Emerging Trends in the Etiology and Antimicrobial Susceptibility Pattern of Enteric Pathogens in Rural Coastal India

Ballal, Mamatha; Devadas, Suganthi Martena; Chakraborty, Rituparna; Shetty, Vignesh

doi:10.4236/ijcm.2014.57058

Cited by 12 publications

(13 citation statements)

References 20 publications

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“… 55 Regional difference in the prevalence of different pathotypes of DEC is well documented. 26 Diarrheagenic E coli (46.3%) was the predominant pathogen that was isolated from diarrheal patients in a study by Ballal et al 56 In this study, in total, 633 preschool children with diarrhea, admitted at the Child Care Hospital and Nalanda Medical College and Hospital, Patna, were randomly enrolled for 2 consecutive years ( Figure 1 ). Of these, presence of E coli was identified in 460 samples (72.7%) ( Table 1 ).…”

Section: Resultsmentioning

confidence: 87%

Molecular Epidemiology of Extended-Spectrum β-Lactamase–ProducingEscherichia coliPathotypes in Diarrheal Children from Low Socioeconomic Status Communities in Bihar, India: Emergence of the CTX-M Type

et al. 2017

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Background:Childhood diarrheal diseases remain highly endemic in India, but the emergence of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli among children with diarrhea in Bihar remains elusive. In this study, we determine and characterize ESBL-producing E coli pathotypes among hospitalized diarrheal preschool children living in low socioeconomic level communities in Bihar, India.Materials and methods:The stool samples were collected everyday throughout the year for 2 consecutive years. In our study, we collected stool samples randomly from every fifth patient. Stool samples were collected from a total of 633 randomly selected diarrheal children (age: 0-60 months) belonging to 17 communities and screened for identification of virulent diarrheagenic E coli (DEC) pathotype (viz, enteropathogenic E coli [EPEC], enteroaggregative E coli [EAEC], enterotoxigenic E coli [ETEC], enteroinvasive E coli [EIEC], and enterohemorrhagic E coli [EHEC]) by a multiplex polymerase chain reaction (PCR) assay. Furthermore, ESBLs were screened by conventional antibiotic resistance pattern testing and later characterized for the presence of β-lactamase (bla) genes by PCR and DNA sequencing.Results:Diarrheagenic E coli was detected in 191 cases (30.2%) of the total 633 diarrheic children. Maximum occurrence of DEC was found in ≤12 months age group (72.7%) with prevalence of the EAEC pathotype. Most isolates were resistant to ampicillin, ciprofloxacin, piperacillin, levofloxacin, ceftazidime, cefotaxime, ceftriaxone, and gentamicin, whereas over 96% of them were sensitive to amikacin. About 37.6% of total 191 DEC isolates were ESBL producers (n = 72), being prevalent among ETEC (n = 35; 18.32%), followed by EPEC (n = 21; 10.9%), EAEC (n = 13; 6.8%), and EIEC (n = 3; 1.57%). Interestingly, the commonest β-lactamase was CTX-M type (blaCTX-M) in 86.1% (n = 62) of the ESBL isolates, followed by blaSHV (n = 49; 68%), blaTEM (n = 37; 51.8%), and blaOXA (n = 21; 29.1%) determinants. Resistance of ESBL isolates was mostly related to ampicillin (100%), ceftriaxone (98.1%), cefotaxime (92.4%), gentamicin (74.1%), and levofloxacin (73.2%), whereas best antimicrobial activities were observed for piperacillin-tazobactam, amikacin, meropenem, and imipenem.Conclusions:This study revealed that EAEC (72.1%) is the predominant pathotype in Bihar, significantly high in ≤12 months age group children (P = .04). Moreover, the widespread prevalence of ESBLs in children, especially the CTX-M type, is of great concern, which requires monitoring of infection control measures through efficient antimicrobial management and detection of ESBL-producing isolates.

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Section: Resultsmentioning

confidence: 87%

Molecular Epidemiology of Extended-Spectrum β-Lactamase–ProducingEscherichia coliPathotypes in Diarrheal Children from Low Socioeconomic Status Communities in Bihar, India: Emergence of the CTX-M Type

et al. 2017

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“…The overall prevalence of Salmonella and Shigella infection was less than the findings from Jimma, in Southwestern Ethiopia (8.4%) [7], Southern Ethiopia (22.5%) [14], and rural coastal India (11.2%) [24]. On the other hand, the magnitude of isolated Shigella species (2.5%) was [25], and Addis Ababa (3.2%) [13].…”

