Bloody Diarrhea (Causes and Drug Sensitivity) among Children Under Five Years of Age Admitted to the Maternity and Children Teaching Hospital in Al- Ramadi City Western of Iraq A Retrospective Descriptive Study

Abstract

Background: Diarrhea is a leading cause of illness and death among children in developing countries, where an estimated 1300 million episodes and 3.2 million deaths occur each year in those under 5 years of age, and about 80% of death in the last 2 years of life. Objective: is to identify the etiological agents of bloody diarrhea with their antibiotics susceptibility and risk factors among children under 5 years of age admitted to maternity and children hospital in -Ramadi city during a specified period retrospectively.Subject & methods: A retrospective descriptive study was subjected, including 125 children under 5 years of age selected from records for management of bloody diarrhea in the hospital, over a period of 4 months from 1st of May to the end of August 2004 and studied for identification of causative micro-organisms and risk factors of bloody diarrhea. Each child was studied for the following: age, sex, residence, source of water supply, frequency and duration of diarrhea, associated symptoms, type of feeding, and positive history of other family members. General stool examination and Cultures of stool specimens were done for all patients.Results: The majority of causative agents were of bacterial origin 82(65.6%) followed by unidentified causative organisms 25 (all of them received antibiotics) while Entamoeba histolytica represented 14.4% of all cases. E.coli 0157 was the most frequent etiological agent among all studied cases 71(56.8%). In vitro isolates bacteria(as whole) showed high sensitivity to ciprofloxacin(92.7%) followed by ceftriaxone(82.9%),amikacin(81.7%) and cefotaxime(72.0%), on the other hand, bacteria isolates showed high resistant to augmentin(90.2%) then to ampicillin(87.-8%) and co-trimaxazol(78.0%) while moderate sensitivity found to gentamyCin and nalidixic acid (51.2% & 50% respectively).Conclusion: Bacterial agents are the commonest cause in this study and E.coli 0157 was the most frequent etiological agent as compared with other causes. Ciprofloxacin appeared to have high sensitivity to all bacterial origin while susceptibility to other antibiotics was variable. Rural area, bottle feeding, and 'uneducated mothers were found to be significant risk factors for developing bloody diarrhea.