Antibiotic resistance pattern of bacterial enteritis among hospitalized children in Ardabil: a single center experience


  • Manouchehr Barak Department of Pediatrics, Ardabil University of Medical Science, Ardabil, Iran
  • Mohsen Arzanlou Department of Bacteriology, Ardabil University of Medical Science, Ardabil, Iran
  • Behnam Babapour Department of Bacteriology, Ardabil University of Medical Science, Ardabil, Iran
  • Lida Ghorbani Department of Pediatrics, Ardabil University of Medical Science, Ardabil, Iran



Antibiotic resistance, E.coli, Gastroenteritis, Hospitalized children, Shigella spp


Background: Gastroenteritis is one of the most important diseases in all parts of the world; and more dangerous among children, elderly, people who are undernourished and those who live in worse conditions. This study was set up to assess the antibiotic resistance pattern of bacterial enteritis among hospitalized children in Ardabil.

Methods: This prospective cross-sectional study was carried out on 52 children who were referred to Bu- Ali hospital with dysentery in 2014.

Results: Among all 52 collected Stool samples, 33 (63.4%) yielded Shigella. The most common Shigella isolate was S. flexneri (n = 17, 48.6%). Of 52 cases, 61.5% were boy, with the average age of 4.8 years. In the antibiogram, Ciprofloxacin and Gentamiycin were the most sensitive antibiotics to Shigella spp. and Co-trimoxazole and Azithromycin showed the highest resistance. Also, Imipenem, Ciprofloxacin and Gentamicin were the most sensitive antibiotics to E. coli and Co-trimoxazole showed the highest resistance. Finally, Azithromycin, Ceftazidime and Nalidixic acid were the most sensitive antibiotics for Salmonella group D.

Conclusions: The results showed that different bacterial species showed maximum sensitivity to different drugs whereas the majority of them were resistant to Co-trimoxazole.


Khorshidi A, Akbari H, Salehi A. Shigellosis frequency, serotyping and antbiotical resistance pattern in Kashan, Iran. KAUMS Journal (FEYZ). 2007;10(4):65-70.

Stefanie WR, Simone A, Schaad UB, Heininger U. A 4 year study on clinical characteristics of children hospitalized with rotavirus gastroenteritis. Eur J Ped. 2009;168(11):1343-8.

Butleton JR, Calderwood SB. Acute infectious diarrhea disease and food poisoning. In: Antony S, Braun Wald FE, Iddelbacher KS, Wilson SD. Harrison's principles of internal medicine. 14th ed. NewYork: McGraw-Hill Company; 1998: 796-800.

Zafar A, Sabir N, Bhutta A. Frequency of isolation of Shigella serogroups/ serotypes and their antimicrobial susceptibility pattern in children from slum areas m Karachi. J pack Med Assoc. 2005;55:184-8.

Salmanzdeh-Ahrabi S, Jafari F, Habibi E, Irajian GR, Aslani MM, Baghbani-Arani F, et al. Serotype distribution and antimicrobial resistance rates of Shigella spp. isolates in Tehran, Iran. Mikrobiyol Bul. 2007;41:453-7.

Sur D, Ramamurthy T, Deen J, Bhattacharya SK. Shigellosis: challenges and management issues. Indian J Med Res. 2004;120(5):454-62.

Jalali A, Nikvash S. The study of drug resistance of salmonella, shigella and pathogenic E.coli in out and inpatients, Tabriz, Iran. Tabriz UMS J. 1998;22(4):24-44.

Mache A, Mengisto Y, Cowley S. Shigella serogroups identified from adult diarrheal outpatients in Addis Ababa, Ethiopia: antibiotic resistance and plasmid profile analysis. East Afr Med J. 2007;74:179-82.

Bäumler AJ, Hargis BM, Tsolis RM. Tracing the origins of Salmonella outbreaks. Science. 2000;287(5450):50-2.

