Journal Article

Surveillance for Bacterial Diarrhea and Antimicrobial Resistance in Rural Western Kenya, 1997–2003

John T. Brooks, John Benjamin Ochieng, Lata Kumar, George Okoth, Roger L. Shapiro, Joy G. Wells, Michele Bird, Cheryl Bopp, Wairimu Chege, Mark E. Beatty, Tom Chiller, John M. Vulule, Eric Mintz and Laurence Slutsker

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 43, issue 4, pages 393-401
Published in print August 2006 | ISSN: 1058-4838
Published online August 2006 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/505866
Surveillance for Bacterial Diarrhea and Antimicrobial Resistance in Rural Western Kenya, 1997–2003

More Like This

Show all results sharing these subjects:

  • Infectious Diseases
  • Immunology
  • Public Health and Epidemiology
  • Microbiology

GO

Show Summary Details

Preview

Background. Diarrhea is a major cause of preventable illness in sub-Saharan Africa. Although most cases of bacterial gastroenteritis do not require antimicrobial treatment, antimicrobial use is widespread. We examined the bacterial causes of diarrhea and monitored antimicrobial susceptibilities of isolates through clinic-based surveillance in a rural Kenyan community.

Methods. From May 1997 through April 2003, diarrheal stool samples from persons presenting to 4 sentinel health centers were cultured by standard techniques for routine bacterial enteric pathogens, for which antimicrobial susceptibilities were determined. A random subset of specimens was also evaluated for diarrheagenic Escherichia coli.

Results. Among stool specimens from 3445 persons, 1092 (32%) yielded at least 1 bacterial pathogen. Shigella species was most commonly isolated (responsible for 16% of all illnesses; 54% of isolates were Shigella flexneri). Campylobacter species and diarrheagenic E. coli predominated among children aged <5 years and were progressively replaced by Shigella species with increasing age. With the exception of Campylobacter species, susceptibility to the antimicrobials used most widely in the community was low: <40% for all isolates tested and <25% for Shigella species. Most persons were treated with an antimicrobial to which their isolate was resistant. Susceptibility to specific antimicrobials was inversely proportional to the frequency with which they were prescribed.

Conclusions. The utility of available antimicrobials for treating bacterial diarrhea in rural western Kenya is substantially limited by reduced susceptibility. More judicious use of appropriate antimicrobials is warranted. Efforts to prevent illness through provision of clean water, improved hygiene, and vaccine development should be strengthened.

Journal Article.  4673 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.