PP 14 - Prevalence of bacterial enteropathogens and antibiogram among children admitted to a leading children’s hospital with gastroenteritisospital with gastroenteritis to Lady Ridgeway Hospital for children and antimicrobial susceptibility patterns

Ranaweera KKPT, Pathirage S.  , Medical Research Institute

Abstract

Introduction

Bacterial diarrhoea remains a major cause of childhood morbidity in developing countries with. Salmonella, Shigella, and Campylobacter as important causes.

 Objective

To determine the prevalence of common bacterial enteropathogens and their antimicrobial susceptibility among pediatric patients with acute diarrhoea.

 Design, setting, and methods

A descriptive cross-sectional study was conducted from December 2024 to December 2025 using 384 stool samples collected from children admitted with acute diarrhoea to the Lady Ridgeway Hospital for Children. Acute diarrhoea was defined as three or more loose stools, +/- blood, within 24 hours. Stool microscopy with wet-mount, culture, antimicrobial susceptibility testing was performed according to CLSI M100 34^thedition and National Laboratory Manual at the Enteric Reference Laboratory, MRI. Stool samples were cultured on Xylose Lysine Deoxycholate agar, MacConkey Agar, and Salmonella-Shigella agar media were incubated aerobically at 35-37℃ overnight. Butzler Campylobacter selective agar was incubated at 37-42 °C for 24-48 hours under microaerophilic conditions (5% O₂-10% CO₂). Further identification of Salmonella and Shigella spices was done using biochemicals and serotyping, Campylobacter was identified as per in-house SOP.

Sociodemographic and clinical data were collected via structured questionnaires. Association between variables were assessed using Chi-square test.

 Results

Among 384 samples analyzed, Salmonella, Shigella or Campylobacter were isolated from 32 (8.33%) samples. Salmonella species were the predominant (6.5% of total samples; n= 25; 78.12% of positive isolates), followed by Campylobacter species (1.04%; n= 4; 12.5%) and Shigella species (0.78%; n= 3; 9.3%). Consumption of food prepared outside the home was significantly associated with culture positivity (p=0.011); no significant associations were found for gender (p=0.936) or age (p=0.182).

Salmonella species were 96% sensitive to ampicillin, amoxicillin-clavulanate, cefotaxime and chloramphenicol, and 100% sensitive to tetracycline and trimethoprim-sulfamethoxazole; ciprofloxacin sensitivity and intermediate sensitivity were 56% and 44%, respectively. All three Shigella species were sensitive to amoxicillin-clavulanate, cefotaxime and chloramphenicol; one each was sensitive to ampicillin and ciprofloxacin, while all were resistant to trimethoprim-sulfamethoxazole. All four Campylobacter species were resistant to ciprofloxacin and sensitive to tetracycline; three were sensitive to erythromycin. Stool microscopy (pus and red blood cells) was significantly associated with bacterial isolation (p<0.001).

 Conclusion

Salmonella species were the predominant pathogen in this pediatric population. Resistance to ciprofloxacin highlights the need for continuous surveillance on antimicrobial sensitivity.