An Epidemiologic Review of Enteropathogens in Gaborone, Botswana Shifting Patterns of Resistance in an HIV Endemic Region 英文参考文献.docVIP

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An Epidemiologic Review of Enteropathogens in Gaborone, Botswana Shifting Patterns of Resistance in an HIV Endemic Region 英文参考文献.doc

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An Epidemiologic Review of Enteropathogens in Gaborone, Botswana Shifting Patterns of Resistance in an HIV Endemic Region 英文参考文献

AnEpidemiologicReviewofEnteropathogensin Gaborone,Botswana:ShiftingPatternsofResistancein anHIVEndemicRegion JackS.Rowe1,2,SamirS.Shah2,5,StephenMotlhagodi3,4,MargaretBafana3,4,EphraimTawanana3,4 HongT.Truong1,SarahM.Wood5,NicolaM.Zetola1,4,AndrewP.Steenhoff1,2,4,5 , * 1Botswana-UPennPartnership,Gaborone,Botswana,2UniversityofPennsylvaniaSchoolofMedicine,Philadelphia,Pennsylvania,UnitedStatesofAmerica,3Botswana NationalHealthLaboratory,Gaborone,Botswana,4PrincessMarinaHospital,Gaborone,Botswana,5TheChildren’sHospitalofPhiladelphia,Philadelphia,Pennsylvania, UnitedStatesofAmerica Abstract Background:TheepidemiologyofdiarrhealdiseaseinBotswana,anHIVendemicregion,islargelyunknown.Ourprimary objective was to characterize the prevalent bacterial and parasitic enteropathogens in Gaborone, Botswana. Secondary objectivesincludeddeterminingcorrespondingantimicrobialresistancepatternsandthevalueofstoolwhiteandredblood cellsforpredictingbacterialandparasiticenteropathogens. Methodology/Principal Findings: A retrospective cross-sectional study examined laboratory records of stool specimens analyzedby theBotswanaNationalHealthLaboratoryinGaborone, BotswanafromFebruary2003 through July2008. In 4485specimensthemediansubjectagewas23[interquartilerange1.6–34]years.Overall,14.4%(644of4485)ofsamples yieldedapathogen.Bacteriaalonewereisolatedin8.2%(367of4485),parasitesalonein5.6%(253of4485)andbothin 0.5%(24of4485)ofsamples.ThemostcommonbacterialpathogenswereShigellaspp.andSalmonellaspp.,isolatedfrom 4.0%(180of4485)and3.9%(175of4485)ofspecimens,respectively.Escherichiacoli(22of4485)andCampylobacterspp. (22of4485)eachaccountedfor0.5%ofpathogens.ComparingantimicrobialresistanceamongShigellaspp.andSalmonella spp.betweentwoperiods,February2003toFebruary2004andJuly2006toJuly2008,revealedanincreaseinampicillin resistance among Shigella spp. from 43% to 83% (p,0.001). Among Salmonella spp., resistance to chloramphenicol decreasedfrom56%to6%(p,0.001).Theabsenceofstoolwhiteandredbloodcell