RISK FACTORS TO ENTERIC BACTERIAL PREVALENCE AND ANTIMICROBIAL RESISTANCE AMONG FOOD HANDLERS IN NAIROBI COUNTY, KENYA

Abstract

Objectives: Enteric bacteria’s antimicrobial resistance expose humans to superbugs and biofilms producing strains. This study aimed at investigating the prevalence of enteric bacteria, antimicrobial resistance patterns and potential risk factors associated with enteric bacterial pathogens transmission among food handlers in Nairobi County, Kenya.
Methodology: A cross-sectional study was conducted and systematic random sampling used to obtain 355 stool samples from food handlers who presented to Centre for Microbiology, Kenya Medical Research Institute, for routine health assessment. The stool samples were cultured for E. coli, Salmonella typhi and Shigella flexneri and Vibrio cholerae using the standard enteric media. Questionnaires were administered to obtain sociodemographic data. Conventional biochemical tests were used in identification of the recovered isolates and antimicrobial susceptibility patterns determined. Factors associated with enteric bacterial infection were evaluated using logistic regression analysis.
Results: An overall enteric bacteria prevalence of 54(15.21%) was found. The most predominant enteric bacteria recovered were 39 (11%) Escherichia coli (11(53.85%) non-pathogenic E. coli, 13(33.33%) enterotoxigenic E. coli, 5(12.82%) enteroaggregative (E. coli), 11(3.1%), 11(3.1%) Shigella flexneri and 4(1.1%) Salmonella typhi. Amoxicillin clavulanic acid, nalidixic acid, cefuroxime and ciprofloxacin were the least effective antimicrobials while meropenem, chloramphenicol and gentamicin were most effective antimicrobials with 0%, 1.85% and 5.56% resistance. Insufficient hygienic food handling practices training was independently associated with enteric bacterial infection (AOR: 9.117; 95% CI: 2.157 – 18.534; P=0.003). However, the insufficient food handling practices training had low odds of antimicrobial resistance despite P-value indicating as statistically significant (AOR:0.118; 95% CI: 0.028 – 0.489; P=0.003).
Conclusion: Enteric bacteria prevalence and resistance continue to soar among food handlers despite periodic medical assessment, threatening public health as potential source of transmission. Insufficient training on hygienic food handling practices was significantly associated with enteric bacterial infection and corresponding antimicrobial resistance