Etiological diversity of diarrhoeal disease in Bangladesh

Abstract

Background: This study compared the diversity of common diarrhoeal pathogens and antimicrobial susceptibility in four hospitals in Bangladesh. Methodology: A total of 13,959 diarrhoea patients, comprising rural Mirzapur [2,820), rural Matlab (2,865), urban Dhaka (5,287) and urban Mirpur (2,987) were included under the diarrhoeal disease surveillance system of icddr,b during 2010-2011; stool specimens were tested for Shigella spp., Vibrio cholerae, enterotoxigenic Escherichia coli and rotavirus. Results: Rotavirus was highest in Mirzapur (28%) followed by Dhaka (24%), Matlab (19%) and Mirpur (18%). Overall, Shigella was significantly more prevalent in rural sites (Mirzapur 13% and Matlab 7%), than in urban sites (Dhaka 3% and Mirpur 3%). Vibrio cholerae was more common in the urban sites of Dhaka (14%) and Mirpur (12%). 72% of Shigella isolates were susceptible to ciprofloxacin in Mirzapur, and 88% to mecillinam. In Dhaka, the figures for Shigella were 65% and 50%, in Matlab 65% and 85%, and in Mirpur 59% and 92% respectively. Susceptibility of Shigella to azithromycin and ceftriaxone in Dhaka was 74% and 95%, and in Mirpur 88% and 92% respectively. Vibrio cholerae showed the highest resistance to trimethoprim-sulfamethoxazole (100% in Mirpur) and lowest resistance to ciprofloxacin (0% in Dhaka, Matlab and Mirpur) and azithromycin (30% in Dhaka to 7% in Mirzapur). Multidrug resistance (≥ 3 antibiotics) for Shigella were: Mirzapur (50%); Dhaka (36%); Matlab (23%) and Mirpur (37%); and for V. cholerae it was 26%, 37%, 49% and 23% respectively. Conclusion: The isolation rates and antimicrobial susceptibility of Shigella spp. and V. cholerae along with rotavirus differed significantly in certain geographical sites.

Norovirus diarrhea in Bangladesh, 2010–2014: prevalence, clinical features, and genotypes

“…For ETEC, stool samples were plated onto MacConkey agar, and for isolation of Vibrio cholerae , taurocholate‐tellurite‐gelatin agar plates were used. The detailed laboratory methods have been described elsewhere [Das et al, ].…”

“…The International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b) runs one urban hospital in Dhaka, the capital city of Bangladesh and a rural hospital in Matlab, located 55 km southeast of Dhaka. Vibrio cholera and rotavirus constituted a major proportion (30–40%) of the diarrheal cases, and no etiologic agent was found in ∼40% of samples [Das et al, ]. Norovirus is not routinely tested as an etiological agent for gastroenteritis in this hospital surveillance system.…”

Shigella Diversity and Changing Landscape: Insights for the Twenty-First Century

“…Rising cases of S. sonnei have also been detected in Bangladesh, which has historically been affected by all four species of Shigella. Between 2001 and 2011 the proportion of S. sonnei infections rose from 7 to 25% of reported cases in Bangladesh, which also corresponds with enhanced sanitation and clean water efforts throughout the country (Das et al, 2013 ; Hulland et al, 2013 ). The reasons for the counter-intuitive increase of S. sonnei in the face of better sanitation have not been determined, however several hypotheses have been put forward (Thompson et al, 2015 ).…”

Resistance Pattern and Molecular Characterization of Enterotoxigenic Escherichia coli (ETEC) Strains Isolated in Bangladesh

“…However, resistance to fluoroquinolones has increased markedly since their introduction in the late 1980s [ 16 ]. Recently ciprofloxacin resistance Shigella and Salmonella has emerged lately in Bangladesh [ 17 , 18 ]. In 2001 ciprofloxacin resistant ETEC was isolated from patients in India [ 19 ].…”