Characterization and drug susceptibility pattern of Salmonella and Shigella in children below five years: a cross-sectional study conducted in Lodwar, Turkana County, in Northern Kenya

Abstract

Introduction: Salmonella and Shigella infections are waterborne associated infections globally known to cause serious illnesses in all age groups, but can be more devastating in children below five years. Antimicrobial resistance has been known to worsen the existing challenge in the management of Salmonella and Shigella infections. The aim is to isolate and identify Salmonella and Shigella among children less than five years with diarrhea and to determine resistance to commonly prescribed drugs at the Lodwar County and Referral Hospital in Northern Kenya. Methods: using a cross-sectional study design, a descriptive experimental study was conducted on 196 children with diarrhea using rectal swabs. A structured questionnaire was used to collect sociodemographic information. Samples were then received in the microbiology laboratory, and macroscopic and microscopic examinations were done before culture on specific selective media. Thereafter, biochemical confirmation of the growths done then confirmed results tabulated before analysis. Results: from the total samples collected (196) Shigella dysenteriae cases were 4 (5%), while Shigella Flexneri were 7 (9%), Shigella sonnei were 3 (4%), Shigella boydii were 4 (5%) and Salmonella typhimurium were 2 (2.4%). From these, about 70% of the isolated Salmonella and Shigella demonstrated high antibiotic resistance to Amoxilliclav and Ampicillin, both with high minimum inhibitory concentrations (MICs) values of about 8ug/ml. While over 80% drug susceptibility was noted in Amikacin (1ug/ml), Ciprofloxacin (2ug/ml), Ceftriaxone (4ug/ml) and Ceftazidime (4ug/ml). Conclusion: Salmonella and Shigella are among the common contributors of diarrhea among children less than five years. Drug resistance among the commonly used antibiotics is a serious indicator that possible misuse of antibiotics especially the beta lactam penicillin's.