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Volume 30, Supplement—October 2024
SUPPLEMENT ISSUE
Articles

Azithromycin Resistance Patterns in Escherichia coli and Shigella before and after COVID-19, Kenya

Elizabeth A. Odundo, Erick C. Kipkirui, Margaret C. Koech, Mary C. Kirui, Ronald K. Kirera, Nancy C. Kipkemoi, Janet N. Ndonye, Alex Ragalo, Collins K. Kigen, James W. Muturi, Vanessa N. Onyonyi, Gathii Kimita, Erick K. Muthanje, Marissa K. Hetrich, Evelyn W. Mahugu, Kirti K. Tiwari, and Hunter J. SmithComments to Author 
Author affiliation: Kenya Medical Research Institute, Kericho and Kisumu, Kenya (E.A. Odundo, E.C. Kipkirui, M.C. Koech, M.C. Kirui, R.K. Kirera, N.C. Kipkemoi, J.N. Ndonye, A. Ragalo, C.K. Kigen, J.W. Muturi, V.N. Onyonyi, G. Kimita, E.K. Muthanje); Walter Reed Army Institute of Research–Africa, Kericho and Kisumu (E.A. Odundo, E.C. Kipkirui, M.C. Koech, M.C. Kirui, R.K. Kirera, N.C. Kipkemoi, J.N. Ndonye, A. Ragalo, C.K. Kigen, J.W. Muturi, V.N. Onyonyi, G. Kimita, E.K. Muthanje, K.K. Tiwari); Cherokee Nation Strategic Programs, Silver Spring, Maryland, USA (M.K. Hetrich); Armed Forces Health Surveillance Division, Silver Spring (M.K. Hetrich, E.W. Mahugu, H.J. Smith); General Dynamics, Silver Spring (E.W. Mahugu)

Main Article

Table 2

Cases and antimicrobial susceptibility of Escherichia coli and Shigella before (2017–2019) and after (2022–2023) COVID-19, Kenya*

Characteristic E. coli
 Shigella spp.
Overall 2017–2019 2022–2023 p value† Overall 2017–2019 2022–2023 p value†
All ages
No. cases 116 63 53 NA 109 69 40 NA
No. tested 2,790 1,672 1,118 NA 2,790 1,672 1,118 NA
Cases/100 persons (95% CI) 4.2
(3.5–5.0)		 3.8
(2.9–4.8)		 4.7
(3.5–6.2)		 0.21 3.9
(3.2–4.7)		 4.1
(3.2–5.2)		 3.6
(2.6–4.8)		 0.47
% Resistant isolates‡
Ciprofloxacin 2.7 1.6 3.9 0.59 0 0 0 >0.99
Levofloxacin 2.7 1.6 3.9 0.59 0 0 0 >0.99
Azithromycin
 23.3
 7.9
 41.5
 <0.001
3.7
 0
 10.0
 0.02
Adults ≥18 y
No. cases 41 19 22 NA 57 31 26 NA
No. tested 1,446 767 679 NA 1,446 767 679 NA
Cases/100 persons (95% CI) 2.8
(2.0–3.8)		 2.5
(1.5–3.8)		 3.2
(2.0–4.9)		 0.38 3.9
(3.0–5.1)		 4.0
(2.8–5.7)		 3.8
(2.5–5.6)		 0.84
% Resistant isolates‡
Ciprofloxacin 5.1 5.3 5.0 >0.99 0 0 0 >0.99
Levofloxacin 5.1 5.3 5.0 >0.99 0 0 0 >0.99
Azithromycin
 24.4
 5.3
 40.9
 0.01
7.0
 0
 15.4
 0.04
Children <18 y
No. cases 75 44 31 NA 52 38 14 NA
No. tested 1,344 905 439 NA 1,344 905 439 NA
Cases/100 persons (95% CI) 5.6
(4.4–6.9)		 4.9
(3.6–6.5)		 7.1
(4.9–9.9)		 0.10 3.9
(2.9–5.0)		 4.2
(3.0–5.7)		 3.2
(1.8–5.3)		 0.37
% Resistant isolates‡
Ciprofloxacin 1.4 0 3.2 0.42 0 0 0 >0.99
Levofloxacin 1.4 0 3.2 0.42 0 0 0 >0.99
Azithromycin 22.7 9.1 41.9 0.002 0 0 0 >0.99

*Four cases (3 E. coli and 1 Shigella) had inconclusive ciprofloxacin and levofloxacin susceptibility results and were excluded from susceptibility profiles. Boldface indicates significant values (p<0.05). NA, not applicable †Pearson χ2 test used to measure differences in prevalence across COVID-19 periods. Fisher exact test used to measure differences in resistance proportions between the pre–COVID-19 and post–COVID-19 periods. ‡One intermediate resistant isolate grouped with fully resistant.

Main Article

Page created: October 16, 2024
Page updated: November 11, 2024
Page reviewed: November 11, 2024
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