Serotypes and Frequency of Multi-drug Resistant Salmonella Isolated from Diarrheal Children In Benghazi, Libya.

Original article


Aisha Y. Gerged 1, Saleh H. Baiu 1, Adel I. Ahmaida 2.

Faculties of Science 1 and Medicine 2, Garyounis University, Benghazi, Libya

Garyounis Medical Journal Vol. 21, No.1. 2004:41-49


Background: salmonella infection is known to be common in developing countries leading to gastroenteritis, septicemia and enteric fevers. Objectives: to know the contribution of salmonella species to acute diarrheal illness and the prevalent sero-groups and types, and to assess wither there is a change of the known antibiotic resistance patterns. Setting: A prospective open study done in Al-fateh Children’s Hospital, Benghazi, Libya during one year from July 2000-June 2001.Patients and Methods: 1017 patients with acute diarrhea and 80 controls were included. Clinical characteristics were taken and stool samples were processed by the usual well known microbiological methods. Results: salmonella was isolated in 60 patients (5.9%), with 11 cases nosocomially acquired. More than 85% of the cases were in under 2 years of age. The serogroups isolated included B, C and D with B and C representing the majority (38.3 and 33% respectively). Seogroup A reported in a study done recently in the same locality was not shown by us. The main serotypes identified were S. typhimurium (22%) and S. muenchen and S. paratyphi (17% each). 83% of the isolates were resistant to one antibiotic or another with multiple antimicrobial resistance in 80% of isolates. High resistance rates were found for amoxicillin/clavulenic acid (45%), ampicillin (40%) amoxicillin (36.7%) and gentaniicin (35%). Only 8.3% and 15% were resistant to piperaciuin and ciprofloxacin respectively. Isolation of multiresistanct strains of Salmonella was significantly associated with prior exposure to antibiotics (p=0.028). The majority of multiresistant strains were of group B, which was significantly different from other groups (p= 0.005 ). The resistance rate declined significantly for Amoxidillin/clavulenic acid (p=0.04), ampici]lin (p=0.004) and tetracyclines (p=0.019) Conclusions: Acute diarrhea is still a major burden on health services. Serogroups B,C and D largely replaced group A. Though resistance rates for some antibiotics have declined, the overall resistance is still high.

Keywords: Acute Gastroenteritis, Salmonella, Antimicrobial Resistance, Benghazi, Libya.