SA Kuve¹*, Jacob O Ouko², Susan Kiiru³, Dan Waithiru³, Ben Brian¹, Zamith Oginga⁵, Sharon Sang³, John Maina³, Noel Oduor⁴ and JN Mwaniki³

¹KEMRI Graduate School, Kenya Medical Research Institute, Jomo Kenyatta University of Agriculture and Technology, Kenya

*Corresponding Author: SA Kuve, KEMRI Graduate School, Kenya Medical Research Institute, Jomo Kenyatta University of Agriculture and Technology, Kenya.

Received: February 27, 2023; Published: March 15, 2023

Abstract

The World Health Organization has declared antimicrobial resistance a public health threat. Known multidrug resistant strains including Escherichia coli and Klebsiella species have notably emerged as a major health threat, especially with their resistance to a number of antimicrobial agents available. This has been associated with high mortality and morbidity rates attributed to infections believed to have been caused by either E. coli or Klebsiella species. This study will unravel the prevalence of E. coli and Klebsiella species, known reservoirs of resistant genes including Bla genes. Despite the threat these organisms possess to the general public, there was need to avail community based data on its prevalence in both symptomatic and asymptomatic individuals and also determine the drug sensitivity profiles as well as the resistance genes present in isolated bacterial agents. The study conducted in Kibera and Dagoretti areas in Nairobi County targeted the outpatients who presented with arrange of stomach related discomfort and had visited either Mbagathi or Mutuini hospitals. These patients would be identified and requested to partake in the study by voluntarily consenting. Follow-up visits were done to have those who shared residential with the already recruited outpatients to take part in the study too as the asymptomatic group. Stool samples were collected and taken to the Microbiology section of Mbagathi district hospital for culture, Biochemical testing and AST profile analysis then later taken to KEMRI CMR for AMR genes analysis via PCR. Stool samples were cultured directly on MacConkey agar and sub-cultured on TSA agar for purification. Standard Biochemical analysis consisting of IMViC was carried out followed by subjecting the predetermined isolates to a number of antimicrobial agents to test for susceptibility testing. Positively identified potential resistance isolates were subjected to PCR to in presence of respective primers to determine presence of ESBL and KPC genes. Sixty-nine percent (69.8%) of the total study participants had target isolates with Kibera predominantly recording about 67.7%. Contacts participants noted an 80% prevalence. E. coli was the pre-dominant species (50%) but Klebsiella species noted high resistance of over 95%. Resistance was determined at 65% with high resistance being reported in 71% and 63% Trimethoprim/sulphamethoxazole and tetracycline respectively. Notably low resistance was noted in IPM (15%) and Cephalosporin (20%). Most isolates exhibited resistance to more than three antimicrobial agents. Forty four percent of phenotypically resistant isolates had ESBL with OXA being pre-dominant (65%). High prevalence of infection noted in Kibera may be attributed to overcrowding and low level of socio-economic factors including lack of safe drinking water, lack of proper disposable systems, drainage systems and toilets and compromised living standards. Despite low prevalence of these bacteria in Dagoretti, high resistance rate was notably recorded attributing resistance to livestock that are kept almost in every residents. Data from the study will assist in further reference to determine the prevalence which will enlighten the policy makers, health officers including clinician, doctors and pharmacists to only prescribe antimicrobial to diagnosed infections to reduce chances of drug resistance. The general public will also get awareness and education on the dangers of over-counter prescription. More data to determine the role played by domesticated livestock in infections will be critical in the fight against AMR.

Keywords: E. coli; Klebsiella; Kenya

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Citation

Citation: SA Kuve., et al. “Epidemiological Analysis and Diversity of Extended Spectrum Β-Lactamases from Escherichia coli and Klebsiella Species Feacal Isolates in Nairobi, Kenya". Acta Scientific Microbiology 6.4 (2023): 64-77.

Copyright

Copyright: © 2022 SA Kuve., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.