Pathogenic E.coli and other pathogenic gram negative enteric strains from foecal samples of children without diarrhoea living in Mukuru slums, Nairobi

Background: Diarrhoea remains a major public health problem among children and adults in developing nations such as Kenya. The risk of infection is higher in children due to their developing immunity, relatively poor hygiene and habits especially those living in informal settlements where water supply and sanitation are inadequate. Objectives: To determine the prevalence of selected enteric pathogens from children without diarrhoea attending two clinics in Mukuru as well as the anti-microbial resistance patterns, and pathogenicity of E. coli isolated. Design: A cross sectional study. Setting: Mukuru slum, Nairobi County. Subjects: Three hundred and twenty two children of ages five and below. Results: Mukuru Kwa Njenga; E. coli 34.6%, Salmonella spp. 1.3%, Shigella 0.7%,  Citrobacter spp. 2.3%, Klebsiella spp. 5.3%, Proteus spp. 7.0%, No growth 2.3%. Mukuru Kwa Reuben; E. coli 63.4%, Salmonella 0.6%, Shigella 0.6%, Citrobacter spp. 1.2% ,Klebsiella spp. 14.3%, Proteus spp. 16.1%, No growth 3.7%. No significant difference among the organisms isolated in both clinics (p = 0.982). Ampicillin, Amoxycillin/ Clavulanic, cefoxitin had high resistance, while gentamicin was 100% susceptible. 46.6% E. coli isolates were positive for at least one of the eight virulence genes tested. Conclusion: Salmonella , Shigella and pathogenic E.coli associated with diarrhoea and presence of resistance genes were identified in foecal samples of children without diarrhoea living in Mukuru informal settlements in Nairobi. The major concern from the findings of this study was the emerging high resistance of E.coli that was observed to cephamycin (Cefoxitin).