Abstract：
Acute gastroenteritis (AGE) poses a significant public health challenge for children in developing countries. Considering the high prevalence of AGE in Iranian children, the aim of this study was to investigate and analyze the patterns and changes in bacterial identification as well as antibiotic resistance in AG over the course of 7 years. From January 2015 to December 2021, a total of 15,300 pediatric patients with AGE were admitted to the Children\'s Medical Center, an Iranian academic referral hospital, Tehran, Iran. Among these cases, 8.9% (1329 individuals) yielded positive stool cultures. The predominant bacterial etiology of AGE was identified as Shigella sonnei (n = 424, 31.9%), and Salmonella group D (n = 367, 27.6%), followed by Shigella flexneri: 16.3% (217 cases), Salmonella group C (n = 152, 11.4%), Salmonella group B (n = 91, 6.8%), Escherichia coli (n = 65, 4.9%), Shigella boydii (n = 10, 0.75%), and Shigella dysenteriae (n = 3, 0.2%). Notably, S. sonnei exhibited high resistance rates to trimethoprim-sulfamethoxazole (97.6%) and nalidixic acid (95.3%). S. flexneri and S. boydii isolates displayed significant resistance to ampicillin (96.8% and 88.9%, respectively). Salmonella group D demonstrated elevated resistance to ciprofloxacin (81.3%) and nalidixic acid (88.5%), with notable sensitivity to trimethoprim-sulfamethoxazole and cefotaxime (97.3% and 97.5%, respectively). E. coli displayed resistance rates of 80%, 74%, and 66% to trimethoprim-sulfamethoxazole, cefotaxime, and ciprofloxacin, respectively. The fluctuating prevalence of S. sonnei and Salmonella group D, two predominant bacterial isolates associated with AGE, underscores the dynamic nature of these pathogens. The notable increase in antibiotic resistance observed in S. sonnei raises concerns, underscoring the critical need for judicious and careful antibiotic use.
摘要：
急性胃肠炎（AGE）对发展中国家的儿童构成了重大的公共卫生挑战。考虑到伊朗儿童的高患病率，这项研究的目的是调查和分析7年来AG中细菌鉴定的模式和变化以及抗生素耐药性。从2015年1月至2021年12月，共有15,300名年龄老化的儿科患者入住儿童医疗中心，一家伊朗学术转诊医院，德黑兰,伊朗。在这些案例中,8.9%(1329个个体)的粪便培养呈阳性。AGE的主要细菌病因被确定为志贺氏菌（n=424，31.9%），沙门氏菌D组（n=367，27.6%），其次是福氏志贺氏菌：16.3%（217例），C组沙门氏菌(n=152,11.4%),沙门氏菌B组（n=91，6.8％），大肠杆菌（n=65，4.9%），博伊氏志贺氏菌（n=10，0.75%），和痢疾志贺氏菌（n=3，0.2％）。值得注意的是,S.sonnei对甲氧苄啶-磺胺甲恶唑（97.6％）和萘啶酸（95.3％）表现出较高的耐药率。福氏菌和博伊迪菌分离株对氨苄青霉素表现出显著的耐药性(96.8%和88.9%，分别)。D组沙门氏菌对环丙沙星(81.3%)和萘啶酸(88.5%)的耐药性升高,对甲氧苄啶-磺胺甲恶唑和头孢噻肟有明显的敏感性（97.3%和97.5%，分别)。大肠杆菌显示80%的耐药率，74%,和66%的甲氧苄啶-磺胺甲恶唑，头孢噻肟,还有环丙沙星,分别。S.sonnei和沙门氏菌D组的患病率波动，与AGE相关的两个主要细菌分离株，强调了这些病原体的动态性质。在S.sonnei中观察到的抗生素耐药性的显着增加引起了人们的关注，强调了明智和谨慎使用抗生素的迫切需要。
