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

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.