ABSTRACT
Background: Urinary tract infections (UTIs) are common bacterial infections, and rising antimicrobial resistance threatens effective treatment in resource-limited settings. Objective: This study determined the prevalence, antimicrobial resistance profiles, and risk factors associated with uropathogenic bacteria among residents of Kibra informal settlement, Nairobi. Methods: A cross-sectional mixed-methods study was conducted in Kibra informal settlement and the microbiology laboratory of a tertiary county hospital between November 2025 and February 2026. A total of 607 urine specimens were collected from symptomatic residents and processed using standard microbiological techniques. Antimicrobial susceptibility testing was performed according to Clinical and Laboratory Standards Institute (CLSI) 2023 guidelines. Additionally, 100 household respondents completed structured questionnaires on antibiotic-use practices, while 50 participants took part in focus group discussions exploring health-seeking behaviour, antibiotic acquisition and use, disposal practices, and barriers to appropriate antibiotic use. Quantitative data were analysed descriptively and inferentially, while qualitative data underwent thematic analysis. Results: Of 607 specimens, 150 (24.7%; 95% confidence interval 21.4–28.3) grew a bacterial uropathogen. Escherichia coli predominated (57.3%). Resistance was highest to ampicillin (92.0%), ceftriaxone (81.8%) and trimethoprim-sulfamethoxazole (74.7%), and lowest to nitrofurantoin (8.4%), amikacin (1.5%) and meropenem (0.0%). Multidrug resistance was 84.7% (127/150); 83.3% (90/108) of isolates from species in which screening is interpretable showed a phenotype consistent with extended-spectrum β-lactamase production. Among 100 respondents, 84.0% took an antibiotic for their last episode, 49.0% bought it without prescription and 42.0% completed the course. No socio-demographic factor was significantly associated with inappropriate antibiotic use (88.0%). F

ABSTRACT
Background: Reproductive tract bacterial infections are a leading cause of morbidity among sexually active women worldwide. Female reproductive tract infections can affect either the upper reproductive tract, which includes the fallopian tubes, ovaries and uterus, or the lower reproductive tract, comprising the vagina, cervix and vulva. Objectives: The study aimed to determine reproductive tract bacterial infections and sexually transmitted infections among women of reproductive age attending Homabay County teaching and referral hospital in Kenya as well as the socio-demographic factors associated with these infections. Materials and Methods: A cross- sectional study design was adopted, employing a systematic sampling technique. The participants were interviewed using a structured questionnaire to obtain data on the socio-demographic factors. Blood and high vaginal swab samples were obtained from each participant for the analysis of bacterial infections. Sample analysis was done at the Homabay County Teaching and referral hospital laboratory, Kenya. Data analysis employed Statistical Package for Social Sciences version 28, with a significance level set at P ≤ 0.05. High vaginal swabs were examined for bacterial vaginosis and grading performed using Nugent’s criteria while blood samples were examined for Treponema pallidum. Results: Findings on reproductive tract bacterial infections among 360 women showed; 20.2% prevalence, with Bacterial vaginosis (BV) infections having 5.8% while for sexually transmitted infections: Treponema pallidum (10.8%) and Neisseria gonorrhoea (3.6%) were established. Conclusions and Recommendations: The study concluded that reproductive tract infections, as well as sexually transmitted infections driven by, T. pallidum and N. gonorrhoea, pose a public health challenge and recommended routine screening among women of reproductive age.

