Antibiotic Resistance Pattern of Diarrheal pathogens in Stool Samples Obtained from Children in Thi-Qar Governorate

Abstract

Background: Diarrheal diseases remain a major cause of morbidity among children worldwide, particularly in developing countries, with Escherichia coli being one of the most common bacterial pathogens. The increasing emergence of antimicrobial resistance among diarrheagenic E. coli poses a serious challenge to effective treatment. Objective: This study aimed to investigate the prevalence of bacterial pathogens, antimicrobial susceptibility patterns, and multidrug resistance among E. coli isolates obtained from children with diarrhea. Methods: A cross-sectional study was conducted on 100 stool samples collected from children aged 1–12 years presenting with diarrheal symptoms. Bacterial isolation was performed on MacConkey and Eosin Methylene Blue (EMB) agar plates, followed by identification using the VITEK 1 compact. Antimicrobial susceptibility testing was carried out using the disk diffusion method according to standard guidelines. Multidrug resistance (MDR) was defined as resistance to three or more antibiotic classes. Results: The results exhibited high positivity rates across all age groups, ranging from 82.6% in the 1–3 years group to 100% in the 10–12 years group. The highest number of positive samples was observed in the 1–3 years age group (57/69), while all samples in the 10–12 years group were positive (6/6). However, no statistically significant association was observed between age group and positivity status (χ² ≈ 2.29, df = 3, p > 0.05). This indicates that the differences in positivity rates among the studied age groups were not statistically significant. E. coli was the predominant isolate, followed by Pseudomonas aeruginosa and Klebsiella pneumoniae. High resistance rates were observed against cefotaxime, tetracycline, and amoxicillin, whereas higher susceptibility was recorded for imipenem, ciprofloxacin, and amikacin. A considerable proportion of isolates were identified as multidrug-resistant, indicating widespread resistance among enteric pathogens. Conclusion: The findings highlight the high prevalence of antimicrobial resistance among diarrheagenic bacteria, particularly E. coli, in children. Continuous surveillance, rational antibiotic use, and implementation of antimicrobial stewardship programs are essential to control the spread of multidrug-resistant pathogens and improve clinical outcomes.