Characteristics of bacterial pathogens associated with acute diarrhea in children under 5 years of age: a hospital-based cross-sectional study

Abstract

BackgroundAcute diarrhea is a leading cause of morbidity and mortality in children, particularly in those under the age of 5 years. Rotavirus is recognized as the leading cause of acute diarrhea in children, however, the contribution of bacterial pathogens as causative agents varies throughout the world. Here we report a hospital-based prospective study to analyze the characteristics of bacterial pathogens associated with acute diarrhea in children under 5 years of age.MethodsStool samples were collected from 508 patients with acute diarrhea under 5 years of age who presented at our hospital. Nine pathogens were isolated and identified by culturing, serology or PCR, these included Salmonella spp., Shigella spp., Vibrio cholerae, diarrheagenic Escherichia coli (DEC), Aeromonas spp., Plesiomonas spp., Vibrio parahaemolyticus, Campylobacter spp. and Yersinia enterocolitica. Antimicrobial sensitivity tests of these pathogens were conducted. The most commonly detected pathogen, Salmonella spp., was further investigated by PCR and sequencing of antibiotic resistance-related genes.ResultsPathogens were identified in 20.1 % of the 508 samples. The most commonly detected pathogens were Salmonella spp. (8.5 %), followed by DEC (4.7 %), Campylobacter jejuni (3.0 %) and Aeromonas spp. (2.0 %). The resistance rates to ampicillin and tetracycline in Salmonella spp. were >60 %, but were <30 % to cephalosporins and quinolones. More than 50 % of DEC strains displayed resistance to ampicillin, cefotaxime and tetracycline, and 60 % of C. jejuni strains were resistant to ciprofloxacin but highly sensitive to the other antibiotics. Among 12 cephalosporin-resistant Salmonella isolates, TEM-1 and CTX-M-14 determinants were present in two (16.7 %) isolates. PCR screening for plasmid-mediated quinolone resistance genes revealed gyrA mutations in one of three highly quinolone resistant isolates.ConclusionsSalmonella spp., DEC, Campylobacter spp. and Aeromonas spp. were the most commonly detected bacterial pathogens in children under the age of 5 years with acute diarrhea. Our findings indicate that ampicillin and tetracycline are not suitable as first line therapeutic drugs against Salmonella spp. Resistance to third generation cephalosporins and quinolones was also detected. TEM-1 and CTX-M-14 genetic determinants, and gyrA mutations, were the major mechanisms associated with high levels of cephalosporin and quinolone resistance, respectively, in Salmonella isolates.

Comparison of Regular and Probiotic Yogurts in Treatment of Acute Watery Diarrhea in Children

“…Researchers have also reported that early oral rehydration and nutrition have been shown to be the main interventions in management of diarrhea [6]. For example, oral rehydration therapy/solution (ORS), the most common approach for management of diarrhea, prevents about three million dehydrationrelated deaths in a year [7]. Recently, the most important goal in management of acute diarrhea is rehydration therapy to correct fluid, glucose, and electrolyte deficits in the body [8].…”

Epidemic and molecular characterization of fluoroquinolone-resistant Shigella dysenteriae 1 isolates from calves with diarrhea

“…35 Over the past few years, the dissemination of PMQR genes among quinolone-resistant Shigella isolates has been surveyed in some studies and has emerged as an important issue across the world. [36][37][38][39] It has been reported that aac(6')-Ib-cr signi cantly increases the frequency of selection of chromosomal mutants to reduce cipro oxacin activity by N-acetylation at the amino nitrogen on its piperazinyl substituent. 40 The aac(6')-Ib-cr-positive Shigella was rst isolated in 1998; 41 however, the most striking nding of our previous and present study was the aac(6′)-Ib-cr allele wide penetration in all quinolone-resistant isolates.…”

Diarrhea in Newborns;

“…The toxin intern produced by this bacterium can cause injury to the mucosa and ultimately bloody stools. 23,24 Breastmilk inhibits the growth of the bacteria and thus tend to have less severe symptoms than non-breastfed babies In patients with diarrhea, a stool pH level of 5.5 or less or presence of reducing substances indicates carbohydrate intolerance, which is usually secondary to viral illness and transient in nature. 25…”