ENTEROPATHOGENIC MICROORGANISMS IN CHILDR EN WITH ACUTE DIARRHEA IN 2HOSPITALS OF ROSARIO, ARGENTINA

As part of a multicenter collaborative study the relative frequency of enteropathogenic agents in children less than 5 years of age with acu te diarrhea was determined. Rates of isolation were similar as regards sex, age, and season. The frequency of polymorphonuclear cells (PMN) in the stools was significantly higher among patients requiring admiss ion in comparison with ambulatory patients. Enteropathogenic E. coli ( EPEC) was isolated more frequently in that group in comparison with ou tpatients (p < 0,001), mainly among children less than 5 months of age . The most prevalent agents were EPEC (26,1%), enterotoxigenic E. coli (ETEC) (9,7%), Shigella (8,5%), Rotavirus (5,1%), Giardia (3,6%), Cam pylobacter (3,2%), and Salmonella (2,4%). The EPEC predominant serogro ups were 0111, 0 55, 0 26, and 0 119. ETEC serotypes 0 153:H45 and 0 1 28:H21 were more often isolated. The predominant species in the genus Shigella were S. flexneri (80.5%), and S. sonnei (9.5%); in the genus Campylobacter, the species were C. jejuni (81,3%), and C. coli (18,7%) . Shigella was clearly related to the presence of PMN in the faeces, i n children less than 5 months old. Campylobacter was more frequent in ambulatory patients more than one year of age. Rotavirus was found pre dominantly in autumn and winter. Salmonella and ETEC were more frequen t in summer. Giardia was associated with weight loss. In about 1 0% of the cases there were simultaneous mixed isolations of two or more age nts. Salmonella isolates were sensitive to the majority of antimicrobi al agents probed. Many Shigella and E. coli were resistant to sulfamet hoxazole-trimethoprim and ampicillin (40-80%). Nearly all enterobacter ia were sensitive to gentamicin and norfloxacin.