European Journal of Epidemiology

, Volume 13, Issue 7, pp 831–836

Bacterial pathogens associated with diarrhoea on the island of Crete

  • G. Samonis
  • S. Maraki
  • A. Christidou
  • A. Georgiladakis
  • Y. Tselentis
Article

Abstract

Stool specimens from 3,600 diarrhoeal patients from the island of Crete, Greece, were examined for bacterial pathogens, during a three-year period (1992–1994). One or more pathogens were identified in 826 patients (22.9%), more often from children. Salmonella spp. were the most frequently isolated organisms in 13.6% of the patients, followed by Campylobacter in 4.7%, and enteropathogenic Escherichia coli (EPEC) in 3.9%. Yersinia enterocolitica was found in 0.7%, Shigella spp. in 0.7% and Aeromonas hydrophila in 0.05%. Vibrio spp. and enterohaemorragic E. coli were not identified in the stools tested. Resistance to ampicillin was observed in 36% of the Salmonella, 62% of the Shigella, and 27% of the EPEC isolates. Cotrimoxazole resistance was observed in 42% of the Shigella and 12% of the EPEC isolates, while tetracycline and the quinolones were inactive against almost half and erythromycin against 20% of the Campylobacter isolates. This is the first study investigating bacterial pathogens associated with diarrhoea on the island of Crete.

