title: Distribution and antimicrobial resistance of enteric pathogens in Chinese paediatric diarrhoea: a multicentre retrospective study, 2008-2013.
abstract: The enteric pathogens causing diarrhoea impair children's health severely. This study retrospectively analysed 1577 pathogens isolated from inpatients and outpatients in six hospitals located in Northern (Inner Mongolia), Northeastern (Hebei), Eastern (Shanghai and Jiangsu), Southern (Hainan) and Central (Hubei) China between 2008 and 2013. Of the 1577 enteric pathogens, Salmonella presented with the highest frequency (36·0%), followed by diarrhoeagenic Escherichia coli (23·7%), Staphylococcus aureus (15·0%), Shigella (13·1%), and Aeromonas (4·6%). The predominant pathogens varied in different regions of China, with Salmonella most prevalent in Shanghai and Hainan, diarrhoeagenic E. coli most prevalent in Inner Mongolia, Jiangsu and Hubei, and Shigella most prevalent in Hebei. Enteric pathogens were more frequently isolated in males (56·9%) than in females (43·1%). The highest proportion of all enteric pathogens was found in infants (67·6%) with a peak in summer and autumn (68·5%). Antimicrobial susceptibility assay demonstrated that Shigella was more resistant to ampicillin, ceftriaxone and sulfamethoxazole than Salmonella. Of the top two serotypes in Salmonella, Typhimurium was more resistant to ciprofloxacin, sulfamethoxazole and chloramphenicol than Enteritidis (P < 0·001). Meanwhile, the resistance rates of Shigella flexneri against ampicillin/sulbactam, ciprofloxacin, and chloramphenicol were significantly higher than those of Shigella sonnei (P < 0·001). Multidrug resistance was apparent in 58·2% of Shigella and 45·9% of Salmonella, and this phenomenon was more pronounced in S. flexneri.
authors.affiliation: Department of Clinical Laboratory,Shanghai Children's Hospital, Shanghai Jiaotong University,Shanghai,China.
authors.forename: H
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Clinical Laboratory,Shanghai Children's Hospital, Shanghai Jiaotong University,Shanghai,China.
authors.forename: F
authors.initials: F
authors.lastname: Pan
authors.affiliation: China Alliance of Translational Medicine for Maternal and Children's Health,China.
authors.forename: X
authors.initials: X
authors.lastname: Zhao
authors.affiliation: China Alliance of Translational Medicine for Maternal and Children's Health,China.
authors.forename: G
authors.initials: G
authors.lastname: Wang
authors.affiliation: China Alliance of Translational Medicine for Maternal and Children's Health,China.
authors.forename: Y
authors.identifier: http://orcid.org/0000-0001-8925-5656
authors.initials: Y
authors.lastname: Tu
authors.affiliation: China Alliance of Translational Medicine for Maternal and Children's Health,China.
authors.forename: S
authors.initials: S
authors.lastname: Fu
authors.affiliation: China Alliance of Translational Medicine for Maternal and Children's Health,China.
authors.forename: J
authors.initials: J
authors.lastname: Wang
authors.affiliation: China Alliance of Translational Medicine for Maternal and Children's Health,China.
authors.forename: J
authors.initials: J
authors.lastname: Pan
authors.affiliation: China Alliance of Translational Medicine for Maternal and Children's Health,China.
authors.forename: J
authors.initials: J
authors.lastname: Song
authors.affiliation: China Alliance of Translational Medicine for Maternal and Children's Health,China.
authors.forename: W
authors.initials: W
authors.lastname: Wang
authors.affiliation: China Alliance of Translational Medicine for Maternal and Children's Health,China.
authors.forename: Z
authors.initials: Z
authors.lastname: Jin
authors.affiliation: China Alliance of Translational Medicine for Maternal and Children's Health,China.
authors.forename: H
authors.initials: H
authors.lastname: Xu
authors.affiliation: China Alliance of Translational Medicine for Maternal and Children's Health,China.
authors.forename: Y
authors.initials: Y
authors.lastname: Ren
authors.affiliation: Jiujiang Maternal and Children's Hospital,Jiangxi,China.
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Clinical Laboratory,Shanghai Children's Hospital, Shanghai Jiaotong University,Shanghai,China.
authors.forename: N
authors.initials: N
authors.lastname: Zhong
mesh_terms: D000293:Adolescent; D000333:Aeromonas / Q000187:drug effects; D017677:Age Distribution; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D002681:China; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial; D004405:Dysentery, Bacillary / Q000453:epidemiology / Q000382:microbiology; D004926:Escherichia coli / Q000187:drug effects; D004927:Escherichia coli Infections / Q000453:epidemiology; D005243:Feces / Q000382:microbiology; D005260:Female; D062305:Geographic Mapping; D006090:Gram-Negative Bacteria / Q000187:drug effects; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies; D012475:Salmonella / Q000187:drug effects; D012480:Salmonella Infections / Q000453:epidemiology / Q000382:microbiology; D012621:Seasons; D017678:Sex Distribution; D012737:Sex Factors; D012760:Shigella / Q000187:drug effects; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic resistance; Salmonella; Shigella; bacteriology; diarrhoea