Antibiotic Susceptibility of Salmonella spp., Shigella spp. and enteropathogenic Escherichia coli strains isolated from diarrheic children in Tripoli, North Lebanon

Authors

  • Monzer Hamze Laboratoire Microbiologie Santé et Environnement (LMSE), Ecole Doctorale des Sciences et de Technologie, Faculté de Santé Publique, Université Libanaise, Tripoli, Lebanon.
  • Marwan Osman Laboratoire Microbiologie Santé et Environnement (LMSE), Ecole Doctorale des Sciences et de Technologie, Faculté de Santé Publique, Université Libanaise, Tripoli, Lebanon.
  • Hassan Mallat Laboratoire Microbiologie Santé et Environnement (LMSE), Ecole Doctorale des Sciences et de Technologie, Faculté de Santé Publique, Université Libanaise, Tripoli, Lebanon.
  • Marcel Achkar Clinical Laboratory, Nini Hospital, Tripoli, Lebanon

DOI:

https://doi.org/10.3823/787

Keywords:

Enterobacteriaceae enteropathogens, Salmonella, Shigella, enteropathogenic Escherichia coli, diarrhea

Abstract

Background. – Enteric infections are a leading cause of diarrheal disease and death in infants and young children, particularly in the developing regions. The aim of this study is to determine the antibiotic susceptibility of three Enterobacteriaceae enteropathogens (Salmonella spp., Shigella spp. and enteropathogenic Escherichia coli (EPEC)) isolated from hospitalized diarrheic children in North Lebanon during the period of 7 years.

Methods and Findings. – 172 Enterobacteriaceae enteropathogens strains were isolated from fecal or blood specimens of 158 hospitalized diarrheic children collected at Nini hospital in Tripoli, North Lebanon. Culture, identification and antibiotic susceptibility of strains were carried out through conventional tools according to standard protocols proposed by the REMIC group and the recommendations of the European Committee on Antimicrobial Susceptibility Testing. Out of 172, 158 (91.9%) Enterobacteriaceae enteropathogens strains were isolated from stool samples and only 14 (8.1%) were isolated from blood cultures. EPEC were predominant (78/172; 45.3%), followed by Salmonella spp. (64/172; 37.2%) and Shigella spp. (30/172; 17.5%). According to API identification and immunological serotyping reports of Salmonella isolates, Salmonella Typhi was the predominant serotype (32/64; 50%). During the study period, antibiotics susceptibility testing showed that around 50% and 25% of the isolates were resistant to ampicillin and extended-spectrum cephalosporins, respectively. Overall, Salmonella Typhi strains were the most susceptible to antibiotics.

Conclusion. – Our study revealed a relatively high antibiotic resistance rate of EPEC, Shigella spp. and non-Typhi Salmonella strains among studied population. The findings of this study provide useful information to survey, prevent and control diarrheal disease and antimicrobial resistance in Lebanon.

References

Kotloff KL, Nataro JP, Blackwelder WC, Nasrin D, Farag TH, Panchalingam S, et al. Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study. Lancet. 2013;382(9888):209-22.

WHO. Diarrhoeal disease. 2013 Contract No.: Fact sheet N°330.

Casburn-Jones AC, Farthing MJ. Management of infectious diarrhoea. Gut. 2004;53(2):296-305.

Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, et al. Global, regional, and national causes of child mortality in 2000-13, with projections to inform post-2015 priorities: an updated systematic analysis. Lancet. 2015;385(9966):430-40.

Diemert DJ. Prevention and self-treatment of traveler's diarrhea. Clin Microbiol Rev. 2006;19(3):583-94.

Seiffert SN, Hilty M, Perreten V, Endimiani A. Extended-spectrum cephalosporin-resistant Gram-negative organisms in livestock: an emerging problem for human health? Drug Resist Updat. 2013;16(1-2):22-45.

Raji MA, Jamal W, Ojemhen O, Rotimi VO. Point-surveillance of antibiotic resistance in Enterobacteriaceae isolates from patients in a Lagos Teaching Hospital, Nigeria. J Infect Public Health. 2013;6(6):431-7.

Randrianirina F, Ratsima EH, Ramparany L, Randremanana R, Rakotonirina HC, Andriamanantena T, et al. Antimicrobial resistance of bacterial enteropathogens isolated from stools in Madagascar. BMC Infect Dis. 2014;14:104.

Dabboussi F, Alam S, Mallat H, Hlais S, Hamze M. [Preliminary study on the prevalence of Campylobacter in childhood diarrhoea in north Lebanon]. East Mediterr Health J. 2012;18(12):1225-8.

