Emergence of gentamicin-resistant E. coli 0111:K58 in a nursery ward at Kenyatta National Hospital
Mutanda, L.N.; Masudi, A.M.; Kangethe, S.K.; Patel, A.
East African Medical Journal 64(4): 241-247
1987
ISSN/ISBN: 0012-835X PMID: 3319509 Document Number: 299453
In December, 1985, an outbreak of diarrhoea occurred in a nursery ward for pre-term babies at Kenyatta National Hospital. E. coli0111:K58 was isolated from 8 out of 18 neonates with diarrhoea, and from 5 out of 19 without diarrhoea. Of the 31 adult contacts, 2 nurses and 1 mother had E. coli0:K58;4 other contacts had different serotypes. Seven out of a total of 15 E. coli0111:K58 were resistant to gentamicin. One out of 7 other E. coli serotypes and 13 out of 44, untypable E. coli were also resistant to gentamicin. Six E. coli0111:K58 and 3 other serotypes were resistant to ampicillin, tetracycline, sulphonamide, streptomycin and co-trimoxazole. Another 5 E. coli0111:K58 were resistant to the above antibiotics and to gentamicin in addition. The MIC 100 of gentamicin for all enteropathogenic E. coli was 62.5 .mu.g/ml. The percentages of E. coli0111:K58 and those of other serotypes inhibited by serial dilution of gentamicin, did not statistically differ. The gel electrophoresis of E. coli0111:K58 and other E. coli serotypes revealed that the multiply antibiotic resistance of the strains was plasmid mediated. Before the outbreak of E. coli0111:K58 resistant to gentamicin, only 1-2% of non-enteropathogenic E. coli isolates and 54 Campylobacter tested between 1982 and 1985, were all sensitive to the drug. The paper stresses the importance of routine serotyping and periodic antibiotic-sensitivity-testing of both enteropathogenic and non-enteropathogenic E. coli strains.