositive. The mean white blood cells (WBC) of the participants were 17720.9 (SD 8929.1) cells/ml with 5.2% had leucopenia. A total of 84 of the 248 (33.9%) of the children had septicaemia with the majority (28.6%) caused by Staphylococcus epidermidis followed by Staphylococcus aureus and Escherichia coli each at 13.1%. Bacteria that were reported singly included Salmonella Paratyphi B, Citrobacter freundii, Gemella morbillorum, Klebsiella pneumoniae, Lactococcus lactis cremoris, Pantoea spp, and Pseudomonas putida. In multivariate regression analysis, female gender (OR 0.6; 95% confidence interval (CI) 0.4 to 0.9), co-infection with malaria (OR 2.7; 95% CI 1.1 to 6.7) and gastrointestinal disorders (OR 2.9, 95% CI 1.3 – 7.3) were independently associated with bacterial septicemia infection. Conclusion: Significantly higher proportion of the children in this region are infected with septicaemia. Majority of the cases were caused by Gram positive bacteria. Age and other c-infection contribute significantly to septicaemia infection in this region. Rapid testing and etiological characterisation of children with suspected symptoms of septicaemia is key in this region in order to institute appropriate treatment and management. Keywords: bacterial Septicemia, Epidemiology, Children under five, South Nyanza, Kenya DOI: 10.7176/JNSR/10-10-06 Publication date:May 31st 202
Prevalence, seasonal variation, and antibiotic resistance pattern of enteric bacterial pathogens among hospitalized diarrheic children in suburban regions of central Kenya
Background: The epidemiology of enteric pathogens has not been well studied in Kenya because of wide disparities in health status across the country. Therefore, the present study describes the prevalence of enteropathogenic bacteria, their seasonal variation, and antibiotic resistance profiles among hospitalized diarrheic children in a suburban region of central Kenya. Methods: Fecal samples were collected between July 2009 and December 2013 from a total of 1410 children younger than 5years, hospitalized with acute diarrhea in Kiambu County Hospital, Kenya. Conventional culture, biochemical, and molecular methods were conducted to identify causative bacterial pathogens and their virulence factors. Antimicrobial susceptibility tests were performed using E-test strips and VITEK-2 advanced expert system (AES) to evaluate the drug-resistance pattern of the isolates. Results: Of the 1410 isolates, bacterial infections were identified in 474 cases. Diarrheagenic Escherichia coli (DEC) was the most frequently isolated pathogen (86.5%). Other pathogens such as Aeromonas (5.5%), Shigella (4%), Salmonella (3.4%), Providencia (3.2%), Vibrio spp. (1.1%), Yersinia enterocolitica (1.1%), and Plesiomonas shigelloides (0.2%) were also identified. Mixed bacterial infection was observed among 11.1% of the cases. The highest infection rate was found during the dry season (59.3%, p=0.04). Most of the DEC was found to be multidrug resistant to trimethoprim/sulfamethoxazole 97.6%, amoxicillin 97.6%, erythromycin 96.9%, ampicillin 96.6%, and streptomycin 89%. Conclusions: This study suggests that DEC is the leading diarrhea-causing bacterial pathogen circulating in central Kenya, and seasonality has a significant effect on its transmission. Proper antibiotic prescription and susceptibility testing is important to guide appropriate antimicrobial therapy