Prevalence of Bacteremia among the HIV and Non HIV Infected Patients Visiting Alupe Sub Hospital, Alupe Division of Teso South Sub-County, Busia County, Kenya between 2017 and 2019

Background: Bacteremia is the presence of viable bacteria in circulating blood. This is common in HIV patients, leading to a significant public health problem worldwide. It is concomitant with upraising cases of antibiotic resistance that results in high morbidity rates leading to increased hospital visits and high mortality rates. Gram-negative bacteria which produce extended-spectrum β-lactamase (ESBL) are becoming more common and pathogenic in this group of people. Genes responsible for resistance are well-known to spread among various microorganisms. By employing a case-control study design, this study determined prevalence of bacteremia in Salmonella ssp, Klebsiella ssp, and Escherichia coli in HIV positive and HIV negative patients attending Alupe subcounty hospital. Methods: A total of 113 HIV positive and 133 HIV negative patients were sampled purposively grounded on Lameshow sample size determination formula. Consent was sought from the study participants followed by questionnaire administration. Blood (10 ml) was collected from each enrolled patient and later subjected to full haemogram (1 ml), Salmonella Antigen test (1 ml) and general bacterial isolation (8 ml). Results: HIV positive patients experienced significantly different bacterial diseases infection from those who were HIV negative (χ2 = 27.684, P = 0.024). In the current study, total prevalence of Salmonella spp. among HIV positive and HIV negative patients was 11.1%, Klebsiella spp., 18.52%, Staphylococcus spp., 48.15%, Shigella spp 7.4% while that of Brucella spp., Neisseria gonorrhea, Aeromonas carviae and Plesomonas shigelloids each was 3.7%. Escherichia coli was not isolated from any of the blood samples collected from the study participants. Results were made available to policy makers for use in coming up with cognizant measures of prevention of bacteremia, hence a healthy society.

Urinary Tract Infection among Adults Seeking Medicare at Kiambu Level 5 Hospital, Kenya: Prevalence, Diversity, Antimicrobial Susceptibility Profiles and Possible Risk Factors

Urinary tract infections are among the most prevalent extra-intestinal infections, with high prevalence globally. This cross-sectional study established prevalence of bacterial aetiology causing urinary tract infection (UTI) and their antimicrobial susceptibility profiles. A questionnaire was used to capture socio-demographic data and possible UTI risk factors among the 206 consented adults seeking medicare at Kiambu Level 5 Hospital. The collected midstream urine samples were subjected to dipstick analysis, microscopy and culture for UTI diagnosis. Results: The overall prevalence rate of UTIs was 27.6%, with women’s prevalence rate being significantly higher at 80.7% compared to men 19.2%. Pregnant women had UTI prevalence at 34% which was higher than other sets of participants. Women who did not frequently change their underpants daily had a higher UTI cases at 34.8%. Escherichia coli, Staphylococcus aureus and Klebsiella pneumoniae were the most prevalent bacterial pathogens at 38.5%, 21% and 19.3%, respectively. Antimicrobial sensitivity analysis revealed high resistances towards Sulfamethoxazole and Ampicillin at range between 50% - 85%, suggesting that these drugs are no longer effective for UTI empirical treatment. The resistance patterns towards Cefotaxime, Cefepime and Ciprofloxacin were below 40%. However, more resistance patterns at a range between 14% - 40% revealed towards Amoxicillin-clavulanic and Nitrofurantoin imply that these are drugs remain potent but there is the need to revise the current UTI management guidelines. In addition, to elude treatment failure, innovation of prophylactic measures is key to halt UTI contraction and offer support to pharmaceutical industries that have fewer new antibiotics in the pipeline.