| dc.description.abstract | The re-emergence of invasive non typhoidal Salmonella (NTS) is exacerbated by antimicrobial
resistance (AMR) to most commonly available antimicrobials. Extreme climatic changes, in
addition to increase in susceptible host population risk factors has resulted in the emergence of
successful clones of Salmonella. Prevalence of S. Typhimurium is documented at 4.2% while
bacteria caused diarrhea at 8.5% in Kapsabet region. Prevalence of NTS in Kisumu is
documented at 39% and MDR at 76%. This warranted the appraisal of antibiotic susceptibility
patterns of clinical Salmonella isolates and determining correlation between antimicrobial
susceptibility and genetic diversity. This study aimed to determine the prevalence, genetic
diversity and antimicrobial susceptibility pattern of clinical Salmonella isolates from Kapsabet
and Kisumu District hospitals. A cross sectional study design was adopted. Systematic random
sampling technique was used and a total of 400 stool specimens were collected from each study
site. Salmonella isolates were identified based on their morphological appearance, biochemical
reaction on various bacteriological culture media in addition to indole, methyl red, voges
proskauers, citrate (IMVIC) and Salmonella a nalytical profile index (API) 20E system and
confirmed by invA gene sequencing. Antimicrobial susceptibility was done using disk diffusion
method. Polymerase chain reaction was used to detect the presence of blareu and sul2 genes
in addition to spv virulence genes. Single locus sequence typing was used to determine genetic
diversity among S. Typhimurium isolates based onjliC gene. A total of 174 Salmonella species
were isolated, 55.75% (971174) and 44.25% (771174) from patients treated at Kapsabet and
Kisumu District hospitals respectively. The predominant Salmonella from Kapsabet was serovar
S. Typhimurium 52.6% (51/97) followed by s.. Enteritidis 26.8% (26/97). The highest
Salmonella isolate from Kisumu was S. Typhimurium 57.1% (44177), followed by S. Enteritidis
24.6% (19177). The other serovars constituted a small proportion in both sites. Kapsabet had
high distribution of serovars, p=0.0288. The difference in prevalence ofNTS among patients was
not significant, p=0.0793. Approximately 70% of Salmonella isolates were MDR, the resistant
phenotype was; ampicillin, chloramphenicol, streptomycin, sulfamethoxazole, tetracycline
(ACSSuT). Kisumu had high resistance to antimicrobials tested p<O.OOO1.blarsu and sul2
genes were associated with antimicrobial susceptibility p< 0.001. A total of 4.54% (2/44) of S.
Typhimurium from Kisumu lacked spv genes while 4.54% (2/45) of all S. Enteritidis lacked spv
genes. Genetic diversity in S. Typhimurium strains correlated with AMR, p= 0.0258. Isolates
exhibited geographic restriction. The overall interclade diversity was p< 0.001. Use of Multi
locus sequence typing is recommended to mitigate phylogenetic discordance. Development of
vaccines for human and vetenary use may be best alternative to antibiotics | en_US |
