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Bacterial pathogens associated with bloody diarrhea in Uruguayan children

M I Mota1, M P Gadea, S González

  • 1Departamento de Bacteriología y Virología, Facultad de Medicina, Instituto de Higiene Arnoldo Berta, Montevideo, 11600, Uruguay.

Revista Argentina De Microbiologia
|July 1, 2010
PubMed

Insights

Bloody diarrhea in children is often caused by Shigella. Most Shigella strains are resistant to ampicillin and trimethoprim-sulfamethoxazole, making these antibiotics ineffective for empirical treatment.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Diarrheal diseases pose a significant global health challenge, particularly in developing nations.
  • Bloody diarrhea, accounting for 20-30% of cases, is associated with increased morbidity and mortality.
  • Antibiotic therapy is crucial for specific bacterial infections like Shigella, Campylobacter, Yersinia, and Salmonella, especially in high-risk pediatric populations.

Purpose of the Study:

  • To identify bacterial pathogens responsible for bloody diarrhea in children.
  • To ascertain the antimicrobial susceptibility profiles of these identified pathogens.

Main Methods:

  • A prospective study involving 249 children with bloody diarrhea was conducted between June 2001 and January 2008.
  • Bacterial agents were isolated and identified using standard microbiological techniques.
  • Antimicrobial susceptibility testing was performed on isolated bacterial strains.

Main Results:

  • Shigella was identified in 19.3% of cases, and Shiga toxin-producing Escherichia coli (STEC) in 1.2%.
  • Campylobacter jejuni, Salmonella spp., and Aeromonas spp. were identified in 14.3%, 4.1%, and 2% of a subset of cases, respectively.
  • A high prevalence of antibiotic resistance was observed in Shigella isolates, with 70% resistant to ampicillin and 27% to trimethoprim-sulfamethoxazole. All Shigella isolates remained susceptible to nalidixic acid, ciprofloxacin, and ceftriaxone. Salmonella and STEC isolates showed susceptibility to all tested antibiotics.

Conclusions:

  • Antibiotic resistance patterns indicate that ampicillin and trimethoprim-sulfamethoxazole are inappropriate choices for empirical treatment of Shigella-associated bloody diarrhea.
  • Effective treatment strategies for bloody diarrhea in children require knowledge of local antimicrobial resistance trends.

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