Antimicrobial-Resistant Bacterial Diarrhea in Rural Western Kenya

• Published in: The Journal of infectious diseases Vol. 183; no. 11; pp. 1701 - 1704
• Main Authors: Shapiro, Roger L., Kumar, Lata, Phillips-Howard, Penny, Wells, Joy G., Adcock, Penny, Brooks, John, Ackers, Marta-Louise, Ochieng, John Benjamin, Mintz, Eric, Wahlquist, Susanne, Waiyaki, Peter, Slutsker, Laurence
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.06.2001; University of Chicago Press; Oxford University Press
• Subjects: Adolescent; Adult; Aged; Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antimicrobials; Bacteriology; Biological and medical sciences; Campylobacter; Campylobacter - drug effects; Child; Child, Preschool; Cholera; Concise Communications; Diarrhea; Diarrhea - drug therapy; Diarrhea - epidemiology; Diarrhea - microbiology; Drug Resistance, Microbial; Epidemiology; Fundamental and applied biological sciences. Psychology; Gram-Negative Bacteria - drug effects; Humans; Infant; Kenya; Male; Medical sciences; Microbiology; Middle Aged; Pathogens; Pharmacology. Drug treatments; Population Surveillance; Preventive medicine; Rural Population; Salmonella; Salmonella - drug effects; Shigella; Shigella - drug effects; Specimens; Vibrio cholerae - drug effects; Kenya; Sub-Saharan Africa; Africa; Human; Salmonella; Campylobacteraceae; Vibrio cholerae; Diarrhea; Shigella dysenteriae; Epidemiology; Antimicrobial agent; Standards; Infection; Campylobacter infection; Resistance; Sensitivity; Bacteriosis; Digestive diseases; Intestinal disease; Vibrionaceae; Bacteria; Isolate; Salmonellosis; Feces; Enterobacteriaceae; Campylobacter
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/320710

Bacterial diarrheal diseases cause substantial morbidity and mortality in sub-Saharan Africa, but data on the epidemiology and antimicrobial susceptibility patterns of enteric bacterial pathogens are limited. Between May 1997 and April 1998, a clinic-based surveillance for diarrheal disease was conducted in Asembo, a rural area in western Kenya. In total, 729 diarrheal specimens were collected, and 244 (33%) yielded ⩾1 bacterial pathogen, as determined by standard culture techniques; 107 (44%) Shigella isolates, 73 (30%) Campylobacter isolates, 45 (18%) Vibrio cholerae O1 isolates, and 33 (14%) Salmonella isolates were identified. Shigella dysenteriae type 1 accounted for 22 (21%) of the Shigella isolates. Among 112 patients empirically treated with an antimicrobial agent and whose stool specimens yielded isolates on which resistance testing was done, 57 (51%) had isolates that were not susceptible to their antimicrobial treatment. Empiric treatment strategies for diarrheal disease in western Kenya need to be reevaluated, to improve clinical care