In Trans-Nzoia County, a surge in the number of patients presenting with enteric infections who require prolonged periods of treatment with antibiotics points to emergence of drug resistance. However, the extent to which E. coli may be responsible for antimicrobial resistance in this population is not known. Moreover, it is not known whether blaTEM gene, associated with antimicrobial resistance in other population, is responsible for antimicrobial in Trans-Nzoia. As such, this study set out to investigate E. coli drug resistant patterns and the role of blaTEM gene in drug resistance in Trans-Nzoia County.