Etiology of diarrhea in young children and patterns of antibiotic resistance in Cambodia

Chhour Y. Meng, Bryan L. Smith, Ladaporn Bodhidatta*, Stephanie A. Richard, Ket Vansith, Ban Thy, Apichai Srijan, Oralak Serichantalergs, Carl J. Mason

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

82 Scopus citations


Background: Little is known about diarrhea etiology and antibiotic resistance in developing countries where diarrhea is a major public health problem. Methods: To describe diarrhea etiology and antibiotic resistance patterns in Cambodia, 600 children aged 3 months to 5 years with acute diarrhea (cases) and 578 children without diarrhea (controls) were enrolled from a hospital in Phnom Penh. Stool samples were collected, and pathogens and antibiotic resistance patterns were described. Results: The most frequently isolated pathogens in these cases were enteroaggregative Escherichia coli (20%) and rotavirus (26%). Enterotoxigenic E. coli, enteroaggregative E. coli, Shigella, Aeromonas, rotavirus, and adenovirus were statistically significantly associated with diarrhea. Among cases, vomiting was associated with viral infections, whereas bloody stool was associated with Shigella. Enterotoxigenic E. coli isolates were highly resistant to ampicillin, sulfonamides, and tetracycline. Approximately 50% of Campylobacter coli and 30% of Campylobacter jejuni isolates were resistant to nalidixic acid and ciprofloxacin. Over 33% of Salmonella isolates were resistant to ampicillin and tetracycline, and almost 100% of Shigella isolates were resistant to trimethoprim/sulfamethoxazole. Conclusions: These data on the etiology of diarrhea and antibiotic resistance patterns in Cambodia will have significant effect on local public health policies and on local resource prioritization practices.

Original languageEnglish
Pages (from-to)331-335
Number of pages5
JournalPediatric Infectious Disease Journal
Issue number4
StatePublished - Apr 2011


  • Antibiotic
  • Cambodia
  • Children
  • Diarrhea
  • Rotavirus


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