title: Etiology of diarrhea in young children and patterns of antibiotic resistance in Cambodia.
abstract: BACKGROUND
  Little is known about diarrhea etiology and antibiotic resistance in developing countries where diarrhea is a major public health problem.
  
  
  METHODS
  To describe diarrhea etiology and antibiotic resistance patterns in Cambodia, 600 children aged 3 months to 5 years with acute diarrhea (cases) and 578 children without diarrhea (controls) were enrolled from a hospital in Phnom Penh. Stool samples were collected, and pathogens and antibiotic resistance patterns were described.
  
  
  RESULTS
  The most frequently isolated pathogens in these cases were enteroaggregative Escherichia coli (20%) and rotavirus (26%). Enterotoxigenic E. coli, enteroaggregative E. coli, Shigella, Aeromonas, rotavirus, and adenovirus were statistically significantly associated with diarrhea. Among cases, vomiting was associated with viral infections, whereas bloody stool was associated with Shigella. Enterotoxigenic E. coli isolates were highly resistant to ampicillin, sulfonamides, and tetracycline. Approximately 50% of Campylobacter coli and 30% of Campylobacter jejuni isolates were resistant to nalidixic acid and ciprofloxacin. Over 33% of Salmonella isolates were resistant to ampicillin and tetracycline, and almost 100% of Shigella isolates were resistant to trimethoprim/sulfamethoxazole.
  
  
  CONCLUSIONS
  These data on the etiology of diarrhea and antibiotic resistance patterns in Cambodia will have significant effect on local public health policies and on local resource prioritization practices.
authors.affiliation: National Pediatric Hospital, Phnom Penh, Cambodia.
authors.forename: Chhour Y
authors.initials: CY
authors.lastname: Meng
authors.forename: Bryan L
authors.initials: BL
authors.lastname: Smith
authors.forename: Ladaporn
authors.initials: L
authors.lastname: Bodhidatta
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Richard
authors.forename: Ket
authors.initials: K
authors.lastname: Vansith
authors.forename: Ban
authors.initials: B
authors.lastname: Thy
authors.forename: Apichai
authors.initials: A
authors.lastname: Srijan
authors.forename: Oralak
authors.initials: O
authors.lastname: Serichantalergs
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Mason
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001419:Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D002160:Cambodia / Q000453:epidemiology; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D024881:Drug Resistance, Bacterial; D005243:Feces / Q000382:microbiology / Q000821:virology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D015995:Prevalence; D014777:Virus Diseases / Q000453:epidemiology* / Q000821:virology*; D014780:Viruses / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents