Mururu Lilian Nkatha^1,, Mourine Kangogo¹, Kenneth Kariuki Waititu², Willie Kipkemboi Sang³

Background: Diarrheal diseases constitute an important cause of death among children under the age of five years globally. These diseases are caused by diarrheagenic Escherichia coli including enteropathogenic Escherichia coli and enterotoxigenic Escherichia coli among other agents. Treatment and management of diarrheal diseases including EPEC and ETEC is complicated by rapidly developing problem of antimicrobial resistance. Methods: Stool samples were collected from children under the age of five years attending Machakos Level 5 hospital. Escherichia coli was isolated and identified by culture-based techniques followed by multiplex polymerase chain reaction using primers specific for virulence genes associated with EPEC and ETEC pathovars. Confirmed EPEC and ETEC pathovars were subjected to a panel of eight antimicrobial agents. Results: Both EPEC and ETEC were detected in 29/118 (24.6%) samples collected during the study period. Prevalence of EPEC was higher 18 (15.3%) compared to ETEC that was detected in 11 (9.3%) samples analyzed. ETEC appeared to be more resistant to ampicillin (90.9%, 66.7%), trimethoprim (81.8%, 77.8%), gentamicin (45.5%, 22.2%), chloramphenicol (27.3%, 16.3%), cefuroxime (18.2%, 5.6%) and ciprofloxacin (9.1%, 5.6%) compared to EPEC respectively. On the other hand, EPEC displayed higher resistance against nalidixic acid (38.9%, 36.4%) and tetracycline (33.3%, 18.2%) compared to ETEC isolates. Conclusion: The role of EPEC and ETEC as a cause of infantile diarrhea cannot be underestimated in Machakos County, Kenya since they are both pathogenic and resistant to commonly used antimicrobial agents.

Escherichia coli, children, diarrhea, antimicrobial resistance