The antimicrobial susceptibility pattern of campylobacter isolates from Nairobi, Kenya
Kabiru, Nyawira Pity
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Campylobacteriosis is a group of infections caused by Gram negative rods of genus Campylobacter. It is among the most common bacterial infections of humans worldwide. Campylobacteriosis in Kenya is managed and treated presumptively according to its clinical features and manifestation. The common antimicrobial drugs used are: fluoroquinolones, macrolides and quinolones. Indiscriminate use of these drugs may lead to development of antimicrobial resistance. The main objective of this study was to investigate the antimicrobial susceptibility pattern of Campylobacter in Aga Khan University Hospital, Nairobi, Kenya. Four hundred and forty seven (447) diarrheic stool samples were obtained from in and oust-patients seeking treatment in the Hospital. For isolation of Campylobacter, stool samples were cultured onto blood-free selective Campylobacter medium. The isolation rates of bacterial pathogens were 29 (6.5%) for Campylobacter species. Other bacteria isolated were Shigella, Salmonella and Enteropathogenic Escherichia coli. The Campylobacter isolates were characterized to species and sub-species by colonial morphology, staining, motility and Analytical Profile Index (API) Campy strip tests. Out of 29 Campylobacter isolates 28 (96.6%) were C. jejuni and one (3.4%) was C. coh. The proportional distribution of C. jejuni bio-type 1 accounted for six (20.7%) while bio-type 2 accounted for 23 (79.3%). There was significant difference between isolation rates of Campylobacter across the age groups (x2 = 8.825, p = 0.032. There was no significant difference in isolation of Campylobacter between males and females (x2 = 0.534, p = 0.465). Out of the 300 samples that had invasive infection 15 (5%) were due to Campylobacter. Antimicrobial susceptibility testing was performed by disk diffusion method and by E-test system according to Clinical and Laboratory Standards Institute (CLST). The study findings showed that there was no resistance to azithromycin, chloramphenicol,, gentamicin and doxycycline. Resistance to ciprofloxacin was detected in four (13.8 %), ampicillin two (7.1 %), nalidixic acid three (10.3 %), cotrimoxazole 23 (79.3 %). Cross-resistance was detected between ciprofloxacin and nalidixic acid and between cotrimoxazole and ampicillin. Beta-lactamase production was detected in 75.5% of the isolates. The results of this study showed that the prevalence of Campylobacter in the patients from Aga Khan University Hospital was 6.5%. There was detection of resistance of the Campylobacter isolates to some antimicrobial drugs commonly used. Beta-lactamase production occurred in many isolates. It is therefore important for the treatment of Campylobacter to be instituted only after susceptibility testing has been done.