{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T16:05:27Z","timestamp":1784822727451,"version":"3.55.0"},"reference-count":68,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["NU2HGH000032"],"award-info":[{"award-number":["NU2HGH000032"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Multidrug-resistant bacterial enteric pathogens such as Salmonella and Shigella have the potential to cause significant mortality and represent a major issue facing the global health community. This is particularly concerning in low-and middle-income countries where access to clean water and antimicrobials is limited. We aimed to determine the frequency, antimicrobial resistance, and presence of resistance genes among Salmonella, Shigella, Vibrioand Campylobacter recovered from patients presenting with diarrhea in an informal settlement in Nairobi, Kenya, from 2018 to 2020. Conventional bacteriologic methods were used for bacterial culture and isolation. BD Phoenix M50 technology was used for the identification and speciation of bacteria recovered from stool samples and for determining minimum inhibitory concentrations to both clinically relevant antimicrobials and agents of epidemiologic significance. PCR testing was subsequently performed to identify resistance genes. The key pathogenic bacteria recovered were: Shigella flexneri (58.3%), Salmonella enterica serovar Typhi (8.3%), Shigella dysenteriae (6.7%), Shigella boydii (6.7%), and Shigella sonnei (6.7%); no Campylobacter or Vibrio were isolated. Overall resistance among Shigella spp. and Salmonella spp. was determined to be highest to ampicillin (83%), followed by tetracycline (50%), cotrimoxazole (47%), chloramphenicol (17%), ceftriaxone (7%), gentamycin (5%), meropenem (2%), ciprofloxacin (0%) and amoxicillin-clavulanic acid (2.0%). Resistance genes detected included \u03b2-lactamases (blaTEM and blaSHV), aminoglycoside 3-N acetyltransferase acc(3), sulfonamide resistance genes (sul1, sul2), and tetracycline resistance genes tet(A) and tet(B). Results emphasize the critical need for active and continuous surveillance of pathogenic enteric bacteria to improve patient management and inform the development of empiric therapy guidelines.<\/jats:p>","DOI":"10.3390\/microorganisms14081610","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T15:05:42Z","timestamp":1784819142000},"page":"1610","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Frequency of Antimicrobial Resistance Among Fecal Bacteria Pathogens in an Informal Settlement in Nairobi, Kenya, 2018 to 2020"],"prefix":"10.3390","volume":"14","author":[{"given":"Bonventure","family":"Juma","sequence":"first","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention, Nairobi 00621, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Mikoleit","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9250-1076","authenticated-orcid":false,"given":"Newton","family":"Wamola","sequence":"additional","affiliation":[{"name":"Center for Global Health Research, Kenya Medical Research Institute, Kisumu 40100, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7771-9058","authenticated-orcid":false,"given":"Mike Powel","family":"Osita","sequence":"additional","affiliation":[{"name":"Center for Global Health Research, Kenya Medical Research Institute, Kisumu 40100, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Ochieng","sequence":"additional","affiliation":[{"name":"Center for Global Health Research, Kenya Medical Research Institute, Kisumu 40100, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3209-9503","authenticated-orcid":false,"given":"Samuel","family":"Kariuki","sequence":"additional","affiliation":[{"name":"Center for Microbiology Research, Kenya Medical Research Institute, Nairobi 00200, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4450-621X","authenticated-orcid":false,"given":"Elizabeth","family":"Hunsperger","sequence":"additional","affiliation":[{"name":"U.S. Centers for Disease Control and Prevention, Nairobi 00621, Kenya"},{"name":"U.S. Centers for Disease Control and Prevention, Atlanta, GA 30329, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"ref_1","unstructured":"WHO (2025, December 06). The Global Antimicrobial Resistance Surveillance System (GLASS) Report: Early Implementation 2017\u20132018. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241515061."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1056\/NEJMoa040275","article-title":"Bacteremia among children admitted to a rural hospital in Kenya","volume":"352","author":"Berkley","year":"2005","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1097\/INF.0b013e318187a87d","article-title":"Community-acquired bacteremia among children admitted to a rural hospital in Mozambique","volume":"28","author":"Roca","year":"2009","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"152","DOI":"10.4269\/ajtmh.2010.09-0578","article-title":"Antimicrobial drug resistance trends of bacteremia isolates in a rural hospital in southern Mozambique","volume":"83","author":"Mandomando","year":"2010","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_5","unstructured":"WHO (2025, December 06). World Health Statistics 2014. Available online: https:\/\/www.who.int\/news\/item\/15-05-2014-world-health-statistics-2014."