Bacterial etiology of acute diarrhea in pediatric patients

Acute diarrhea is an important cause of morbidity and mortality in developing countries, and in some cases, it requires antimicrobial therapy. The use of antibiotics needs a previous knowledge of local epidemiology. In order to know these parameters, the result of enteropathogenic bacteria isolated from 7.075 fecal samples from ambulatory patients up to 15 years old, assisted at the Hospital de Ninos de La Plata from 2001 to 2003 was retrospectively studied. A total of 1,221 enteropathogenic bacteria were isolated (17.26%). The pathogens identified by standard methods were Shigella flexneri (27%), Shigella sonnei (21.2%), Campylobacter spp.(30.1%), Aeromonas spp.(9.4%), Salmonella spp. (5.4%), enteropathogenic Escherichia coli (5.7%), enteroinvasive Escherichia coli (0.9%) and Escherichia coli 0157 (0.4%). Strains from Shigella dysenteriae, Shigella boydii and Yersinia spp were not isolated in this study. Shigella flexneri strains were resistant to ampicillin (92.4%, 89.2%, 91.9%), co-trimoxazole (51.5%, 50%, 44%) and chloramphenicol (73.8%, 85.9%, 79.2%) for 2001, 2002 and 2003 respectively. Shigella sonnei strains were resistant to ampicillin (39.4%, 20.6%, 12.9%), co-trimoxazole (60.6%, 54.3% 38.7%) and chloramphenicol (6%, 2.9%, 3.3%) for each year. Strains resistant to ciprofloxacin, nitrofurans and third generation cephalosporins were not isolated.