Diarrhea-related multidrug-resistant enteric pathogens in China

Objective To study the rational use of drugs in clinical treatment and epidemiologic investigation of diarrhea-related multidrug-resistant enteric pathogens. Methods Stool samples, collected from acute diarrhea patients in 4 class A hospitals of Beijing, Xinjiang Uygur Autonomous Region, Hangzhou and Henan Province from 2002 to 2010, were cultured. Enteric pathogens were identified from the samples by biochemical and serum agglutination test. Their susceptibility and resistance to antibiotics were tested using paper strip method. Results Of the 874（50.17%） multidrug-resistant strains isolated from 1 742 enteric pathogens in the past 9 years, 463（26.58%） were resistant to 3 antibiotics and 411（23.59%） were resistant to 4 or more antibiotics. The most common multidrug-resistant enteric pathogen was Shigella spp（65.42%） followed by Escherichia coli（61.26%）, Aeromonas spp（45.83%）, Salmonella spp（37.38%）, Plesiomonas shigelloides（28.21%） and Vibrio spp（19.44%）. The resistance of different multidrug-resistant enteric pathogens to ampicillin, chloramphenicol, trimethoprim and sulphame-thoxazole from 2002 to 2005 was 18.08%, 10.48%, 26.69% and 48.60% respectively, and to ampicillin, cefotaxime and trimethoprim and sulphame-thoxazole from 2006 to 2010 was 32.14%, 9.30%, 7.69%, 16.53% and 11.01%, respectively. Conclusion There exist many species of pathogens causing infectious diarrhea in China. The prevalence of multidrug-resistant enteric pathogens is high and their resistance to common antibiotics changes with time. It is therefore necessary to strengthen their monitoring in order to provide evidences for the rational use of drugs.