},{"key":"ref_6","first-page":"8","article-title":"Antimicrobial resistance in the WHO African region: Current status and roadmap for action","volume":"39","author":"Essack","year":"2017","journal-title":"J. Public Health"},{"key":"ref_7","first-page":"27","article-title":"Antimicrobial resistance in the African Region: Issues, challenges and actions proposed","volume":"16","author":"Ndihokubwayo","year":"2013","journal-title":"Afr. Health Monit."},{"key":"ref_8","unstructured":"African Union (2025). African Union Framework for Antimicrobial Resistance Control 2020\u20132025, Africa Centres for Disease Control and Prevention (Africa CDC), African Union Commission."},{"key":"ref_9","first-page":"60","article-title":"Antibiotic susceptibility profiles of bacteria isolates obtained from patientspresenting with diarrhoea in Machakos Distric Hospital, Kenya","volume":"2","author":"Juma","year":"2015","journal-title":"East Cent. Afr. Med. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"140","DOI":"10.12688\/wellcomeopenres.15977.1","article-title":"Antimicrobial resistance in gram-negative bacteria from urinary specimens: A study of prevalence, risk factors and molecular mechanisms of resistance (ARGUS) in Zimbabwe\u2013a study protocol","volume":"5","author":"Olaru","year":"2020","journal-title":"Wellcome Open Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"S10","DOI":"10.1093\/cid\/ciy898","article-title":"Multidrug-resistant nontyphoidal Salmonella hotspots as targets for vaccine use in the management of infections in endemic settings","volume":"68","author":"Kariuki","year":"2019","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_12","unstructured":"Tolmasky, M.E. (2007). Overview of dissemination mechanisms of genes coding for resistance to antibiotics. Enzyme-Mediated Resistance to Antibiotics: Mechanisms, Dissemination, and Prospects for Inhibition, Wiley."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1128\/AAC.50.2.534-541.2006","article-title":"Horizontal transfer of bla CMY-bearing plasmids among clinical Escherichia coli and Klebsiella pneumoniae isolates and emergence of cefepime-hydrolyzing CMY-19","volume":"50","author":"Wachino","year":"2006","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Lee, C.-R., Lee, J.H., Park, K.S., Kim, Y.B., Jeong, B.C., and Lee, S.H. (2016). Global dissemination of carbapenemase-producing Klebsiella pneumoniae: Epidemiology, genetic context, treatment options, and detection methods. Front. Microbiol., 7.","DOI":"10.3389\/fmicb.2016.00895"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1128\/AAC.48.4.1249-1255.2004","article-title":"Dissemination of CTX-M-type \u03b2-lactamases among clinical isolates of Enterobacteriaceae in Paris, France","volume":"48","author":"Eckert","year":"2004","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1089\/mdr.2011.0010","article-title":"Fitness and molecular mechanisms of resistance to rifaximin in in vitro selected Escherichia coli mutants","volume":"18","author":"Pons","year":"2012","journal-title":"Microb. Drug Resist."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Wang, J., Stephan, R., Karczmarczyk, M., Yan, Q., H\u00e4chler, H., and Fanning, S. (2013). Molecular characterization of blaESBL\u2013harboring conjugative plasmids identified in multi-drug resistant Escherichia coli isolated from food-producing animals and healthy humans. Front. Microbiol., 4.","DOI":"10.3389\/fmicb.2013.00188"},{"key":"ref_18","first-page":"173","article-title":"Genetic characterization of the mechanisms of resistance to amoxicillin\/clavulanate and third-generation cephalosporins in Salmonella enterica from three Spanish hospitals","volume":"14","author":"Cercenado","year":"2011","journal-title":"Int. Microbiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1111\/j.1469-0691.2007.01846.x","article-title":"Phenotypic detection of extended-spectrum \u03b2-lactamase production in Enterobacteriaceae: Review and bench guide","volume":"14","author":"Drieux","year":"2008","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_20","unstructured":"GARP (2025, December 06). Situation Analysis and Recommendations: Antibiotic Use and Resistance in Kenya. Available online: https:\/\/onehealthtrust.org\/wp-content\/uploads\/2017\/06\/kenya_executivesumm_web_15.pdf."