Section: Discussionmentioning

confidence: 85%

Prevalence and antimicrobial susceptibility of Salmonella and Shigella species isolated from diarrheic children in Ambo town

et al. 2020

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Background: Diarrhea, particularly of enteric bacterial pathogen, remains a major cause of morbidity and mortality in Ethiopia. Despite the high prevalence of diarrheal disease among under-five children, antibiotic resistance of bacterial pathogens test is not part of routine childcare in the study area. This study aimed to investigate the prevalence and antimicrobial susceptibility status of Salmonella and Shigella species among diarrheic children attending public health institutions in Ambo town, west Showa, Ethiopia. Methods: Institutional based, cross-sectional study was carried out from January to July 2014 among 239 diarrheic children below five years of age in Ambo town, Ethiopia. Information about patient demographics, signs, and symptoms was obtained from the parents/guardians of each child using a questionnaire. Stool samples from diarrheic children were collected and processed for isolation of Salmonella and Shigella using conventional microbiology procedures. Suspected Salmonella isolates were confirmed by genus-specific PCR and serotyped using a slide agglutination test. Susceptibility to 10 commonly used antimicrobials was assessed using the Kirby Bauer disc diffusion method. Results: From the 239 children screened, only nine (3.8%) of them were positive for either Salmonella (n = 3) or Shigella (n = 6) and 19 (7.9%) positive for the intestinal parasite. Three species of Shigella were identified: Shigella flexinari (n = 3), Shigella boydii (n = 2), and Shigella sonnei (n = 1). The three Salmonella isolates were S. chicago, S. caracas, and S. saintpaul. Salmonella and Shigella isolates were resistant to ampicillin (88.9%), followed by tetracycline (66.7%), cotrimoxazole (55.6%), chloramphenicol (44.4%), amoxicillin (33.3%), nalidixic acid (11.1%) and cefotaxime (11.1%). All isolates were sensitive to amikacin, ciprofloxacin, and gentamycin. Conclusion: In this study, either Salmonella or Shigella species were detected only in 3.8% of diarrheic children in Ambo town, suggesting the dominance of other causes of diarrhea in the study area. A further study targeting other causes of diarrhea should be conducted to establish the major causes of childhood diarrhea in the study area.

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“…S. flexneri is the most prevalent serogroup in other studies from India. [ 11 12 13 ] The most common Shigella serotype obtained in our study was S. sonnei (62.5%). So far, there are no reports of such high incidence of S. sonnei reports from India.…”

Section: Discussionmentioning

confidence: 91%

Antibiotic susceptibility pattern of Shigella isolates in a tertiary healthcare center

2018

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BACKGROUND AND OBJECTIVES: Shigellosis is one of the most common causes of morbidity and mortality in children in developing countries. To the best of our knowledge, there is no published data in the study area on the antimicrobial susceptibility pattern and prevalence of Shigella species among diarrheagenic cases. Therefore, a retrospective analysis was done to find the Shigella serotypes, common age group affected, and antimicrobial resistance pattern of Shigella isolates in South Kerala METHODS: Stool samples collected from cases of dysentery and diarrhea from January 2011 to December 2016 were processed. Standard bacteriological methods were used to isolate, identify, and determine the antimicrobial susceptibility pattern of Shigella isolates. The data were analyzed using SPSS version 16. RESULTS: Among 1585 stool samples, 48(3%) yielded Shigella . The most common serogroup isolated was Shigella sonnei (62.5%) followed by Shigella flexneri. Of 48 isolates, 44(91.6%) isolates were found to be multidrug resistant. Over the 5-year period, the isolates show 100% resistance to nalidixic acid, ciprofloxacin, and cotrimoxazole. Eight isolates were found to be resistant to ceftriaxone and cefotaxime. The presence of Extended spectrum betalactamase (ESBL) was phenotypically confirmed in five isolates. CONCLUSION: Even though S. flexneri is the most common Shigella-causing diarrhea, S. sonnei was found to be the most important species responsible in our study. Multidrug resistance was common (91.6%) and the most common multidrug resistance profile was ampicillin-nalidixic acid-cotrimoxazole-ciprofloxacin. Regular monitoring of antibiotic susceptibility pattern including detection of beta lactamases should be done in all microbiology laboratories. Guidelines for therapy should be monitored and modified based on regional susceptibility reports.

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Emerging Trends in the Etiology and Antimicrobial Susceptibility Pattern of Enteric Pathogens in Rural Coastal India

Cited by 12 publications

References 20 publications

Molecular Epidemiology of Extended-Spectrum β-Lactamase–ProducingEscherichia coliPathotypes in Diarrheal Children from Low Socioeconomic Status Communities in Bihar, India: Emergence of the CTX-M Type

Molecular Epidemiology of Extended-Spectrum β-Lactamase–ProducingEscherichia coliPathotypes in Diarrheal Children from Low Socioeconomic Status Communities in Bihar, India: Emergence of the CTX-M Type

Prevalence and antimicrobial susceptibility of Salmonella and Shigella species isolated from diarrheic children in Ambo town

Antibiotic susceptibility pattern of Shigella isolates in a tertiary healthcare center

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