Enteropathogenic bacteria Gastroenteritis Resistance 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Huilan S, Zhen LG, Mathan MM, Mathew MM, Olarte J, Espejo R, Maung K, Ghafoor MA, Khan MA, Sami Z, Sutton RG. Etiology of acute diarrhoea among children in developing countries: A multicentre study in five countries. Bull WHO 1991; 65: 549–555.Google Scholar
  2. 2.
    Guerrant RL. Principles and syndromes of enteric infections. In: Mandell GL, Bennett JE, Dolin R (eds), Principles and Practice of Infectious Diseases. New York: Churchill Livingstone, 1995: 945–962.Google Scholar
  3. 3.
    Mims CA, Playfair JHL, Roitt IM, Wakelin D, Williams R (eds), Medical Microbiology. Mosby, 1993.Google Scholar
  4. 4.
    Samonis G, Elting L, Skoulika E, Maraki S, Tselentis Y. An outbreak of diarrhoeal disease attributed to Shigella sonnei. Epidemiol Infect 1994; 112: 235–245.Google Scholar
  5. 5.
    Farmer JJ, Kelly MT. Enterobacteriaceae. In: Balows A, Hausler WJ Jr, Herrmann KL, Isenberg HD, Shadomy HJ (eds), Manual of clinical microbiology. Washington DC: American Society for Microbiology, 1991: 360–383.Google Scholar
  6. 6.
    Penner L. Campylobacter, Helicobacter, and related spiral bacteria. In: Balows A, Hausler WJ Jr, Herrmann KL, Isenberg HD, Shadomy HJ (eds), Manual of clinical microbiology. Washington DC: American Society for Microbiology, 1991: 402–409.Google Scholar
  7. 7.
    National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial disk susceptibility tests. Approved standard M2-A4. National Committee for Clinical Laboratory Standards, Villanova, PA, 1990.Google Scholar
  8. 8.
    Rodrigue DC, Tauxe RV, Rowe B. International increase in Salmonella enteritidis: A new pandemic? Epidemiol Infect 1990; 105: 21–27.Google Scholar
  9. 9.
    Centers for Disease Control: Salmonella surveillance report: Annual summary 1990. Centers for Disease Control, Atlanta, 1991.Google Scholar
  10. 10.
    Vatopoulos AC, Mainas E, Balis E, Threlfall EJ, Kanelopoulou M, Kalapothaki V, Malamou-Lada H, Legakis NJ. Molecular epidemiology of ampicillin-resistant clinical isolates of Salmonella enteritidis. J Clin Microbiol 1994; 32: 1322–1325.Google Scholar
  11. 11.
    Wilcox MH, Spencer RC. Quinolones and Salmonella gastroenteritis. J Antimicrob Chemother 1992; 30: 221–228.Google Scholar
  12. 12.
    Acar JF, O'Brien TF, Goldstein FW, Jones RN. The epidemiology of bacterial resistance to quinolones. Drugs 1993; 45(suppl 3): 24–28.Google Scholar
  13. 13.
    Prats G, Mirelis B, Portus M, Rabelle N, Perikas R, Ausina V, Coll P. Gastroenteritis etiology in a University Hospital during 1983. Eur J Epidemiol 1986; 2: 118–123.Google Scholar
  14. 14.
    Blaser MJ. Campylobacter and related species. In: Mandell GL, Bennett JE, Dolin R (eds), Principles and practice of infectious diseases. New York: Churchill Livingstone, 1995: 1948–1956.Google Scholar
  15. 15.
    Navarro F, Miro E, Fuentes I, Mirelis B. Campylobacter species: Identification and resistance to quinolones. Clin Infect Dis 1993; 17: 815–816.Google Scholar
  16. 16.
    Thielman NM. Enteric Escherichia coli infections. Curr Opinion Infect Dis 1994; 7: 582–591.Google Scholar
  17. 17.
    Edelman R, Levine MM. Summary of a workshop on enteropathogenic Escherichia coli. J Infect Dis 1983; 147: 1108–1118.Google Scholar
  18. 18.
    Doyle MP. Foodborne illness. Pathogenic Escherichia coli, Yersinia enterocolitica and Vibrio parahaemolyticus. Lancet 1990; 336: 1111–1115.Google Scholar
  19. 19.
    Pham JN, Bell SM, Lanzarone JYM. Biotype and antibiotic sensitivity of 100 clinical isolates of Yersinia enterocolitica. J Antimicrob Chemother 1991; 28: 13–18.Google Scholar
  20. 20.
    Preston MA, Brown S, Borczyk AA, Riley G, Krishnan C. Antimicrobial susceptibility of pathogenic Yersinia enterocolitica isolated in Canada from 1972 to 1990. Antimicrob Agents Chemother 1994; 38: 2121–2124.Google Scholar
  21. 21.
    Cover TL, Aber RC. Yersinia enterocolitica. N Engl J Med 1989; 321: 16–24.Google Scholar
  22. 22.
    Harnett N. High level resistance to trimethoprim, cotrimoxazole and other antimicrobial agents among clinical isolates of Shigella species in Ontario, Canada: An update. Epidemiol Infect 1992; 109: 463–472.Google Scholar
  23. 23.
    Brito-Alayon NE, Blando AM, Monzon-Moreno C. Antibiotic resistance patterns and plasmid profiles for Shigella spp. isolated in Cordoba, Argentina. J Antimicrob Chemother 1994; 34: 253–259.Google Scholar
  24. 24.
    Olukoya DK, Oni O. Plasmid profile analysis and antimicrobial susceptibility patterns of Shigella isolates from Nigeria. Epidemiol Infect 1990; 105: 59–64.Google Scholar
  25. 25.
    Voogd CE, Schot CS, van Leeuwen WJ, van Klingeren B. Monitoring of antibiotic resistance in Shigella isolated in Netherlands, 1984–1985. Eur J Clin Microbiol Infect Dis 1992; 11: 164–167.Google Scholar
  26. 26.
    Dupont HL. Use of quinolones in the treatment of gastrointestinal infections. Eur J Clin Microbiol Infect Dis 1991; 10: 325–329.Google Scholar
  27. 27.
    Salam MA, Bennish ML. Antimicrobial therapy for shigellosis. Rev Infect Dis 1991; 13(suppl 4): 332–341.Google Scholar
  28. 28.
    Singh DV, Sanyal SC. Antibiotic resistance in clinical and environmental isolates of Aeromonas spp. J Antimicrob Chemother 1994; 33: 368–369.Google Scholar

Copyright information

© Kluwer Academic Publishers 1997

Authors and Affiliations

  • G. Samonis
    • 1
  • S. Maraki
    • 1
  • A. Christidou
    • 1
  • A. Georgiladakis
    • 1
  • Y. Tselentis
    • 1
  1. 1.Department of Clinical Bacteriology – Parasitology – Zoonoses and Geographical MedicineUniversity Hospital of HeraklionHeraklion, CreteGreece

Personalised recommendations