Diversity of antibiotic resistance phenotypes in bacteria responsible for childhood diarrhea and their influence on the success of probabilistic (empirical) treatments | ||
| Microbes and Infectious Diseases | ||
| Articles in Press, Accepted Manuscript, Available Online from 10 November 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/mid.2025.336675.2350 | ||
| Authors | ||
| Christian Italen Bingangoye1, 2; Sévérin Medzégué Nguéma1, 3; Rick-Leonid Ngoua Meye Misso* 4, 5; Mey-Leslie Eyang Nze3; Louis-Clément Obame Engonga1; Armel Ndong Mintsa3; Joel Fleury Djoba Siawaya2; Joseph Privat Ondo1 | ||
| 1University of Science and Technology of Masuku, Franceville, Gabon | ||
| 2National Laboratory of Public Health, Libreville, Gabon | ||
| 3University Hospital Center of Libreville, Gabon | ||
| 4University of Health Sciences, Owendo, Gabon | ||
| 5Institute of Infectious Diseases Professor Daniel Gahouma, Gabon | ||
| Abstract | ||
| Background Gastroenteritis is a common problem among children. Worldwide, diarrheal diseases are the third leading cause of death in children under 5, killing an estimated 443,832 children each year. Many antibiotics are recommended to treat diarrhea of bacterial origin, but the emergence of antibiotic-resistant bacteria is responsible for a high rate of therapeutic failure. The aim of this study was to identify enteric bacteria in children and assess the influence of their phenotypes on antibiotic therapy. Methods A questionnaire was submitted to participants to collect socio-demographic and clinical data. After collecting stool samples, bacteriological analysis was performed using the standard method for the identification of enteric pathogens. Antibiotic susceptibility testing was then carried out using the Kirby-Bauer method. Results: Overall, Salmonella spp was the most isolated germ (25%), followed by E. coli spp (20.70%), Yersinia spp (5.20%), and Shigella spp (3.40%) among the 116 children included in this study. We identified several resistance phenotypes, Beta-lactam (ESBL 25.40%, High-level penicillinase 17.50%, Cephalosporinase 19%, CHN 9.50%, Sensitive/wild type 28.60%), quinolone (Phenotype I 74.60%, Phenotype IV 25.40%), sulfonamide (Resistance 41.30%, Sensitive/wild type58.70%). Furthermore, 77.78% (21/27) of probabilistic treatments, or seven times more likely to result in treatment failure, compared to 0/36 (0%) for those who received non-probabilistic treatment. Conclusion: Our results provide new insights into the management of diarrheal diseases and guide the stakeholders in the fight against the emergence of future forms of bacterial resistance to antimicrobials through the appropriate use of antibiotics. | ||
| Keywords | ||
| Keywords Diarrhea; Antimicrobial resistance; Probabilistic treatments | ||
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