Osman M, El Safadi D, Benamrouz S, Guyot K, Dei-Cas E, Aliouat el M, et al. Initial data on the molecular epidemiology of cryptosporidiosis in Lebanon. PLoS One. 2015;10(5):e0125129.

Al-Ali RM, Chehadeh W, Hamze M, Dabboussi F, Hlais S, Mallat H. First description of gastroenteritis viruses in Lebanese children: a pilot study. J Infect Public Health. 2011;4(2):59-64.

Osman M, El Safadi D, Cian A, Benamrouz S, Nourrisson C, Poirier P, et al. Prevalence and Risk Factors for Intestinal Protozoan Infections with Cryptosporidium, Giardia, Blastocystis and Dientamoeba among Schoolchildren in Tripoli, Lebanon. PLoS Negl Trop Dis. 2016;10(3):e0004496.

SFM. Référentiel en Microbiologie Médicale (REMIC). 5ème édition ed. Paris: Société Française de Microbiologie; 2015.

Ochoa TJ, Contreras CA. Enteropathogenic Escherichia coli infection in children. Curr Opin Infect Dis. 2011;24(5):478-83.

Araujo JM, Tabarelli GF, Aranda KR, Fabbricotti SH, Fagundes-Neto U, Mendes CM, et al. Typical enteroaggregative and atypical enteropathogenic types of Escherichia coli are the most prevalent diarrhea-associated pathotypes among Brazilian children. J Clin Microbiol. 2007;45(10):3396-9.

Scaletsky IC, Fabbricotti SH, Silva SO, Morais MB, Fagundes-Neto U. HEp-2-adherent Escherichia coli strains associated with acute infantile diarrhea, Sao Paulo, Brazil. Emerg Infect Dis. 2002;8(8):855-8.

Amrieh S, Hamze M, Mallat H, Achkar M, Dabboussi F. Detection of Escherichia coli O157:H7 and O104:H4 in patients with diarrhea in Northern Lebanon and characterization of fecal E. coli producing ESBL and carbapenemase genes. The International Arabic Journal of Antimicrobial Agents. 2014;4(3:4).

Kanj SS, Kanafani ZA, Shehab M, Sidani N, Baban T, Baltajian K, et al. Epidemiology, clinical manifestations, and molecular typing of Salmonella typhi isolated from patients with typhoid fever in Lebanon. Journal of epidemiology and global health. 2015;5(2):159-65.

Naji-Rammal S, Bedrossian N. [Typhoid fever in Lebanon: epidemiological study]. Sante. 2010;20(2):81-6.

Hamze M, Vincent P. [Typhoid fever in north Lebanon: a 8-year study (1992-1999) using the Widal test]. East Mediterr Health J. 2004;10(1-2):180-6.

Hamze M, Naboulsi M, Vincent P. [Evaluation of the Widal test for diagnosing typhoid fever in Lebanon]. Pathol Biol (Paris). 1998;46(8):613-6.

Crump JA, Luby SP, Mintz ED. The global burden of typhoid fever. Bull World Health Organ. 2004;82(5):346-53.

Malaeb M, Bizri AR, Ghosn N, Berry A, Musharrafieh U. Salmonella burden in Lebanon. Epidemiol Infect. 2016;144(8):1761-9.

Ekdahl K, Andersson Y. The epidemiology of travel-associated shigellosis--regional risks, seasonality and serogroups. J Infect. 2005;51(3):222-9.

Matar GM, Jaafar R, Sabra A, Hart CA, Corkill JE, Dbaibo GS, et al. First detection and sequence analysis of the bla-CTX-M-15 gene in Lebanese isolates of extended-spectrum-beta-lactamase-producing Shigella sonnei. Ann Trop Med Parasitol. 2007;101(6):511-7.

Beyrouthy R, Robin F, Dabboussi F, Mallat H, Hamze M, Bonnet R. Carbapenemase and virulence factors of Enterobacteriaceae in North Lebanon between 2008 and 2012: evolution via endemic spread of OXA-48. J Antimicrob Chemother. 2014;69(10):2699-705.

Moubareck C, Doucet-Populaire F, Hamze M, Daoud Z, Weill FX. First extended-spectrum-beta-lactamase (CTX-M-15)-producing Salmonella enterica serotype typhimurium isolate identified in Lebanon. Antimicrob Agents Chemother. 2005;49(2):864-5.

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Published

2016-09-21

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