Abstract
BackgroundMultiple drug resistance has become a major threat to the treatment of cholera. Recent studies in Kenya have described the epidemiology, especially the risk factors, of cholera; however, there is little information on the phenotypic and drug susceptibility patterns of Vibrio cholerae (V. cholerae) in outbreaks that in the recent past have occurred in western Kenya.AimTo characterise and determine the antibiotics’ susceptibility profiling of toxigenic V. cholerae isolates from Kisumu County.SettingThe project was conducted in Kisumu County, Kenya.MethodsA total of 119 V. cholerae O1, biotype El Tor, isolates collected during 2017 cholera outbreak in Kisumu County were used for this study. The samples were cultured on thiosulphate-citrate-bile salts sucrose (TCBS) agar and biochemical tests were carried out using standard procedures. Susceptibility tests were conducted by using various conventional antibiotics against standard procedures.ResultsOf the 119 isolates, 101 were confirmed to be V. cholerae belonging to serotypes Inaba and Ogawa, with Inaba being the predominant serotype (73.95%). The isolates were susceptible to ciprofloxacin (100%), ofloxacin (100%), gentamycin (100%), doxycycline (99%), ceftriaxone (99%) and streptomycin (96.04%) antimicrobials, and resistant to erythromycin (53.47%), amoxicillin (64.4%), nalidixic acid (83.2%) and ampicillin (89.11%), with high resistance to cotrimoxazole (99%) and tetracycline (97%).ConclusionVibrio cholerae was resistant to multiple antibiotics, including those commonly used in the management of cholera. Taken together, there is a need to carry out regular surveillance on antimicrobial drug resistance during outbreaks.
Highlights
A cholera outbreak in November 2007 that began in Nyanza claimed 67 lives out of 1243 cases by April 2008.11,12 Previous cholera outbreaks in Nyanza were not as severe as that of 2007.13 Currently, V. cholerae antimicrobial resistance has become a global concern as fewer new antibiotics are being discovered, with more pathogens becoming resistant to most commonly used antibiotics.[14]
Growth characteristics of presumptive V. cholerae were determined on thiosulphate-citrate-bile salts sucrose (TCBS) selective media as large yellow mucoid colonies, which was suggestive of the presence of V. cholerae strains
This finding concurs with a previous study conducted on V. cholerae O1 strains isolated in the coastal region of Kenya between 2005 and 2007, where serotype Inaba emerged as the main cause of epidemic.[16]
Summary
Antibiotic resistance has been increasing since the introduction of antibiotics in the middle of the 20th century.[1,2] Since the introduction of tetracyclines, many other antibiotics have been introduced, but each has shown resistance at some level.[3,4] The level of circulating virulent, multiple drugresistant (MDR) bacteria has been a global threat to healthcare.[5,6] Toxigenic Vibrio cholerae (V. cholerae) O1 or O139 has been a cause of gastrointestinal infections and is involved in severe outbreaks of dehydrating diarrhoea in most of developing nations worldwide.[1,2] Cholera – a disease associated with poor sanitation – is often transmitted by consumption of food and water contaminated with bacterium.[7]. Multiple drug resistance has become a major threat to the treatment of cholera. Recent studies in Kenya have described the epidemiology, especially the risk factors, of cholera; there is little information on the phenotypic and drug susceptibility patterns of Vibrio cholerae (V. cholerae) in outbreaks that in the recent past have occurred in western Kenya
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