ABSTRACT
Background: Bacterial infections of the reproductive tract are a leading cause of morbidity among women of child bearing age globally. These infections can affect either the upper reproductive tract, encompassing the fallopian tubes, ovaries and uterus, or the lower reproductive tract, featuring the vagina, cervix and vulva. Objectives: The study aimed to determine the incidence of bacteria causing reproductive tract bacterial infections among women of reproductive age attending Homabay County teaching and referral hospital in Kenya and their current antibiotic susceptibility profiles. Materials and Methods: A cross- sectional study design was adopted, employing a systematic sampling technique. The minimum sample size was determined using Fisher et al.'s formula and sample analysis done at the Homabay County Teaching and referral hospital laboratory. High vaginal swabs were examined for bacterial vaginosis and grading performed using Nugent’s. All gonorrhoea isolates were tested for antibiotic sensitivity using the disc diffusion method with reference to CLSI 2024 guidelines. Data analysis employed Statistical package for social sciences version 28, with a significance level set at P ≤ 0.05. Fisher’s exact test was employed to assess the sensitivity of Neisseria gonorrhoea to various antibiotics commonly prescribed for treatment. Ethical approval was provided by the Kenyatta University Ethical Review Committee and research permit obtained from the National Commision for Science, Technology and Innovation. Results: Findings on reproductive tract infections among 360 women showed 20.3 % incidence. Neisseria gonorrhoea exhibited 100% resistance to tetracycline, 34% resistance to penicillin, and 100% sensitivity to ceftriaxone. Conclusions and Recommendations: Owing to the high incidence rate and poor sensitivity rates to most antibiotics, the study recommended regular screening of women of child bearing age for reproductive tract bacterial infections and prioritizing c

ABSTRACT
Background: Urinary tract infections are among the most frequently occurring bacterial infections worldwide. Recent increases in Antimicrobial Resistance have led to increased disease burden especially in urinary tract infections in informal settlements where prescribed regimens are limited due to associated costs. Objectives: The study aimed to identify uropathogenic bacterial agents and their antibiotic susceptibility profiles isolated in Kibra Informal Settlement, Nairobi City County, Kenya. Methods: A cross-sectional study design was adopted in this study. Results: Of the 150 isolates tested, Escherichia coli was the most frequent uropathogen identified (57.3%), followed by Klebsiella pneumoniae (10.0%), Pseudomonas aeruginosa (5.3%) and Staphylococcus aureus (4.7%). Isolates were found to be most resistant to Ampicillin (92.0%), third-generation Cephalosporins (76.7-81.8%), and Trimethoprim- sulphamethoxazole (74.7%), and least resistant to nitrofurantoin (8.4%), Amikacin (1.5%) and Meropenem (0.0%). Overall, 84.7% of all isolates were empirical drug resistant. Of Gram-negative isolates, 74.2% exhibited phenotypic resistance patterns consistent with Extended-Spectrum Beta-Lactamase production. Among surveyed community members, 84.0% of respondents who reported having experienced a urinary tract infections episode in the preceding three months went on to use an antibiotic to treat their illness. Conclusion: The study findings demonstrated an urgent need for institution of community-based AMR stewardship education initiatives, and immediate revision of Antimicrobial Susceptibility Testing-guided treatment guidelines. Additionally, for empirical urinary tract infections treatment in Kenya’s informal urban settlements, there is a need to prioritize Nitrofurantoin and other low resistance antibiotics. This study also recommends implementation of routine facility-based antibiotic program surveillance and establishment of coordinated One Health antimicrobial stewardsh

ABSTRACT
Retail medicine outlets serve as the first point of contact for most Ghanaians seeking treatment for common ailments. However, weak regulation has led to the widespread dispensing of antimicrobials without a prescription in community pharmacies and over-the-counter medicine shops (OTCMS), fueling antimicrobial resistance (AMR). This cross-sectional study assessed the sale of prescription-only antimicrobials for common self-limiting conditions that do not require antimicrobial therapy in Tamale, northern Ghana. Using the simulated patient (SP) method, adult male actors presented with symptoms of urinary tract infection, upper respiratory tract infection, and acute diarrhoea. Three escalating levels of demand were employed to evaluate dispensing practices without a prescription. A total of 35 community pharmacies and 25 OTCMS were visited three times each, resulting in 180 SP visits. In community pharmacies, pharmacists were the most frequently encountered staff (34.3%), while medicine counter assistants predominated in OTCMS (44.0%). The overall prevalence of dispensing antimicrobials without a prescription was alarmingly high at 91.7% (165/180). Antimicrobials were commonly sold at the first level of demand, 64.8% in community pharmacies and 86.7% in OTCMS. Watch group antibiotics were more frequently dispensed in pharmacies (45.8%), whereas Access antibiotics dominated in OTCMS (47.3%). The most dispensed agents were ciprofloxacin (19.6%), amoxicillin-clavulanic acid (14.4%), and doxycycline (11.0%). This study reveals widespread violations of national regulations governing antimicrobial sales, particularly in OTCMS where such sales are illegal. Urgent implementation of antimicrobial stewardship programmes, stricter enforcement of regulations, and targeted staff training are recommended to curb irrational antimicrobial use and combat AMR in Ghana.

