Antimicrobial Resistance of Enteric Pathogens Isolated from Acute Gastroenteritis Patients in Gaza strip, Palestine
Background: Acute gastroenteritis is a severe infection of the gastrointestinal tract (GI). The antibiotic resistance of enteric bacteria has profound clinical implications because it threats the life and worsens the acute gastroenteritis disease. This study is a matched case-control study and aims to determine enteropathogenic bacteria, their antibiotic resistance and associated-risk factors in diarrheal patients in Gaza Strip.
Methods: 132 patients with acute diarrhea were investigated. In addition, data were collected from 132 healthy controls having the same characteristics of patients except the fact they didn’t suffer from diarrhea within the last three months. The age categories of patients are < 5 and > 5 years old. Data were collected through completing a questionnaire form for cases and controls and stool samples were collected from six Primary Health Care Clinics and these samples were inoculated on selective media in Remal clinic- Microbiology laboratory.
Results: 12 (9.1%) enteropathogenic bacteria were isolated from 132 stool samples. Salmonella, Campylobacter coli/jejuni, and Aeromonas hydrophilia were isolated in equal numbers from samples 3/12 (25% each), Shigella 2/12 (16.7%), and Yersinia enterocolytica 1/12 (8.3%). The two Shigella spp. are Shigella boydii. The antimicrobial profile of all isolated enteropathogenic bacteria showed high resistance rates for the tested antimicrobials (C. coli/jejuni (52.4%), followed by A. hydrophilia (49.2%), Y. enterocolytica (42.9%), Shigella (26.2%) and Salmonella spp. (22.2%). In addition the antimicrobial profile of the isolated enteropathogenic bacteria showed high resistance rate to rifampin (91.6%), clindamycin (83.3%), erythromycin (75%), cephalexin and tetracycline (66.6%).
Conclusions: The isolated enteropathogenic bacteria showed high resistance rate to several antimicrobials. This study isolated C. coli/jejuni, A. hydrophilia, and Y. enterocolytica, which are not screened for during routine examinations of stool samples in Palestinian health laboratories in Gaza Strip.
Recommendations: We recommend improving of laboratory services in Gaza Strip to extend their ability to isolate all types of enteropathogenic bacteria especially those, which are not isolated routinely.
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