Detection and identification of bacterial enteropathogens by polymerase chain reaction and conventional techniques in childhood acute gastroenteritis in Gaza, Palestine

Background: Acute gastroenteritis and diarrhea are common and costly problems that cause significant morbidity and mortality in children worldwide. In Palestine, diarrhea is one of the major causes of outpatient visits and hospitalizations. Methods: To improve knowledge on the etiology of gastroenteritis and diarrhea in our patient population, stool specimens from 150 children under 5 years of age suffering from acute gastroenteritis were investigated for various common bacterial enteropathogens by conventional and molecular techniques. Results: Bacterial enteropathogens were detected in 17.3% of the diarrheal samples. Shigella spp was the most common bacterial pathogen (6.0%), followed by Campylobacter coli/jejuni (4.7%), Escherichia coli O157: H7 (4.7%), and Salmonella spp (2.0%). Shigella and Salmonella isolates were tested for their susceptibility to common antimicrobial agents and most of the Shigella isolates were resistant to ampicillin, trimethoprim/sulfamethoxazole and doxycycline and most of the Salmonella isolates showed resistant to ampicillin, trimethoprim/sulfamethoxazole, doxycycline and nalidixic acid. Conclusions: The results highlight the value of using a combination of traditional and molecular techniques (PCR) in the diagnosis of bacterial gastroenteritis. Furthermore, this study demonstrated that E. coli O157: H7 and Campylobacter, which are not screened for routinely in the Gaza Strip, were significant enteropathogens. (C) 2007 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.