Lal M, Kaur H, Gupta LK. Y enterocolitica gastroenteritis A Prospective study. Indian J Med Microbiol. 2003;16(21):186-8.

Sarshar M, Tavafi H, Ghorbani-Dalini S, Souod N, Kargar M, Shahrokhi N. Tetracycline Resistance Genes of Diarrhogenic E. coli in Pediatric Patients. Iranian J Infect Dis and Tropical Med. 2012;17(57):13-8.

Jamshidi A, Matbooei A. Shigella spp Frequency, Serotyping and Antibiotic Resistance Pattern in Acute Diarrheic Patients in Zanjan Shahid Beheshti Hospital, During 2003-2007. ZUMS Journal. 2008;16(62):77-84

Jafari F, Hamidian M, Rezadehbashi M, Doyle M. Prevalence and antimicrobial resistance of diarrheagenic Escherichia coli and Shigella species associated with acute diarrhea in Tehran, Iran. Can J Infect Dis Med Microbiol. 2009;20(3):56-62.

Djie-Maletz A, Reither K, Danour S, Anyidoho L, Saad E, Danikuu F, et al. High rate of resistance to locally used antibiotics among enteric bacteria from children in Northern Ghana. J Antimicrob Chemother. 2008;61:1315-8.

Tariq N, Jaffery T, Ayub R, Alam AY, Javid MH. Frequency and antimicrobial susceptibility of aerobic bacterial vaginal isolates. J Coll Physicians Surg Pak. 2006;16:196-9.

Garcia PG, Silva VL, Diniz CG. Occurrence and antimicrobial drug susceptibility patterns of commensal and diarrheagenic Escherichia coli in fecal microbiota from children with and without acute diarrhea. J Microbiol. 2011;49:46-52.

Theresa JO, Joaquim R, Margarita M, Luis JD. High frequency of antimicrobial resistance of diarrheagenic E. coli in Peruvian infants. Am J Trop Med Hyg. 2009;81:296-301.

Al-Moyed KA, Harmal NS, Al-Harasy AH, Al-Shmahy HA. Increasing single and multiantibiotic resistance in Shigella species isolated from shigellosis patients in Sanaa, Yemen. Saudi Med J. 2006;27(8):1157-60.

Hosseini MJ, Nabavi M, Nasri Razin B, Hosseini Doost R, Hekmat S. Antibiotic resistance among Shigella serotypes isolated from Shigellosis cases in Booali Hospital, 1999-2001. Pajoohandeh J. 2003;8(1):35-8.

Tabatabaei ST. Frequency and antimicrobial susceptibility of bacteria isolated from Urine, stool and blood cultures of Rafsanjan University of Medical Science Laboratories during 2003. J Rafsanjan Univ Med Sci. 2008;17(2):115-20.

Ghadamli P. A study on the clinical manifestation and antibiotic susceptibility for shigellosis in children in mofid children hospital 1995-1997. Iranian J Infect Dis Tropical Med. 1999;11(4):33-6.

Sharifzadeh A, hmatzadeh F, Namjoo A, danesh A. Antibiotic susceptibility among antibiotic resistant salmonellae isolated from children (0-2 years) affected by diarrhea in Shahrekord and resistance factor transmissibility to E.Coli k12. J Shahrekord Univ Med Sci. 2004;6(1):1-6.

Eshraghi S, Soltan Dalall M, Fardsanei F, Zahraii Salehi T, Ranjbar R, Nikmanesh B, et al .Salmonella enteritidis and antibiotic resistance patterns: a study on 1950 children with diarrhea. Tehran Univ Med J. 2010;67(12):876-82.

Jomezadeh N, Babamoradi SH, Kalantar E, Javaherizadeh H. Isolation and antibiotic susceptibility of Shigella species from stool samples among hospitalized children in Abadan, Iran. Gastroenterol Hepatol Bed Bench. 2014;7(4):218-23.






Original Research Articles