Etiology of childhood diarrhoea among under five children and molecular analysis of antibiotic resistance in isolated enteric bacterial pathogens from a tertiary care hospital, Eastern Odisha, India.
Anti-Bacterial Agents
/ therapeutic use
Bacterial Infections
/ diagnosis
Child, Preschool
Ciprofloxacin
/ therapeutic use
Cross-Sectional Studies
Diarrhea
/ diagnosis
Drug Resistance, Microbial
/ drug effects
Escherichia coli
/ isolation & purification
Escherichia coli Infections
/ diagnosis
Female
Fluoroquinolones
/ therapeutic use
Gastroenteritis
/ diagnosis
Humans
India
/ epidemiology
Infant
Infant, Newborn
Male
Microbial Sensitivity Tests
Molecular Diagnostic Techniques
/ methods
Molecular Typing
/ methods
Prevalence
Tertiary Care Centers
Childhood diarrhoea
DEC
E.coli
Etiology
Multidrug-resistant
Mutation
QRDR
Surveillance
Under 5 years
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
02 Dec 2019
02 Dec 2019
Historique:
received:
23
11
2018
accepted:
24
09
2019
entrez:
4
12
2019
pubmed:
4
12
2019
medline:
30
1
2020
Statut:
epublish
Résumé
Although, India has made steady progress in reducing deaths in children younger than 5 years, the proportional mortality accounted by diarrhoeal diseases still remains high. The present hospital based cross sectional study was carried out to understand the prevalence of various bacterial pathogens associated with the diarrhoea cases in under 5 years age group. During, 1st September, 2015 to 30th November 2017, all the childhood diarrhoea cases (≤5 yrs) of SCB Medical College in Odisha, India were included in the study. Stool samples were collected and processed for the isolation of causative bacterial pathogen and the isolated bacterial pathogens were subjected to antibiotic sensitivity testing, molecular analysis of drug resistance. Clinical and demographic data were collected and analyzed. Three hundred twenty patients were enrolled in the study during the study period from whom 82 bacterial isolates were obtained indicating a proportional causality of 25.6% for bacterial diarrhoea among children in this region. Entero toxigenic E.coli (ETEC) accounted for majority of the cases and and more than 50% of the strains were found to be multi-drug resistant (resistant to more than 3 class of antibiotics). More than 50% of the strains were resistant to current choice of treatment like ciprofloxacin, ofloxacin and ceftriaxone and 2.4% being resistant to Imipenem. ESBL production was also observed in some of the strains and one isolate harboured the NDM-1 gene. Fluoroquinolone resistance was found to be linked with multiple mutations in the QRDR region followed by PMQR determinants. The current study, to the best of our knowledge is first of its kind which demonstrated the etiology of bacterial diarrhoea in children less than 5 years old and identified diarrheogenic E. coli as the predominant enteropathogen in Odisha. Majority of the isolates being multi-drug resistance calls for a continuous surveillance system in the region which will be helpfulin identifying emerging resistance pattern and for developing suitable intervention stategies.
Sections du résumé
BACKGROUND
BACKGROUND
Although, India has made steady progress in reducing deaths in children younger than 5 years, the proportional mortality accounted by diarrhoeal diseases still remains high. The present hospital based cross sectional study was carried out to understand the prevalence of various bacterial pathogens associated with the diarrhoea cases in under 5 years age group.
METHODS
METHODS
During, 1st September, 2015 to 30th November 2017, all the childhood diarrhoea cases (≤5 yrs) of SCB Medical College in Odisha, India were included in the study. Stool samples were collected and processed for the isolation of causative bacterial pathogen and the isolated bacterial pathogens were subjected to antibiotic sensitivity testing, molecular analysis of drug resistance. Clinical and demographic data were collected and analyzed.
RESULTS
RESULTS
Three hundred twenty patients were enrolled in the study during the study period from whom 82 bacterial isolates were obtained indicating a proportional causality of 25.6% for bacterial diarrhoea among children in this region. Entero toxigenic E.coli (ETEC) accounted for majority of the cases and and more than 50% of the strains were found to be multi-drug resistant (resistant to more than 3 class of antibiotics). More than 50% of the strains were resistant to current choice of treatment like ciprofloxacin, ofloxacin and ceftriaxone and 2.4% being resistant to Imipenem. ESBL production was also observed in some of the strains and one isolate harboured the NDM-1 gene. Fluoroquinolone resistance was found to be linked with multiple mutations in the QRDR region followed by PMQR determinants.
CONCLUSION
CONCLUSIONS
The current study, to the best of our knowledge is first of its kind which demonstrated the etiology of bacterial diarrhoea in children less than 5 years old and identified diarrheogenic E. coli as the predominant enteropathogen in Odisha. Majority of the isolates being multi-drug resistance calls for a continuous surveillance system in the region which will be helpfulin identifying emerging resistance pattern and for developing suitable intervention stategies.
Identifiants
pubmed: 31791267
doi: 10.1186/s12879-019-4501-6
pii: 10.1186/s12879-019-4501-6
pmc: PMC6889523
doi:
Substances chimiques
Anti-Bacterial Agents
0
Fluoroquinolones
0
Ciprofloxacin
5E8K9I0O4U
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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