Seasonality of Enteric Bacterial Pathogens and Antimicrobial Resistance Profiles among Diarrheic Children in Nairobi City, Kenya

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.