{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:02:16Z","timestamp":1788350536863,"version":"build-2803163510"},"reference-count":51,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2017,11,6]],"date-time":"2017-11-06T00:00:00Z","timestamp":1509926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2017,11,6]],"date-time":"2017-11-06T00:00:00Z","timestamp":1509926400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2017,12,1]]},"abstract":"<jats:p>\n                    This study was conducted to find the etiology of acute diarrhea in Iranian children and determine the antimicrobial resistance patterns. The pathogenic bacteria were recovered from 110\/269 (40.9%) diarrheal fecal samples with the following profiles: the most predominant pathogen was diarrheagenic\n                    <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                    (DEC) (43.6%), comprising enteroaggregative\n                    <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                    (23.6%), enteropathogenic\n                    <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                    (10.9%), enteroinvasive\n                    <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                    (5.5%), and enterotoxigenic\n                    <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                    (3.6%);\n                    <jats:italic toggle=\"yes\">Shigella<\/jats:italic>\n                    spp. (37.3%),\n                    <jats:italic toggle=\"yes\">Salmonella<\/jats:italic>\n                    spp. (12.7%) and\n                    <jats:italic toggle=\"yes\">Campylobacter jejuni<\/jats:italic>\n                    (6.4%) were ranked second and fourth in terms of prevalence, respectively. The rates of extended-spectrum beta-lactamase (ESBL) production were 66.7% and 53.7% in DEC and\n                    <jats:italic toggle=\"yes\">Shigella<\/jats:italic>\n                    , respectively. Resistance to ampicillin (AMP) (95.1%), trimethoprim\/sulfamethoxazole (SXT) (73.2%), azithromycin (ATH) (21.9%), and ciprofloxacin (CIP) (14.6%) was observed among\n                    <jats:italic toggle=\"yes\">Shigella<\/jats:italic>\n                    isolates. Multidrug resistance phenotype was observed in 24.4% (10\/41) of\n                    <jats:italic toggle=\"yes\">Shigella<\/jats:italic>\n                    isolates, with the most common pattern of resistance to cefotaxime, ceftriaxone, ceftazidime, AMP, SXT, and ATH. This study indicates an alarming increase in the ESBL production of DEC and\n                    <jats:italic toggle=\"yes\">Shigella<\/jats:italic>\n                    spp. and identifies them as the two most prevalent diarrhea-causing enteropathogens in the region. The results show that CIP could be an alternative to third-generation cephalosporins against these two pathogens. Therefore, it is proposed that further investigation be done in the pursuit of alternative antibiotics that are effective against the resistant cases. For instance, one study could look into the comparative clinical effectiveness of third-generation cephalosporins versus CIP, the latter not being presently the drug of choice for the treatment of acute diarrhea in children in Iran.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2017.0204","type":"journal-article","created":{"date-parts":[[2017,11,6]],"date-time":"2017-11-06T10:33:01Z","timestamp":1509964381000},"page":"1037-1044","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":45,"title":["Diarrheagenic\n                    <i>Escherichia coli<\/i>\n                    and\n                    <i>Shigella<\/i>\n                    with High Rate of Extended-Spectrum Beta-Lactamase Production: Two Predominant Etiological Agents of Acute Diarrhea in Shiraz, Iran"],"prefix":"10.1177","volume":"23","author":[{"given":"Maneli","family":"Aminshahidi","sequence":"first","affiliation":[{"name":"Shiraz University of Medical Sciences","place":["Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Arastehfar","sequence":"additional","affiliation":[{"name":"Shiraz University of Medical Sciences","place":["Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gholamreza","family":"Pouladfar","sequence":"additional","affiliation":[{"name":"Shiraz University of Medical Sciences","place":["Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esmayil","family":"Arman","sequence":"additional","affiliation":[{"name":"Shiraz University of Medical Sciences","place":["Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fereshteh","family":"Fani","sequence":"additional","affiliation":[{"name":"Shiraz University of Medical Sciences","place":["Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,11,6]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000096"},{"key":"e_1_3_3_3_2","first-page":"193","article-title":"Epidemiology of acute diarrheal diseases among children under 5 years of age in Tehran, Iran","volume":"3","author":"Kolahi A.A.","year":"2008","unstructured":"Kolahi A.A., , Nabavi M., , and Sohrabi M.R.. 2008. 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