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/j.ijantimicag.2005.02.006","article-title":"Mechanisms of quinolone resistance in Escherichia coli and Salmonella: Recent developments","volume":"25","author":"Hopkins","year":"2005","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1128\/AAC.39.1.185","article-title":"PCR mapping of integrons reveals several novel combinations of resistance genes","volume":"39","author":"Levesque","year":"1995","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3417","DOI":"10.1128\/JCM.00835-08","article-title":"Urinary tract infections in a South American population: Dynamic spread of class 1 integrons and multidrug resistance by homologous and site-specific recombination","volume":"46","author":"Labbate","year":"2008","journal-title":"J. Clin. Microbiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1111\/j.1574-6976.2011.00277.x","article-title":"Analysis of antibiotic resistance regions in Gram-negative bacteria","volume":"35","author":"Partridge","year":"2011","journal-title":"FEMS Microbiol. Rev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"34906","DOI":"10.1007\/s11356-020-09992-7","article-title":"How climate change can affect cholera incidence and prevalence? A systematic review","volume":"27","author":"Asadgol","year":"2020","journal-title":"Environ. Sci. Pollut. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1111\/avj.12458","article-title":"Antimicrobial resistance genes in Actinobacillus pleuropneumoniae, Haemophilus parasuis and Pasteurella multocida isolated from Australian pigs","volume":"94","author":"Dayao","year":"2016","journal-title":"Aust. Vet. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.wen.2024.11.003","article-title":"Overcoming water, sanitation, and hygiene challenges in critical regions of the global community","volume":"7","author":"Bose","year":"2024","journal-title":"Water-Energy Nexus"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e15598","DOI":"10.1016\/j.heliyon.2023.e15598","article-title":"Cholera prevention, control strategies, challenges and World Health Organization initiatives in the Eastern Mediterranean region: A narrative review","volume":"9","author":"Buliva","year":"2023","journal-title":"Heliyon"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.procbio.2024.07.002","article-title":"Antimicrobial peptides: Source, application and recent developments","volume":"145","author":"Chettri","year":"2024","journal-title":"Process Biochem."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1128\/AEM.03540-14","article-title":"Non-O1\/non-O139 Vibrio cholerae carrying multiple virulence factors and V. cholerae O1 in the Chesapeake Bay, Maryland","volume":"81","author":"Ceccarelli","year":"2015","journal-title":"Appl. Environ. Microbiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1046\/j.1365-2958.2002.02857.x","article-title":"Identification of novel factors involved in colonization and acid tolerance of Vibrio cholerae","volume":"43","author":"Merrell","year":"2002","journal-title":"Mol. Microbiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e384\u20139","DOI":"10.1016\/j.ijid.2009.06.020","article-title":"Epidemics of severe cholera caused by El Tor Vibrio cholerae O1 Ogawa possessing the ctxB gene of the classical biotype in Orissa, India","volume":"14","author":"Pal","year":"2010","journal-title":"Int. J. Infect. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"fnaf009","DOI":"10.1093\/femsle\/fnaf009","article-title":"Antimicrobial susceptibility and genomic characterization of Vibrio cholerae non-O1\/non-O139 isolated from clinical and environmental samples in Jiaxing City, China","volume":"372","author":"Jia","year":"2025","journal-title":"FEMS Microbiol. Lett."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Nielsen, A.T., Dolganov, N.A., and Rasmussen, T. (2010). A bistable switch and anatomical site control Vibrio cholerae virulence gene expression in the intestine. PLoS Pathog., 6.","DOI":"10.1371\/journal.ppat.1001102"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1007\/s00203-020-01847-6","article-title":"Stringent response interacts with the ToxR regulon to regulate Vibrio cholerae virulence factor expression","volume":"202","author":"Raskin","year":"2020","journal-title":"Arch. Microbiol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Samanta, S. (2023). Mechanisms of gastrointestinal pathogenesis and landscape of intestinal immunity. Viral, Parasitic, Bacterial, and Fungal Infections, Elsevier.","DOI":"10.1016\/B978-0-323-85730-7.00023-0"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1089\/fpd.2024.0165","article-title":"Recent trends of Vibrio cholerae: Global and regional incidences","volume":"23","author":"Siamalube","year":"2025","journal-title":"Foodborne Pathog. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"237","DOI":"10.3201\/eid0803.010233","article-title":"Human campylobacteriosis in developing countries","volume":"8","author":"Coker","year":"2002","journal-title":"Emerg. Infect. