COMMUNITY-ACQUIRED BACTERIAL-INFECTIONS AND THEIR ANTIMICROBIAL SUSCEPTIBILITY IN NAIROBI, KENYA

The purpose of the study was to determine the pattern and antimicrobia l sensitivity on community acquired bacterial strains in Nairobi, Keny a. Clinical specimens collected from out-patient clinics at the Kenyat ta National Hospital were cultured on appropriate media and identified according to Cowen and Steel's manual. The antimicrobial sensitivity was determined using comparative disc diffusion techniques. Between 19 91 and 1995, there were a total of 1659 positive cultures comprising 3 0 different bacterial species. Out of the overall gram negative isolat es (61.9%), E.coli and Klebsiella spp formed over 70%. Among the gram positive, Staphylococcus aureus, Enterococcus and coagulase negative s taphylococcus spp constituting 41%, 26% and 18% respectively were the most common. Most organisms showed multiple resistance patterns to com monly used antimicrobials similar to hospital acquired infections. The gram negative isolates were resistant to cotrimoxazole, ampicillin, t etracyclines, chloramphenicol, and sulphamethoxazole. However, the sen sitivity of these organisms to gentamicin and kanamycin was between 60 and 90%. Among the gram positive isolates, there was a high resistanc e to penicillin and tetracyclines (60-90%) while the resistance to lin comycin, minocycline and chloramphenicol was low (5-50%). All isolates were, however, highly sensitive to cephalosporins and fluoroquinolone s. Beta-lactamase production among E.coli, Klebsiella spp and Staphylo coccus aureus was 48.9%, 76.7%, 76.1% respectively. Methicillin resist ance for Staphylococcus aureus was 59.2%. Indiscriminate use of antibi otics in the community may have selected for resistant strains. This c alls for urgent need to review policies on prescription practices.