Prevalence and Antimicrobial Resistance Patterns of Campylobacter Species Isolated from Poultry in Mathira, Nyeri County. Report for Fleming Fund Fellowship Programme.

Introduction Antimicrobial resistance is a growing global threat that is increasing animal and human health concerns. Antimicrobial resistance arises when antimicrobial agents fail to effectively kill microorganisms that were previously susceptible to them (Ayukekbong, 2017). The emergence of AMR is attributed to imprudent antimicrobial use arising from inappropriate practices in prescription, misuse, and overuse in both human and animal health (Muloi, 2019). This leads to exposure of animal and human normal flora and pathogens to selection pressure leading to the emergence of antimicrobial resistant strains which can withstand and survive in the presence of antimicrobial agents which would initially kill them. These new strains can be spread from animals to humans and the environment. In low and middle-level countries (LMICs), antibiotics are used for the treatment and prevention (prophylaxis) of infectious diseases in animals and humans. Most of these antibiotics are accessed from pharmacies and agro-veterinary shops over the counter without prescriptions from clinicians ad veterinary professionals and the data on antibiotic use in these countries is scarce (Muloi, 2019). Campylobacter species are bacterial pathogens recognized as a cause of gastroenteritis in the human population and pose a major public health threat worldwide. There are several species of Campylobacter which include C. jejuni, C.coli, C. lari and C.uppsaliensis, capable of causing human illness. However, C. jejuni and C.coli are the most commonly isolated species from poultry and poultry products and cause diarrhoea in patients, mainly children under the age of 1-year, young adults, and immunosuppressed persons. Campylobacter is present in the gut of most animals as normal flora and is transferred to foods from the faeces during slaughter and is acquired through consumption of undercooked poultry and other meat as well as water and unpasteurized milk. Fruits and vegetables can be contaminated by water containing faeces from birds and other animals. Campylobacter can also be transmitted through contact with dog and cat faeces as well as drinking contaminated water. Campylobacter infections are common in low- and middle-income countries as well as developed countries. Methods A total of 380 cloacal swabs were collected randomly from 53 farmers in Mathira, Nyeri, Kenya. They were transported in sterile Amies charcoal swabs under a cold chain and stored at 4°C. They were enriched in Preston broth and incubated for 24 h at 42 °C, after which they were streaked onto mCCDA agar and incubated for 48 h at 42 °C under microaerobic conditions generated by Campy Gen™ packs. Typical grey moist, swarming and discrete colonies were identified using MALD-TOF. Antimicrobial susceptibility was carried out with Ampicillin, Tetracycline, Ciprofloxacin, Gentamycin, Erythromycin, and Nalidixic acid by disk diffusion method, and disk diameters were measured and interpreted using the CLSI guidelines. Results A total of 271 out of 380 (71.32%) bacteria isolated on culture were Campylobacter spp. 190 (50%) were C. jejuni while 81 (22%) were C. coli. Resistance to Ampicillin was 40% for C. coli and 30% for C. jejuni respectively. 54% of C. coli isolates were resistant to Tetracycline while 52% were C. jejuni. 68% of the C. coli were resistant to Ciprofloxacin as compared to C.jejuni at 38%. Resistance to Erythromycin for C. coli 10% and 17% for C. jejuni. 65% of C. coli was resistant to Nalidixic acid as compared to 38% of C. coli. Conclusions The study found a high prevalence of Campylobacters at 71.3% with marked multiple drug resistance to Tetracyclines, Ciprofloxacin, and Nalidixic acid. Resistance to Gentamycin and Erythromycin was markedly low and these antibiotics can be reserved for treatment of human campylobacteriosis. Strengthening and support of surveillance activities for AMR should be enhanced across human and food animal sectors to establish the extent of emergence and and spread of resistance in Campylobacter. National and regional laboratories capacity for testing of pathogens of public health importance should be strengthened increased