Prevalence and Antimicrobial Profiles of Shigella

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Prevalence of Shigella Species and Their Antimicrobial Resistance Patterns Among Patients Visiting Kenyatta University Health Unit Authors: Anthony Kebira Nyamache1 and Collins Otieno Ogari1 Collins Ogari1 Email: Collins58@yahoo.com Corresponding author Dr. Anthony Kebira Nyamache akibera2000@yahoo.com or akibera2000@gmail.com 1 Department of Microbiology, School of Pure and Applied Sciences, Kenyatta University, P.O. Box 43844 (00100), Nairobi, Kenya.

Abstract Background: Shigellosis is a major public health problem and increasing antimicrobial resistance has complicated its treatment. This study was aimed at determining the prevalence of Shigella species and their antimicrobial resistance patterns among patients visiting Kenyatta University health unit, Nairobi Kenya, during May-August 2011. Findings: Of the 102 stool samples cultured, 16 (15.7%) yielded Shigella species; S. boydii 12 (75%), S. sonnei 3 (19%) and S. flexneri 1 (6%). All the 16 isolates showed resistance to at least two antibiotics and …were multi-drug resistance. The highest resistance rates were encountered with Ampicillin 16 (100%), Sulphamethaxazole 15 (93%) and Cotrimoxazole12 (75%) while those susceptible were Gentamycin 16(100%) and Chloramphenicol 12 (75%). Conclusions: There is a high level of resistance to most of the antibiotics used for treatment of shigellosis. Gentamycin was found to be the drug of choice in this setting with a need for consistent drug resistance surveillance. .

Key Words: Shigella, Antimicrobial susceptibility, resistance, Kenya.

Background Shigella is one of the most important causes of gastroenteritis and death of 3-5 millions of children under the age of 5 years in developing countries, where sub-standards hygienic conditions and unsafe water supplies prevail [1,2]. Infection by Shigella species can lead to illness ranging from mild, self-limited diarrhoea to severe dysentery with frequent passage of blood and mucus, high fever, cramps, tenesmus, and in rare cases, bacteraemia. In addition, complications of shigellosis are seen most frequently in children, the elderly, and the immunocompromised [2]. Shigellosis (bacillary dysentriae) is recognized by the World Health Organization as a major global public health problem [2]. Among the bacterial causes of dysentery, Shigella species continue to be the most important, with high infectivity rate and the development of antimicrobial resistance [2, 3]. Since 1940, when resistance of Shigella species to sulphonamide was first recognised in Japan, resistance to Shigella species have become progressively recorded to most widely used antimicrobial agents (3, 4). Over the past decades, Shigella species have become progressively resistant to most widely-used antimicrobials [5] hence complicating the treatment of shigellosis [6]. Multiple drug resistance transmitted plasmids among Shigella species have been reported in many countries [7]. So far, limited reports exist on the occurrence and antibiotic resistance patterns of Shigella species among University health facilities in particular and in Kenya in general. The purpose of the present study was undertaken to determine the prevalence of Shigella species and their antimicrobial resistance patterns among patients visiting Kenyatta University health unit for better management of shigellosis. MATERIALS AND METHODS Study design The study was conducted at the University health unit which is known to serve a population comprising mainly 80% of the student population and a large number of teaching and nonteaching staff are their dependants. A total of 102 individuals of the age 1-60 years category were recruited into the study. The participants were patients referred to the laboratory for stool analysis from the in-patient and out-patient departments of health unit, all within Kiambu County. Their informed consent will sort and obtained and an ethical clearance and authorization to collect specimen and data for research be...
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