ANTIMICROBIAL RESISTANCE PROFILES OF DIARRHEAL PATHOGENS ISOLATED FROM HOSPITALIZED ADULT PATIENTS WITH ACUTE GASTRO-ENTERITIS,

Abstract

Background: Acute gastroenteritis is a self-limiting disease, but in high-risk patients for bacteremia like neonates and immunocompromised patients, appropriate antimicrobial treatment is required. Antimicrobial resistance (AMR) has become a global health challenge, particularly in bacterial pathogens causing gastrointestinal infections, thus per protocol treatment is necessary. Material and methods: This retrospective descriptive study included 200 in-patients with acute gastroenteritis, at the University Clinic for Infectious Diseases, Skopje, between July 2022 and August 2024. Stool samples were collected and tested by standard microbiological methods. Antimicrobial resistance profiles of isolates were determined by the disc-diffusion technique according to EUCAST. Results: Among 200 patients analyzed, 53% were confirmed to have an infectious etiology, with Salmonella enteritis group D as the predominant pathogen (36%), followed by Clostridium difficile and Campylobacter jejuni (6%). S. typhimurium was isolated in one patient. Viral etiology like Norovirus and Rotavirus was detected in 4,5% of cases. Resistance to ampicillin was observed in all Salmonella isolates, while C. jejuni showed no resistance to standard antimicrobial therapy. We lack data on C. difficile susceptibility. Conclusions: These findings provide insights in the most commonly found diarrheal pathogens in our setting and the resistance trends, for which reason further and appropriate empirical treatment options in patients with acute gastroenteritis should be explored.