Antibiotic-resistant bacteria found in children, livestock and food in city study
Resistance to antibiotic drugs is a "global health emergency" that threatens the progress made by modern medicine, the head of the UN's health agency warned as a new report was published on September 20, 2017.
A dangerous strain of antibiotic-resistant bacteria is widely circulating among children, livestock, and food in Nairobi’s Dagoretti South, according to a new study that highlights growing concerns about drug resistance in urban areas.
Research by the International Livestock Research Institute (ILRI) found that more than 85 per cent of samples from children and nearly half of livestock samples contained bacteria resistant to at least one antibiotic, raising serious public health concerns that reflects a widespread national problem.
The six-month study, conducted in 2021, examined 585 households in the Uthiru/Ruthimitu and Riru areas, focusing on families with children aged between six months and two years. Scientists collected 540 stool samples from children, 296 livestock faecal samples, and 859 food samples.
The study found that “16 per cent of samples contained diarrheagenic E. coli, a strain that can cause severe illness in children."
Escherichia coli (E. coli) refers to a large and diverse group of bacteria commonly found in the gut of humans and warm-blooded animals. According to the World Health Organisation (WHO), most strains of E. coli are harmless. However, specific strains can cause severe foodborne disease.
Infection with the bacteria is usually a result of eating food contaminated with faeces from domestic or wild animals, or drinking contaminated water.
Mr Brian Mwangi, a pharmaceutical technologist at Kijabe Hospital, told Nation Africa that the results are concerning.
The study revealed that 93 per cent of children's stool samples, 95 per cent of livestock faecal samples, and 22 per cent of food samples tested positive for E. coli. More alarming was that nearly all food samples showed resistance to at least one antibiotic.
The bacteria showed particular resistance to commonly prescribed antibiotics, including Trimethoprim-sulfamethoxazole (53 per cent resistance), Ampicillin (48 per cent resistance) and Tetracycline (41 per cent resistance).
"These are bacteria that are very hard to treat," Mr Mwangi says. "Some strains show resistance to multiple drugs simultaneously, severely limiting treatment options."
Trimethoprim–sulfamethoxazole, says Mr Mwangi, is used to treat pneumonia for HIV infected adults and children, to treat urinary tract infections, meningitis and ear infections.
Ampicillin is used to treat genitourinary tract infections, respiratory and ear, nose and throat infections such as tonsillitis and sinusitis. Tetracycline is used to treat infections caused by bacteria, including pneumonia and other respiratory tract infections; certain infections of skin, eye, lymphatic, intestinal, genital and urinary systems; and other infections that are spread by ticks, lice, mites, and infected, animals.
Studies show that this antibiotic resistant E. coli strain causes diarrhoea or vomiting that lasts more than two days. The strain also accounts for about three out of every 20 deaths among children.
The study identified several risk factors contributing to antimicrobial resistance, such as on-site disposal of livestock manure in households, cohabitation of people and livestock, on-site garbage disposal and recent history of diarrhoea in children.
"Diarrheagenic E. coli (bacteria that causes diarrhoea) from children showed significantly higher resistance to all antibiotics compared to those from livestock and food. Overall, 30 per cent of the 274 samples found to have the strain that causes diarrhoea from all three sources exhibited multidrug resistance," says the study.
Dr Lubanga Dickens, a pediatrician at Bungoma County Referral Hospital, explains the challenges in detecting antimicrobial resistance (AMR). "It is generally difficult to detect AMR, and most of the time will require lab testing. The best way to detect resistance is when a patient fails to respond to a previously effective drug."
The World Health Organisation reports that AMR was directly responsible for 1.27 million global deaths in 2019 and contributed to 4.95 million deaths. The situation in Dagoretti South reflects this growing global crisis.
"Treatment of AMR is quite expensive," Dr Lubanga says. "Sometimes you have to combine antibiotics, use more expensive alternatives, or resort to last-line antibiotics. This makes it difficult to treat subsequent infections."
"In this peri-urban setting where livestock and humans cohabit within complex food systems, the co-occurrence of resistance particularly between ampicillin and tetracycline, indicates potential transmission of resistant bacteria across sources, emphasising the need for a One Health approach to address AMR. This co-occurrence reduces treatment options by compromising the efficacy of first-line antibiotics commonly prescribed for diarrheal diseases," the study further says.
The study suggests preventive efforts to mitigate AMR in peri-urban environments to include "separating livestock from human dwellings, implementing or reinforcing policies for safe manure and garbage disposal to minimise environmental contamination, and strengthening diagnostic capacity at local health centres to ensure appropriate treatment of diarrhoea, thereby reducing unnecessary use of broad-spectrum antibiotics."
Curbing resistance in humans and animals, advises Mr Mwangi will come about if people take antibiotics at the correct dose at the right times and for the right number of days, use the antibiotic only to treat the infection for which it was prescribed and avoid self-prescribing antibiotics at home.
"You should not take antibiotics unless prescribed specifically for you. You should also not give antibiotics that were prescribed for you to other people. And if you have any leftover antibiotics, take the remainder to a pharmacy for appropriate disposal," he says.
"For someone who already exhibits resistance, we treat to complete cure. If you don't achieve complete cure, they can still get resistance," said Dr Lubanga.
Understanding E. coli
- E. coli is a group of bacteria commonly found in human and animal intestines
- Most strains are harmless, but some can cause severe illness
- Infection typically occurs through contaminated food or water
- Symptoms can include diarrhea, urinary tract infections, and pneumonia
Key Statistics
- 85.8% of children's samples showed antibiotic resistance
- 47.5% of livestock samples showed resistance
- 30% of positive samples showed multiple drug resistance
- Study covered 585 households in Dagoretti South
