Detection of multidrug resistant organisms of concern including S. maltophilia and B. cepacia at a referral hospital in Kenya

It is important to monitor of antibiotic susceptibility patterns of bacteria in clinical settings periodically to ascertain the current trends as well as re-establish empirical therapy. This study aimed to determine bacterial contaminants and their antimicrobial susceptibility patterns from medical equipment, inanimate surfaces and clinical samples isolated from Thika Level V Hospital (TLVH). Three hundred and five samples were collected and comprised of urine, pus swabs, catheter swabs, stool and environmental samples. Bacterial identification and antimicrobial susceptibility testing were done on VITEK 2 and disc diffusion respectively. Coagulase negative Staphylococci (28 /160, 17.5%) were the most isolated species from patients followed by E. coli (22 /160 13.8%) and S. aureus (22/160, 13.8%). The bed rail was the most contaminated surface with S. aureus at (6/42)14.2%. The clinical sample that yielded the highest number of pathogens was pus (92/160). Trauma patients had the largest proportion of isolates (67/160, 41.8%). Bacteria recovered from this study demonstrated high levels of resistance especially enteric bacteria. Extended Spectrum Beta Lactamase phenotype was noted in 29/44 (65.9%) enteric isolates. Although ESBL genetic confirmatory studies are needed, this study shows that there is an urgent need for actions that mitigate the spread of antibiotics resistant bacteria. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study was funded by The Kenya National Research Fund ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study was approved by the Research and Ethics committee of Mount Kenya University (MKU/ERC/1963) and licensed by National Commission for Science, Technology, and Innovation (NACOSTI) (NACOSTI/P/18/33304/25986). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data prodcued in the present study are available upon reasonable request to the authors