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Shideh Assar , Arshid Yousefi Avarvand^* , Ahmad Shamsizadeh , Mehran Hakimzadeh , Parisa Majlesi

Abstract

Diarrheal diseases remain the leading cause of death among children under 5 years old. Shigella and Escherichia coli are the most common bacterial causes of gastroenteritis in children, particularly in developing countries. Antimicrobial resistance in bacterial pathogens is a worldwide challenge. This study was conducted to investigate the clinical characteristics and antibiotic sensitivity patterns of Shigella and Escherichia coli isolated from hospitalized children with acute infectious diarrhea. In this study, 420 patients aged 2 months to 14 years with acute infectious diarrhea hospitalized in Ahvaz Teaching Hospitals during 2021-2022, were included. After history taking and physical examination, stool samples of the patients were cultured and antibiogram tests were performed using the agar disk diffusion method based on the CLSI guidelines. The analysis of stool samples revealed that 7.1% of patients were culture positive, 2.1% for E. coli and 5% for Shigella. Shigella sonnei was the predominant species followed by Shigella flexneri. The highest sensitivity was observed to Ciprofloxacin (90.5% among Shigella isolates and 77.8% among E. coli isolates). The rate of resistance in Shigella isolates to Ciprofloxacin, Ceftriaxone and Azithromycin were 9.5%, 62%, 77.1% respectively and in E. coli isolates were 22.2%, 55.6%, 88.9% respectively. Considering the increasing of antibiotic resistance, Ceftriaxone and Azithromycin are no longer good choices for empiric treatment of Shigellosis and E. coli infections in our region. The rate of resistance to Ciprofloxacin also shows an increase but it is still lower than the reported rate in other regions‎.