Etiology of Diarrhoea with Reference to Multiple Drug Resistant Enteric Bacterial Pathogens

Abstract

A total of 340 stool samples were processed and studied from both sexes including all ages of patients. Association of enteropathogens between male and female was not statistically significant. Incidence of diarrhoea (28.23%) as well as prevalence of enteropathogens (34.31%) was found highest in the age group (20-30) years. The highest prevalence of enteropathogens (44.87%) was found in August. Of the total isolated enteropathogens, Vibrio cholerae O1 was observed in 51.96% followed by Shigella (18.6%) and Salmonella (8.82%) and parasites were also detected from 20.58% samples. All isolated V. cholerae O1 were El Tor, Inaba. Among Shigella, majority of isolates were S. flexneri. Among Salmonella, S. typhi, S. typhimurium and Salmonella spp. (polyvalent A-S positive) were identified. Entamoeba histolytica, Girdia lamblia, Ascaris lumbricoides and Trichuris trichiura were isolated among parasites. All isolated (100%) V. cholerae O1 were resistant to nalidixic acid and cotrimoxazole, whereas 68%; 63%; 53%; 37% and 11% Shigella were resistant to nalidixic acid, ampicillin, cotrimoxazol, mecillinam and ciprofloxacin respectively. Similarly, 55.5%; 44.4% and 11.1% Salmonella were resistant to nalidixic acid; ampicillin and cotrimoxazole respectively. All V. cholerae strains, 10 strains of Shigella and 2 strains of Salmonella were found multi drug resistant (MDR). The clinical history of the positive cases revealed that abdominal pain, fever, vomiting, dehydration and nausea were the symptoms of enteric infection.

Multiple drug resistant Vibrio cholerae, Salmonella and Shigella from Nepalgunj Cholera outbreak and different hospitals of Nepal

“…(3.73%). The bacterial incidence found in this study is low in comparison to other findings such as 30% by Shrestha (2008) and 27.14% by Karki et al (2010). The variation between the prevalence rates of enteropathogens may be due to different geographic set up, socioeconomic status, environmental hygiene, water and sanitary measures, study time difference and exclusion of certain enteropathogens of diarrhoea in the study, etc.…”

Prevalence of Protozoa and Indicator Bacteria in Wastewater Irrigation Sources in Kathmandu Valley, Nepal: Cases from Kirtipur, Bhaktapur, and Madhyapur Thimi Municipalities

“…Diarrhea in Kathmandu Valley is common in people of all age groups and is predominantly caused by protozoa and helminths, whose infection rate is higher, particularly during the rainy season [8][9][10][11]. Studies have shown parasites like Giardia intestinalis, Cryptosporidium parvum, Entamoeba histolytica, and Ascaris lumbricoides to be dominant in stool samples of diarrheal patients in Kathmandu Valley [9,12,13]. Better understanding of the occurrence of waterborne pathogens can facilitate the evaluation of the risk of infection to humans.…”