Epidemiological study of prevalent pathogens in the Northwest region of Argentina (NWA).

Northwest Argentina (NWA) is a poor economic-geographical region, with the highest rate of diarrhea diseases. At the moment, there are no reports showing the epidemiological status of this region that would allow to establish methods for prevention and control of these infections and to indicate of the prevalent pathogen that produces them. Therefore we carried out an epidemiological study of the gastroenteritis etiological agents and their incidence in the pediatric population. A total of 17 823 fecal samples were collected, 14 242 from HNJ-Tuc, 2,257 from CePSI-Stgo and 1,324 from HINEP-Cat. In 2,595 samples a bacterial agent was identified, the 93.64% corresponded to Shigella/Salmonella clinical isolates. Shigella genus was the prevalent pathogen, being Shigella flexneri 2 the most frequent serotype. Most of the Shigella clinical isolates presented themselves as multidrug-resistant (MDR), harboring 2 to 3 genetic resistance determinants. 50% of the affected patients were children under 4 years old. Here, we demonstrate that bacterial gastrointestinal diseases strongly affect the health of NWA population. The appearance of epidemic outbreaks, as happened during 2014, suggest that they may be related to the socio-economic poverty of NWA. Recently, Shigella flexneri 2 has become the highest NWA´s incidence infectious agent. The acquisition of new antibiotic resistance determinants may play an important role in their adaptation and persistence.