Bacteriology of infections in a rural tropical area of Kenya: isolates and antibiotic susceptibility.

No microbial data are available for rural tropical areas. Yet most people in Africa live in rural areas where the burdens of infectious diseases remain the primary cause for morbidity and mortality. A pilot study was done by culturing midstream urine from patient with dysuria (100 with Gram-negative fermentative rods), blood from patients with FUO (55/307 positive) and swabs from patients with infected wounds (29 with Staphylococcus aureus). Bacteria were identified and susceptibility tests were performed according to protocols. Klebsiella was the most common isolate from urine (48%). The overall resistance in urine isolates for ampicillin was 76% and for cotrimoxazole, 60%. The main isolates from blood were Klebsiella Enterobacter sp (21/55) and Salmonella (14/55) in patients from agricultural areas, and Staphylococcus aureus (12/55) in patients from desert areas. The Staphylococcus aureus from wounds were all penicillin resistant and 9/29 were cloxacillin resistant. Influence of the environment, underlying pathology and previous use of antibiotics give unexpected predominance of Klebsiella and high resistance in all isolates. Large scale surveillance studies are needed so that prescription of antibiotics can be based on locally obtained data.