ABSTRACT
Background: Infectious diarrhea remains a significant global health concern, especially in less developed regions. The disease's impact on children under five years old is particularly severe, causing a high mortality rates in Low- and Middle-income Countries (LMICs). Objectives: The study aimed to investigate to characterize bacterial causative agents of diarrhea among children below 5 years attending Kiandutu Health care center in Thika, Kiambu County. It also sought to determine the antibiotic susceptibility testing of the isolated bacteria among children below 5 years attending Kiandutu Health care center in Thika, Kiambu County. Materials and Methods: The study utilized an exploratory descriptive approach because it will look at the many aspects of the disease incidence, including the onset of disease and treatment for the children attending Kiandutu Health Centre. Results: In characterizing the bacterial causative agents of diarrhea, Escherichia coli was isolated in 45.1%. In the remaining cases, in 54.9%, there was no growth or no pathogen isolated. In addition, MDR, which was defined as resistance to at least one agent in three different antimicrobial categories, was highly prevalent; it was identified in 78.3% (36/46) of the isolates. By stratification according to their ESBL status, all the ESBL-positive isolates showed MDR at 100% (23/23), compared to 56.5% (13/23) among the ESBL-negative isolates. The most sensitive antibiotic was chloramphenicol: 40 isolates were found to be sensitive and 6 resistants, giving a 13% resistance rate. Second to this was Amoxyclav, with 37 sensitive and 8 resistant. moderately effective antibiotic was ciprofloxacin, with 28 sensitive, 13 resistant, and 5 intermediates, yielding a 28.3% resistance rate. Conclusions and Recommendations: Resistance is ubiquitous, even among infections acquired within communities. Empiric antibiotic treatment is increasingly ineffective, with most first-line drugs failing against common pathoge

ABSTRACT
Carbapenem-resistant Enterobacterales (CRE) infections, which are associated with high morbidity and mortality, are increasingly reported worldwide, particularly in healthcare settings. This observational study investigated patients with CRE infections at an Indian tertiary care hospital. The infections predominantly affected elderly individuals: the 61–80 age group accounted for 59.4% of cases, while the 71–80 subgroup alone comprised 38.6% of patients. Regarding hospital stay duration, nearly half of the patients (48.3%) were hospitalized for 0–10 days, whereas 31.0% remained hospitalized for 31 days or more. The most frequently utilized indwelling devices were Foley catheters, followed by nebulizers, nasogastric (NG) tubes, and ventilators. Microbiologically, Klebsiella pneumoniae was the primary isolate (58.6%), followed by Escherichia coli (27.3%), Pseudomonas aeruginosa (6.1%), Acinetobacter baumannii (2.0%), non-lactose fermenters (2.0%), and Providencia rettgeri, Enterobacter cloacae, and Aspergillus spp. (2.0% each). This study highlights the clinical and microbiological characteristics of CRE isolated from hospitalized patients. Genetic analysis revealed that blaNDM and blaOXA-48 were the most prevalent carbapenemase genes, while blaKPC and blaIMP occurred less frequently. Notably, several isolates co-harbored multiple resistance genes (such as blaNDM and blaOXA-48, suggesting the emergence of multidrug-resistant variants with complex resistance determinants.