Distribution and antimicrobial resistance of enteric pathogens in Chinese paediatric diarrhoea: a multicentre retrospective study, 2008-2013

Epidemiol Infect. 2015 Sep;143(12):2512-9. doi: 10.1017/S0950268814003756. Epub 2015 Jan 14.

Abstract

The enteric pathogens causing diarrhoea impair children's health severely. This study retrospectively analysed 1577 pathogens isolated from inpatients and outpatients in six hospitals located in Northern (Inner Mongolia), Northeastern (Hebei), Eastern (Shanghai and Jiangsu), Southern (Hainan) and Central (Hubei) China between 2008 and 2013. Of the 1577 enteric pathogens, Salmonella presented with the highest frequency (36·0%), followed by diarrhoeagenic Escherichia coli (23·7%), Staphylococcus aureus (15·0%), Shigella (13·1%), and Aeromonas (4·6%). The predominant pathogens varied in different regions of China, with Salmonella most prevalent in Shanghai and Hainan, diarrhoeagenic E. coli most prevalent in Inner Mongolia, Jiangsu and Hubei, and Shigella most prevalent in Hebei. Enteric pathogens were more frequently isolated in males (56·9%) than in females (43·1%). The highest proportion of all enteric pathogens was found in infants (67·6%) with a peak in summer and autumn (68·5%). Antimicrobial susceptibility assay demonstrated that Shigella was more resistant to ampicillin, ceftriaxone and sulfamethoxazole than Salmonella. Of the top two serotypes in Salmonella, Typhimurium was more resistant to ciprofloxacin, sulfamethoxazole and chloramphenicol than Enteritidis (P < 0·001). Meanwhile, the resistance rates of Shigella flexneri against ampicillin/sulbactam, ciprofloxacin, and chloramphenicol were significantly higher than those of Shigella sonnei (P < 0·001). Multidrug resistance was apparent in 58·2% of Shigella and 45·9% of Salmonella, and this phenomenon was more pronounced in S. flexneri.

Keywords: Antibiotic resistance; Salmonella; Shigella; bacteriology; diarrhoea.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Aeromonas / drug effects
  • Age Distribution
  • Anti-Bacterial Agents / pharmacology*
  • Child
  • Child, Preschool
  • China
  • Diarrhea / epidemiology
  • Diarrhea / microbiology*
  • Drug Resistance, Multiple, Bacterial
  • Dysentery, Bacillary / epidemiology
  • Dysentery, Bacillary / microbiology
  • Escherichia coli / drug effects
  • Escherichia coli Infections / epidemiology
  • Feces / microbiology
  • Female
  • Geographic Mapping
  • Gram-Negative Bacteria* / drug effects
  • Gram-Negative Bacterial Infections / epidemiology
  • Gram-Negative Bacterial Infections / microbiology*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Microbial Sensitivity Tests
  • Retrospective Studies
  • Salmonella / drug effects
  • Salmonella Infections / epidemiology
  • Salmonella Infections / microbiology
  • Seasons
  • Sex Distribution
  • Sex Factors
  • Shigella / drug effects
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology*
  • Staphylococcus aureus* / drug effects

Substances

  • Anti-Bacterial Agents