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1097\/QCO.0000000000000091","article-title":"Update on the burden of campylobacter in developing countries","volume":"27","author":"Kosek","year":"2014","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2092478","DOI":"10.1155\/2020\/2092478","article-title":"Prevalence, risk factors, and antimicrobial resistance profiles of thermophilic Campylobacter species in humans and animals in Sub-Saharan Africa: A systematic review","volume":"2020","author":"Gahamanyi","year":"2020","journal-title":"Int. J. Microbiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1093\/cid\/ciw542","article-title":"Epidemiology and impact of campylobacter infection in children in 8 low-resource settings: Results from the MAL-ED study","volume":"63","author":"Amour","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Abebe, W., Earsido, A., Taye, S., Assefa, M., Eyasu, A., and Godebo, G. (2018). Prevalence and antibiotic susceptibility patterns of Shigella and Salmonella among children aged below five years with Diarrhoea attending Nigist Eleni Mohammed memorial hospital, South Ethiopia. BMC Pediatr., 18.","DOI":"10.1186\/s12887-018-1221-9"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1128\/AAC.00797-10","article-title":"Clinical characteristics of bloodstream infections due to ampicillin-sulbactam-resistant, non-extended-spectrum-\u03b2-lactamase-producing Escherichia coli and the role of TEM-1 hyperproduction","volume":"55","author":"Paterson","year":"2011","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"S302","DOI":"10.1093\/cid\/civ728","article-title":"Burden of invasive nontyphoidal Salmonella disease in a rural and urban site in Kenya, 2009\u20132014","volume":"61","author":"Verani","year":"2015","journal-title":"Clin. Infect. Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"34","DOI":"10.31248\/JNDM2023.012","article-title":"Isolation and characterization of some enteric bacteria associated with acute diarrhea among children in Kano, Northern Nigeria","volume":"2","author":"Ali","year":"2024","journal-title":"J. New Discov. Microbiol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Zhu, D.-D., Li, X.-R., Ma, T.-F., Chen, J.-Q., Ge, C.-H., Yang, S.-H., Zhang, W., Chen, J., Zhang, J.-J., and Qi, M.-M. (2025). Multidrug-Resistant Extraintestinal Pathogenic Escherichia coli Exhibits High Virulence in Calf Herds: A Case Report. Microbiol. Res., 16.","DOI":"10.3390\/microbiolres16030059"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.eng.2019.10.014","article-title":"Association between the phenotypes and genotypes of antimicrobial resistance in Haemophilus parasuis isolates from swine in Quang Binh and Thua Thien Hue Provinces, Vietnam","volume":"6","author":"Van","year":"2020","journal-title":"Engineering"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Tekedar, H.C., Arick, M.A., Hsu, C.-Y., Thrash, A., Blom, J., Lawrence, M.L., and Abdelhamed, H. (2020). Identification of antimicrobial resistance determinants in Aeromonas veronii strain MS-17-88 recovered from channel catfish (Ictalurus punctatus). Front. Cell. Infect. Microbiol., 10.","DOI":"10.3389\/fcimb.2020.00348"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Tosisa, W., Mihret, A., Ararsa, A., Eguale, T., and Abebe, T. (2020). Prevalence and antimicrobial susceptibility of Salmonella and Shigella species isolated from diarrheic children in Ambo town. BMC Pediatr., 20.","DOI":"10.1186\/s12887-020-1970-0"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"8277976","DOI":"10.1155\/2023\/8277976","article-title":"Prevalence and Antimicrobial-Resistant Features of Shigella Species in East Africa from 2015\u20132022: A Systematic Review and Meta-Analysis","volume":"2023","author":"Ayele","year":"2023","journal-title":"Interdiscip. Perspect. Infect. Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e018515","DOI":"10.1136\/bmjgh-2024-018515","article-title":"Burden of Shigella and enterotoxigenic Escherichia coli infections among children under 5 years in Ethiopia, Kenya and Malawi: A systematic review and meta-analysis","volume":"11","author":"Mwendera","year":"2026","journal-title":"BMJ Glob. Health"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Nyarkoh, R., Odoom, A., and Donkor, E.S. (2024). Prevalence of Shigella species and antimicrobial resistance patterns in Africa: Systematic review and meta-analysis. BMC Infect. Dis., 24.","DOI":"10.1186\/s12879-024-09945-2"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Lien, L.T.Q., Lan, P.T., Chuc, N.T.K., Hoa, N.Q., Nhung, P.H., Thoa, N.T.M., Diwan, V., Tamhankar, A.J., and Lundborg, C.S. (2017). Antibiotic resistance and antibiotic resistance genes in Escherichia coli isolates from hospital wastewater in Vietnam. