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Enteric Pathogens Associated with Childhood Diarrhea in Tripoli-Libya

By Amal Rahouma, John D. Klena, Zaineb Krema, Abdalwahed A. Abobker, Khalid Treesh, Ezzedin Franka, Omar Abusnena, Hind I. Shaheen, Hanan El Mohammady, Abdulhafid Abudher and Khalifa Sifaw Ghenghesh


Stool samples from children < 5 years of age with diarrhea (N = 239) were examined for enteric pathogens using a combination of culture, enzyme-immunoassay, and polymerase chain reaction methods. Pathogens were detected in 122 (51%) stool samples; single pathogens were detected in 37.2% and co-pathogens in 13.8% of samples. Norovirus, rotavirus, and diarrheagenic Escherichia coli (DEC) were the most frequently detected pathogens (15.5%, 13.4%, and 11.2%, respectively); Salmonella, adenovirus, and Aeromonas were detected less frequently (7.9%, 7.1%, and 4.2%). The most commonly detected DEC was enteroaggregative E. coli (5.4%). Resistance to ≥ 3 antimicrobials was observed in 60% (18/30) of the bacterial pathogens. Salmonella resistance to ciprofloxacin (63.1%) has become a concern. Enteric viral pathogens were the most significant causative agents of childhood diarrhea in Tripoli. Bacterial pathogens were also important contributors to pediatric diarrhea. The emergence of ciprofloxacin-resistant Salmonella represents a serious health problem that must be addressed by Libyan health authoritie

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Publisher: The American Society of Tropical Medicine and Hygiene
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