Epidemiology and drug resistance of Salmonella and Aeromonas in the faecal samples from pediatric patients with infectious diarrhea at a children’s medical center in Suzhou, China from 2016 to 2023

Abstract

Background and study aims

Diarrheal diseases among children represent a prominent global health challenge, leading to significant morbidity and mortality, especially in emerging economies. This study aims to investigate the prevalence and trends of bacterial pathogens causing diarrhea in children.

Patients and methods

We retrospectively conducted an analysis of outpatient and inpatient records at Children’s Hospital of Soochow University, from 2016 to 2023. Only children presenting with diarrhea were included in the study. The clinical microbiology laboratory performed cultivation and identification of faecal samples, along with drug susceptibility testing on isolated Salmonella and Aeromonas species.

Results

A total of 2,163 cases of Salmonella, 334 cases of Aeromonas were identified from 13,662 faecal culture samples. There was a noticeable annual increase in the detection of Salmonella and Aeromonas in recent years. Samples from children with the age group of 12 to 35 months were more likely to be positive for Salmonella than those from children with other age groups, whereas those with the age group of 6 to 11 months were more prone to Aeromonas. Samples taken in the summer were most likely to be positive for Salmonella and Aeromonas. Samples from hospitalized children were considerably more likely to be positive for Salmonella than those from outpatient children. Salmonella-infected children were predominantly admitted to departments of digestion and infectious diseases, whereas Aeromonas-infected patients were spread across various clinics, especially gastroenterology. Salmonella Group B and Aeromonas punctata (caviae) were the most prevalent strains among their respective species. Notably, the resistance of Salmonella and Aeromonas to fluoroquinolone antibiotics has been escalating since 2018, with inpatients exhibiting a significantly higher rate of drug resistance compared to outpatients.

Conclusion

The integration of bacterial identification and drug susceptibility testing is crucial for the effective prevention and management of childhood diarrhea. The use of targeted antibiotics is essential to curb the rise of drug-resistant strains and ensure effective treatment outcomes.