Bacterial enteropathogens causing acute diarrhoea in children in a tertiary care hospital, Imphal
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20211271Keywords:
Bacterial enteropathogens, Diarrhoeagenic E. coli, Diarrhoea in childrenAbstract
Background: Diarrhoeal diseases are responsible for causing 3 million deaths worldwide every year especially among the children and also the commonest cause of morbidity and mortality in developing countries like India. Infective diarrhoea could be either bacterial, viral, parasitic or occasionally a combination of these.
Methods: A cross-sectional study was carried out in children below 12 years with acute diarrhoea in theMicrobiology Department, RIMS, Imphal for a period of 2 years. Stool samples were subjected to routine microbiological examination, followed by culture and sensitivity. Data were collected in a predesigned data collection sheet.
Results: Majority of the diarrhoeal cases were seen among the age group of 1-3 years (44.3%), predominantly among the male children (66.2%) and mostly in summer. Out of 210 culture positive stool samples, Escherichia coli(83.3%) was the predominant enteropathogen with followed by Shigella spp.(12.9%), Klebsiella spp. (2.9%) and Salmonella spp. (1%). Serotyping revealed thirty five enteropathogenic E. coli, eighteen Shigella flexneri, seven Shigellasonnei, two Shigella boydii and two Salmonella typhimurium. Majority of the isolates showed high resistance to amoxicillin, ampicillin, ciprofloxacin, ofloxacin and cotrimoxazole.
Conclusions: Bacterial enteropathogens are an important cause of acute diarrhoea among children. Rehydration therapy remains the initial treatment. Though it is usually self-limiting, empirical and specific antimicrobial therapy can be considered in certain situations. Awareness of improving hygiene and infectious diseases may help reduce the burden of infection.
References
Rathaur VK, Pathania M, Jayara A, Yadav N. Clinical study of acute childhood diarrhoea caused by bacterial enteropathogens. J Clin Diagn Res. 2014;8(5):1-5.
Park K. Acute diarrhoeal diseases. In: Park K, editor. Parks textbook of preventive and social medicine, 15th edition. Jabalpur: Banarsidas Bhanot. 1998:171-4.
Radlovic N, Lekovic Z, Vuletic B, Radlovic V, Simic D. Acute diarrhoea in children. Srp Arh Celok Lek. 2015;143(11):755-62.
Dallal MS, Khorramizadeh M, Moezardalan K. Occurence of enteropathogenic bacteria in children under 5 years with diarrhoea in South Tehran. East Mediterr Health J. 2006;12(6):798-803.
Lee WS, Puthucheary SD. Bacterial enteropathogens isolated in childhood diarrhoea in Kuala Lumpur- the changing trend. Med J Malaysia. 2002;57(1):24-9.
Nataro JP, Kaper JP. Diarrhoeagenic Escherichia coli. Clin Microbiol Rev. 1998;11(1):142-201.
Das S, Saha R, Singhal S. Enteric pathogens in North Indian patients with diarrhoea. Indian J Community Med. 2007;32(1):27-31.
Jafari F, Hamidian M, Rezadehbashi M. Prevalence and antimicrobial resistance of diarrhoeagenic E. coli and Shigella species associated with acute diarrhoea in Tehran, Iran. Can J Infect Dis Med Microbiol. 2009;20(3):56-62.
Patel JB, Weinstein MP, Eliopoulos GM, Jenkins SG, Lewis JS, Limbago B, et al. Performance standards for antimicrobial susceptibility testing, CLSI supplement M100. 28th ed. Wayne, PA: CLSI. 2018.
Ansari S, Sherchand JB, Parajuli K, Mishra SK, Dahal DK, Shrestha S, et al. Bacterial aetiology of acute diarrhoea in children under five years of age. J Nepal Health Res Counc. 2012;10(22):218-23.
Siziya S, Muula AS, Rudatsikira E. Correlates of diarrhoea among children below the age of 5 years in Sudan. Afr Health Sci. 2013;13(2):376-83.
Poo MI, Lee WS. Admission to hospital with childhood acute gastroenteritis in Kuala Lumpur, Malaysia. Med J Malaysia. 2007;62(3):189-93.
Subhashkumar R, Thayumanavan T, Vivekanandhan G, Lakshmanaperumalsamy P. Etiology of children’s diarrhoea in Southern India: associated pathogens and usual isolates. Afr J Microbiol Res. 2012;6911):2808-15.
Mani R, Udgaonkar U, Pawar S. Study of enteropathogenic Escherichia coli (EPEC) diarrhoea in children. Indian J Pathol Microbiol. 2003;46(1):118-20.
Muni S, Kumar A, Shahi SK, Pankaj D, Sen A, Salila S. Diarrhoea with special reference to enteropathogenic Escherichia coli in children below five years at a tertiary care centre. Indian J Contempt Med Res. 2017;4(9):1934-7.
Kale VV, Iyer LL, Jain MK. Shigellosis in infants and children. J Postgrad Med. 1982;28(4):206-9.
Dallal MS, Khorramizadeh M, Moezardalan K. Occurence of enteropathogenic bacteria in children under 5 years with diarrhoea in South Tehran. East Mediterr Health J. 2006;12(6):798-803.
Manikandan C, Amsath A. Antimicrobial resistance of enteric pathogens isolated from children with acute diarrhoea in Pattukkottai, Tamil Nadu. Int J Pure Appl Zool. 2013;1(2):139-45.
Jarousha AM, Jarou MA, Qouqa IA. Bacterial enteropathogens and risk factors associated with childhood diarrhoea. Indian J Pediatr. 2011;78(2):165-70.