EVOLVING ANTIMICROBIAL RESISTANCE IN VIBRIO CHOLERAE: INSIGHTS FROM KENYA,2015–2023

Abstract

Background: Antimicrobial resistance (AMR) is a significant public health
problem, with a considerable number of attributable and associated deaths both globally and in Kenya. There is an inherent data gap on AMR for Vibrio cholerae in Kenya. The present study aimed to document the pattern of Antimicrobial Resistance to Vibrio cholerae in Kenya.
Methods: This study used a retrospective, descriptive, and cross-sectional
design. Data on the antimicrobial susceptibility and resistance of V. cholerae to various antibiotics were extracted from the National Public Health Laboratory (NPHL) of the Ministry of Health, Kenya, between 2015 and 2023. The data were subjected to descriptive analysis to determine the rates of sensitivity, intermediate resistance and antimicrobial resistance.
Results: The findings reveal that V. cholerae isolates were highly sensitive to chloramphenicol (94.0%), tetracycline (90.2%), gentamicin (86.8%), levofloxacin (94.1%), and cefuroxime (85.5%). Further, the isolates were highly resistant to Ampicillin (94.0%), Nalidixic acid (100%), Erythromycin (77.3%), and Ceftazidime (66.7%). Over two thirds (68.3%) of the isolates exhibited AMR, while 31.7% showed resistance to only one type of antibiotic. Among the isolates that exhibited resistance, 40.7% were resistant to two antibiotics, while 27.6% were resistant to more than two antibiotics. The predominant AMR pattern overall was Ciprofloxacin + Cefepime, while Ampicillin + Ciprofloxacin + Nalidixic acid was the predominant pattern of resistance to more than two
antibiotics.
Conclusion: This study demonstrates an increasing trend of Antimicrobial
Resistance (AMR) among Vibrio cholerae isolates in selected Kenyan counties, particularly to commonly used antibiotics, such as ampicillin, nalidixic acid,and erythromycin. Conversely, high sensitivity was observed for chloramphenicol, levofloxacin, and tetracycline. Notably, a significant
proportion of the isolates exhibited Multi Drug Resistance (MDR), posing a
serious threat to effective cholera treatment. In order to mitigate this trend, routine surveillance of AMR in V.cholerae is recommended along with stringent antimicrobial stewardship.