Bacterial Aetiologies of Diarrhea Among Children Seeking Treastment in Nairobi City, Kenya

Author

Mark Kilongosi Webale

Abstract

 Diarrhea remains to be a public healtb burden globally including Kenya. Therefore, this cross-sectional study characterized enteric bacteria and antibiotic resistance among diarrheic children younger than five years seeking treatment at Mbagathi hospital, Nairobi city, Kenya.  Stool samples were cultured and identified via gram staining and biochemical tests. Resistant phenotypes were determined by disk diffusion method.   Polymerase chain amplification was used for genotyping. A total of 136 (36.4%) children were infected with diarrheagenic E. coli harbouring enteroaggregative Escherichia coli (EAEC), enteropathogenic Escherichia coli (EPEC), enterotoxigenic Escherichia coli (ETEC) or enteroinvasive Escherichia coli (EIEC) single and hybrid virulent gene.  Salmonella species harbouring invA, hilA, sopB or stn virulent genes was detected in 9 (2.4%) children.  There were 12 (3.2%) children infected with Shigella species which harboured ipaH virulent gene.  Campylobacter and Yersinia species which harboured cadF and Inv virulent genes, was isolated from 6 (1.6%) and 5 (1.3%) children, respectively.  Aeromonas species which harboured aerA, hlyA, alt, or ast virulent genes was detected in 4 (1.1%) children. There were 9 (2.4%) children co-infected with Shigella species and E. coli.  Prevalence of E. coli in particular EAEC and ETEC virulent genotypes and that of Shigella/E. coli co-infection was higher during the dry season (P<0.05).  Most of the phenotypic resistant isolates harboured citm, bla CMY, aadA1, aac(3)-IV, qnr, catA1, ereA and tetA genes associated with ampicillin, ceftriaxone, streptomycin, gentamycin, ciprofloxacin, chloramphenicol, erythromycin and tetracycline resistance.  Bacteria remaims to be an important cause of diarrhea in children in Nairobi. Therefore, children in Nairobi should be provided with safe water, sanitation and hygiene. 

Keywords

• Bacterial diarrhoea, Childhood diarrhoea, Nairobi, Kenya, Pediatric gastroenteritis, Under-five morbidity, Enteric pathogens, Stool culture

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