Isolation and Characterization of Bacteria Pathogens in Blood and Stool Samples among Patients Presenting with Typhoid Fever Symptoms in Alupe, Busia County
Mureithi, Maryanne Wanjiru
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Typhoid fever is a waterborne and food borne disease caused by Salmonella enterica serotype Typhi (S. Typhi). Studies have established that some patients presenting with typhoid-like symptoms are usually inflicted by other bacteria pathogens, which mayor may not be transmitted by fecal oral route. It is common belief that typhoid fever cases are high in Alupe and continue to cause significant morbidity among the people of Alupe, Busia County. The study focused on isolation and characterization of the bacteria pathogens in blood and stool among patients presenting with typhoid fever symptoms at two health facilities located in Alupe, Busia County. A total of one hundred and fifty patients were recruited and thereafter their blood and stool samples collected. Subsequently, laboratory analysis at KEMRI-CIPDCR was done to isolate and characterize bacteria pathogens as well as their antibiotic susceptibility profiles done. One hundred and forty nine blood cultures and 140 stool cultures were performed. Bacterial pathogens were detected in 11 positive cultures with both gram-positive (27.3%) and gram-negative bacteria (72.7%) obtained. Bacteria isolated from blood cultures included Staphylococcus aureus (50%), Proteus mirabilis (16.67%) and Escherichia coli (33.33%). Those from stool cultures included Escherichia coli (80%) and Shigella dysentriae (20%). Using Widal test, 73 (50%) samples tested positive for typhoid but there was no S. Typhi isolated from both blood and stool cultures. All the isolates showed moderate to high resistance to ampicillin-cloxacillin, tetracycline and cefuroxime. The high susceptibility of the isolates to gentamicin, chloramphenicol and ciprofloxacin is a welcome relief to increasing widespread multi-drug resistance. In Alupe, a malaria endemic region, S. Typhi is not the main cause of invasive bacteremia in patients presenting with signs and symptoms of typhoid fever. There is need for improved diagnostic methods; patients presenting with typhoid fever symptoms should also be screened for other bacteria pathogens in addition to Salmonella to enhance proper treatment and overall control of multi-drug resistance due to misdiagnosis and improper prescription of antibiotics.