Abstract. Stool samples from children < 5 years of age with diarrhea ( N = 239) were examined for enteric pathogens using a combination of culture, enzyme-immunoassay, and polymerase chain reaction methods. Pathogens were detected in 122 (51%) stool samples; single pathogens were detected in 37.2% and co-pathogens in 13.8% of samples. Norovirus, rotavirus, and diarrheagenic Escherichia coli (DEC) were the most frequently detected pathogens (15.5%, 13.4%, and 11.2%, respectively); Salmonella , adenovirus, and Aeromonas were detected less frequently (7.9%, 7.1%, and 4.2%). The most commonly detected DEC was enteroaggregative E. coli (5.4%). Resistance to ≥ 3 antimicrobials was observed in 60% (18/30) of the bacterial pathogens. Salmonella resistance to ciprofloxacin (63.1%) has become a concern . Enteric viral pathogens were the most significant causative agents of childhood diarrhea in Tripoli. Bacterial pathogens were also important contributors to pediatric diarrhea. The emergence of ciprofloxacin-resistant Salmonella represents a serious health problem that must be addressed by Libyan health authorities * Address correspondence to Khalifa Sifaw Ghenghesh, Department of Microbiology and Immunology, Faculty of Medicine, Alfateh University, Tripoli, Libya. E-mail: ghenghesh@yahoo.com 887 DIARRHEA IN LIBYAN CHILDREN VA) were used to detect antigens of Cryptosporidium , Entamoeba histolytica , and Giardia lamblia in all specimens.Epi Info, version 3.5.1 software (Centers for Disease Control and Prevention, Atlanta, GA) was used to analyze the data. P values were calculated using the χ 2 test; P values < 0.05 were considered statistically significant. RESULTSEnteric pathogens were detected in 122 (51%) stool samples examined; single pathogens in 37.2%, and multiple pathogens in 13.9% ( Table 2 ). The most common pathogens detected were enteric viruses (82/239; 34.3%) followed by bacterial pathogens (64/239; 26.8%); parasitic pathogens (10/239; 4.2%) were the minority of detected pathogens.Overall, the most common individual pathogens detected were norovirus, rotavirus, and DEC. Among the DEC, pCVD432 (EAggEC) predominated at 5.4% (13/239) followed by eaeA (EPEC/EHEC) at 4.6% (11/239). No est and eltB genes (ETEC) were detected in this work. Salmonella species were detected in 7.9%; the majority of these were group C2. Cryptosporidium was the primary parasitic diarrheal pathogen detected (2.1%) ( Table 2 ).Total enteric pathogens were detected more frequently among diarrheic children ≤ 2 years of age (55.2%, 100/181; P < 0.03, odds ratio [OR] = 2.02) compared with children > 2 years of age (37.9%, 22/58). Although total enteric pathogens were detected at a higher rate in male (54%, 74/137) than in female (47.1%, 48/102) diarrheic children, the difference was not statistically significant ( P > 0.05).Of the 239 diarrheic children included in the study 202 (84.5%) had vomiting, 176 (73.6%) had fever, and 82 (34.3%) had dehydration. Vomiting, fever, and dehydration were significantly associated with children ≤ 2 years o...

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