Abstract:
Although enteric bacterial pathogens are a leading cause of diarrhea in children under
five years, their distribution and antimicrobial resistance is characterized by seasonal
variation. This cross-sectional study determined seasonal variation of enteric bacterial
pathogens and their antimicrobial resistance among diarrheic children during the dry
(n=218) and rainy seasons (n=156) in Nairobi city, Kenya. Stool microbiology tests were
used to diagnose enteric bacterial pathogens. Antimicrobial resistance was determined
by disk diffusion test. Prevalence of diarrheagenic E. coli, in particular enteroaggregative
E. coli (EAEC) and enterotoxigenic E. coli (ETEC), was higher during the dry season
(P<0.05). While the prevalence of Shigella species infections did not differ significantly
across the seasons (P=0.997), prevalence of Shigella/E. coli co-infection was significantly
higher during the dry season (P=0.012). Antimicrobial resistance rates of diarrheagenic
E. coli to ampicillin, amoxicillin/clavulanic acid and erythromycin was higher while that
of ciprofloxacin was lower during the rainy season (P<0.05). Antimicrobial resistance
rates of Shigella species to ampicillin, ceftriaxone, streptomycin and erythromycin was
higher during the rainy season (P<0.05). There is seasonal variation in diarrheagenic E.
coli, particularly EAEC and ETEC, and co-infection with Shigella species. Diarrheagenic
E. coli and Shigella species showed seasonal trend in resistance to four commonly
prescribed antibiotics.
Keywords: Seasonality, enteric bacterial pathogens, antimicrobial resistance.
