Abstract:
children. Kenya reports around 2.6 million cases and 7,000 deaths annually due to diarrhea.
Antibiotic-resistant DEC strains are a significant public health concern, complicating treatment.
The objective of this research was to correlate children’s water consumption and antimicrobial-
resistant DEC development. The study sampled 1124 children under five with diarrhea in
Nakuru, Kenya, using a case-control design. Among 384 eligible children, 192 cases showed
Amoxicillin-resistant DEC. Water samples from households were collected and analyzed for DEC
presence. The samples were filtered, plated onto MacConkey agar, and subcultured onto Eosin
Methylene Blue agar for further analysis. The DEC pathotypes were identified based on
morphological and biochemical characteristics, and antibiotic resistance was assessed using the
Kirby-Bauer disk diffusion method. The study revealed a strong correlation of 11.613 (95 %
Confidence Interval [CI]: 6.495–20.765, p-value: 0.000) between microbial burden in vended
water (water sold by vendors) used by different households consumption and antimicrobial
resistance in DEC. Water sources showed a high prevalence of DEC, primarily Enteroaggregative,
enteropathogenic, enterotoxigenic, and enteroinvasive E. coli. DEC isolates also exhibited varying
antibiotic resistance, and genes like
bla
CTX-M,
bla
TEM, and
bla
SHV were identified using PCR. The
Spearman correlation coefficient was one, showing that resistance genes in water and stool were
perfectly correlated. The study emphasizes the significance of improving water quality, hygiene,
and antibiotic-resistant bacteria control to prevent and manage DEC and infectious diseases in
Kenya. To combat outbreaks, effective surveillance and rapid reaction procedures are essential.
The findings help to shape public health policies and initiatives.
