A Bacteriological Study Among Patients Below Five Years of Age Suffering From Diarrhoea and Gastroenteritis With Special Reference to the Responsible Serotypes of Escherichia Coli at a Tertiary Healthcare Hospital in Eastern Bihar

Abstract

Diarrhoea is defined as passage of loose, liquid or watery stools. In the developing countries, diarrhoea remains a wet season disease with bacteria playing a greater role. The agents responsible for infantile diarrhoea may be bacteria, viruses, parasites, malnutrition and drugs. Infectious agents that cause diarrhoeal disease are usually spread by the fecal-oral route. Escherichia coli (E. coli) is a gram-negative bacillus that may be found in the normal intestinal flora of humans and animals, but can also be an important cause of enteric illness. Our present study is an attempt to fulfil this vacuum and investigate the most common pathogens causing these diseases amongst patients in and around a tertiary care hospital of eastern Bihar, with special reference to the serotypes of Escherichia coli. MATERIAL AND METHODS: Samples were collected from both male and female patients below five years of age, admitted to the Pediatrics Department, with complains of diarrhoea and gastroenteritis. Samples were processed, identified and antibiotic sensitivity was done as per standard protocol. Serotyping of E. coli isolates was carried out using antisera as per manufacturer's instructions. RESULTS: Different diarrhoeagenic strains of E. coli showed that the maximum numbers of strains were EPEC, followed by DAEC. EAEC and ETEC accounted for only a small percentage of strains. Upon Serotyping the different E. coli isolates from patients with diarrhoea, the results showed that the Serotype O26, O111 and O55 were the predominant serotypes of EPEC. Among the ETEC strains only 2 serotypes were seen viz. O6 and O15. Serotype O44 and O125 were the only two serotypes of EAEC seen. Among the DAEC, the only serotype was O1. The antibiotic susceptibility pattern of various isolates shows maximum resistance against ampicillin followed by cefixime. Strains were significantly sensitive to amikacin, gentamicin and ofloxacin. CONCLUSION: Our result shows high rate of diarrhoeagenic E. coli among Indian children presenting with diarrhoea particularly in Katihar / Kosi region of Bihar. The finding of diverse E. coli subtypes even amongst the small number of E. coli isolates highlights the importance of pathogenic E. coli in cases of diarrhoea and gastroenteritis and stresses upon the need for enhanced surveillance of children with diarrhoea in these parts of the globe.

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

“…This is the first report of molecular epidemiology of DEC pathotypes and occurrence of ESBL-producing strains among diarrheal preschool children from low socioeconomic communities of Patna, Bihar (India). A report from Katihar/Kosi region of Bihar by Muni et al 74 showed that among different types of DEC, the maximum number of strains was EPEC (49.1%), followed by DAEC (34.5%), EAEC (10.9%), and ETEC (5.5%). In another study from India, Singh et al 75 reported DEC in 88.33% of isolates, EPEC (72.5%) being the predominant pathotype followed by EAEC (63.33%), ETEC (45.83%), and EHEC (9.16%).…”