Related Experiment Videos
Viruses and bacteria in pediatric diarrhea in Thailand: a study of multiple antibiotic-resistant enteric pathogens
Insights
Antibiotic use in pediatric diarrhea in Bangkok is frequent, leading to high rates of plasmid-mediated antibiotic resistance in common enteric pathogens like E. coli and Shigella.
Area of Science:
- Microbiology
- Pediatrics
- Infectious Diseases
Background:
- Pediatric diarrhea is a significant health concern.
- Antibiotic resistance in enteric pathogens poses a growing threat.
Purpose of the Study:
- To investigate the prevalence of enteric pathogens in children with diarrhea.
- To determine the extent of prior antibiotic use in these children.
- To assess the frequency of plasmid-mediated antibiotic resistance.
Main Methods:
- Studied 105 children with diarrhea admitted to a Bangkok hospital.
- Identified enteric pathogens using laboratory methods.
- Assessed antibiotic resistance through phenotypic and genotypic analysis, including conjugation experiments and plasmid analysis via agarose gel electrophoresis.
Main Results:
- Common pathogens included Rotavirus (36%), enterotoxigenic E. coli (18%), and Shigella (9%).
- Antibiotics were detected in 29% of admitted children's urine.
- High rates of multidrug resistance were observed in Shigella, enterotoxigenic E. coli, and Salmonella.
- Plasmid-mediated transfer of antibiotic resistance (R factors) and toxin production was demonstrated.
Conclusions:
- Frequent antibiotic use in pediatric diarrhea treatment in Bangkok contributes to high rates of plasmid-mediated resistance.
- This resistance poses a significant challenge for managing infectious diarrhea in children.
Abstract:
Children with diarrhea admitted to a rehydration ward of a children's hospital in Bangkok were investigated to determine the prevalence of enteric pathogens, the extent of children's previous antibiotic therapy, and the frequency of plasmid-mediated antibiotic resistance among infecting bacteria. Rotavirus (36%), enterotoxigenic Escherichia coli (18%), Shigella (9%), Salmonella (6%), Campylobacter jejuni/coli (4%), and Vibrio cholerae (2%) infections were among 105 children with diarrhea. Antibiotics were detected in 29% of urines collected from children on admission. All Shigella, 83% of enterotoxigenic E. coli, and 40% of Salmonella were resistant to more than one antibiotic. Sixty-two percent of 24 antibiotic-resistant enteric pathogens transferred R factors to E. coli K12 by conjugation. Four of four multiresistant E. coli that produced heat-labile and heat-stable toxin transferred resistance and the ability to produce heat-labile toxin. An analysis of plasmids by agarose gel electrophoresis indicated enterotoxigenicity and antibiotic resistance were associated with separate plasmids in transconjugants from these six matings. Antibiotics are used frequently in the treatment of pediatric diarrhea in Bangkok, which has undoubtedly contributed to the high frequency of plasmid-mediated resistance among enteric pathogens.