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14070699"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/S1473-3099(05)70189-4","article-title":"Antimicrobial resistance in developing countries. Part I: Recent trends and current status","volume":"5","author":"Okeke","year":"2005","journal-title":"Lancet Infect. Dis."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1038\/s41545-020-0051-0","article-title":"Antibiotic resistance genes from livestock waste: Occurrence, dissemination, and treatment","volume":"3","author":"He","year":"2020","journal-title":"npj Clean Water"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Langata, L.M., Maingi, J.M., Musonye, H.A., Kiiru, J., and Nyamache, A.K. (2019). Antimicrobial resistance genes in Salmonella and Escherichia coli isolates from chicken droppings in Nairobi, Kenya. BMC Res. Notes, 12.","DOI":"10.1186\/s13104-019-4068-8"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s40794-016-0045-6","article-title":"Molecular characterization and antibiotic resistance profiles of Salmonella isolated from fecal matter of domestic animals and animal products in Nairobi","volume":"3","author":"Nyabundi","year":"2017","journal-title":"Trop. Dis. Travel Med. Vaccines"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s13756-021-00886-y","article-title":"Carriage of antimicrobial-resistant bacteria in a high-density informal settlement in Kenya is associated with environmental risk factors","volume":"10","author":"Omulo","year":"2021","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Kariuki, S., Mbae, C., Van Puyvelde, S., Onsare, R., Kavai, S., Wairimu, C., Ngetich, R., Clemens, J., and Dougan, G. (2020). High relat-edness of invasive multi-drug resistant non-typhoidal Salmonella genotypes among patients and asymptomatic carriers in endemic informal settlements in Kenya. PLoS Neglected Trop. Dis., 14.","DOI":"10.1371\/journal.pntd.0008440"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1038\/s41467-019-13995-5","article-title":"Antimicrobial-resistant enteric bacteria are widely distributed amongst people, animals, and the environment in Tanzania","volume":"11","author":"Subbiah","year":"2020","journal-title":"Nat. Commun."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Okeke, I.N. (2010). Poverty and root causes of resistance in developing countries. Antimicrobial Resistance in Developing Countries, Springer.","DOI":"10.1007\/978-0-387-89370-9_3"},{"key":"ref_62","unstructured":"CLSI (2023). M02 Disk Diffusion Reading Guide, Clinical and Laboratory Standards Institute. [2nd ed.]. CLSI quick guide M02-Ed14-QG."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1093\/jac\/dkl020","article-title":"The role of horizontal gene transfer in the spread of trimethoprim-sulfamethoxazole resistance among uropathogenic Escherichia coli in Europe and Canada","volume":"57","author":"Blahna","year":"2006","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1633","DOI":"10.1099\/jmm.0.034140-0","article-title":"Antimicrobial resistance and distribution of sul genes and integron-associated intI genes among uropathogenic Escherichia coli in Queensland, Australia","volume":"60","author":"Long","year":"2011","journal-title":"J. Med. Microbiol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"137","DOI":"10.4014\/jmb.1409.09041","article-title":"Characterization of trimethoprim-sulfamethoxazole resistance genes and their relatedness to class 1 integron and insertion sequence common region in gram-negative bacilli","volume":"25","author":"Shin","year":"2015","journal-title":"J. Microbiol. Biotechnol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e081906","DOI":"10.1136\/bmjopen-2023-081906","article-title":"Landscape analysis of the Kenyan policy on the treatment and prevention of diarrheal disease among under-5 children","volume":"14","author":"Mberu","year":"2024","journal-title":"BMJ Open"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e00105-00118","DOI":"10.1128\/mBio.00105-18","article-title":"Emergence of an extensively drug-resistant Salmonella enterica serovar Typhi clone harboring a promiscuous plasmid encoding resistance to fluoroquinolones and third-generation cephalosporins","volume":"9","author":"Klemm","year":"2018","journal-title":"MBio"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1093\/ije\/dyt148","article-title":"Profile: Manhi\u00e7a Health Research Center (Manhi\u00e7a HDSS)","volume":"42","author":"Sacoor","year":"2013","journal-title":"Int. J. Epidemiol."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/14\/8\/1610\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T15:19:39Z","timestamp":1784819979000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/14\/8\/1610"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,23]]},"references-count":68,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["microorganisms14081610"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms14081610","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,23]]}}}