Prospective study of the incidence of diarrhoea and prevalence of bacterial pathogens in a cohort of Vietnamese children along the Red River

Isenbarger, Daniel W.; Hiền, Bùi Thị Thu; Ha, Hoang Thi Thu; Ha, Tran Thu; Bodhidatta, Ladaporn; Pang, Lorrin; Cam, Phung Dac

doi:10.1017/s0950268801005933

Cited by 45 publications

(56 citation statements)

References 22 publications

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“…Our study is in accordance with several other studies that reported multiresistance of Shigella to commonly used therapeutic antimicrobials (5,25,26,40). Except for amoxicillin-clavulanic acid (AMC) exhibiting moderate activity to Shigella, other antibiotics were still active against this pathogen.…”

Section: Resultssupporting

confidence: 92%

“…due to limited resources available in the laboratory. Diarrhea was defined as (i) at least three loose (or watery) stools within 24 h, regardless of other gastrointestinal symptoms; (ii) two or more loose stools associated with at least one other symptom of gastrointestinal infection (abdominal pain, cramping, nausea, vomiting, and fever); or (iii) passage of a single loose stool with grossly evident blood and/or mucous (25). Two independent episodes were separated by at least 3 days of being diarrhea-free.…”

Section: Methodsmentioning

confidence: 99%

“…Etiological studies of diarrheal diseases have been done in Vietnam (25,39), which have not identified all six DEC groups. Another study found that ETEC and EPEC were major causes of acute diarrhea, accounting for 25 and 45% of acute diarrhea pathogens in Tu Liem district and in a pediatric hospital, respectively (23).…”

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confidence: 99%

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DiarrheagenicEscherichia coliandShigellaStrains Isolated from Children in a Hospital Case-Control Study in Hanoi, Vietnam

et al. 2008

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This case-control study detected and characterized Shigella and diarrheagenic Escherichia coli (DEC) types among Vietnamese children less than 5 years old. In 249 children with diarrhea and 124 controls, Shigella spp. was an important cause of diarrhea (P < 0.05). We used multiplex PCR and DNA probes to detect enteroinvasive E. coli (EIEC), enteroaggregative E. coli (EAggEC), enteropathogenic E. coli (EPEC), attaching and effacing E. coli (A/EEC), verocytotoxin-producing E. coli (VTEC), and enterotoxigenic E. coli (ETEC). The prevalences of DEC in the diarrhea and control groups were 25.7 and 10.5%, respectively. In 62 children with diarrhea, 64 DEC strains included 22 EAggEC (8.8%), 2 EIEC (0.8%), 23 A/EEC (9.2%), 7 EPEC (2.8%), and 10 ETEC strains (4.0%). Among controls, 13 DEC strains included 5 EAggEC strains (4.0%), 7 A/EEC strains (5.6%), and 1 EPEC strain. The characterization of DEC by serotypes, antimicrobial susceptibility patterns, virulence genes, and pulsed-field gel electrophoresis showed the occurrence of many different and highly heterogenic DEC subtypes, but common serotypes were found among ETEC, EIEC and EPEC, respectively. Serotyping was used to distinguish between A/EEC and EPEC. However, A/EEC, EPEC, and EAggEC were isolated at high frequency from both cases and controls. Further in-depth studies are needed to better understand important virulence factors of DEC, especially A/EEC, EPEC, and EAggEC.

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Section: Resultssupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

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DiarrheagenicEscherichia coliandShigellaStrains Isolated from Children in a Hospital Case-Control Study in Hanoi, Vietnam

et al. 2008

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“…Many studies have highlighted the heterogeneous distribution of Shigella serogroups (Pazhani et al, 2005;Taneja et al, 2004). In addition, an increasing number of Shigella isolates have been identified as untypable by serotyping in many countries (Isenbarger et al, 2001;Roy et al, 2006;Zafar et al, 2009). Unusual isolates of S. flexneri were first reported from travellers in Japan with diarrhoea (Matsushita et al, 1992) and from a restaurant-associated outbreak in California (Trevejo et al, 1999).…”

Section: Discussionmentioning

confidence: 99%

Genetic characteristics and changing antimicrobial resistance among Shigella spp. isolated from hospitalized diarrhoeal patients in Kolkata, India

Ghosh

Pazhani

Chowdhury

et al. 2011

Journal of Medical Microbiology

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To study the prevalence pattern and trends in the phenotypic and genetic characteristics of shigellae, we tested 212 isolates isolated from diarrhoeal patients admitted to the Infectious Diseases Hospital, Kolkata, India, from November 2007 to October 2010. Prevalence of Shigella spp. was higher in the .5 years age group (69 %) than in children in the ,5 years age group (31 %). Serotypes 2a, 3a and untypable isolates of Shigella flexneri were frequently detected. An increase in the isolation of Shigella sonnei (15 %) is a novel trend in this region. Fluoroquinolone resistance among S. flexneri serotypes 2a, 3a and other serogroups of shigellae is another evolving trend. The set gene was exclusively present in S. flexneri 2a, and the sen gene was detected in all serogroups. PFGE revealed the grouping of S. flexneri isolates according to their serotypes with approximately 80-100 % similarity, whilst Shigella dysenteriae type 2 and S. sonnei were clonal in nature. There was no demarcation in the prevalence of serotypes, antimicrobial resistance or clonality between the two age groups. INTRODUCTIONShigellosis remains a considerable public-health problem in many parts of the world. About 125 million cases of Shigella infection occur annually in Asia, of which approximately 14 000 are fatal (Bardhan et al., 2010). The distribution of serogroups of Shigella spp. differs from country to country: Shigella flexneri, Shigella sonnei and Shigella boydii serogroups are predominant in developing countries, whilst S. sonnei is frequently reported in industrialized countries. Prevalence of Shigella dysenteriae is mostly reported from South Asia and sub-Saharan Africa (Kotloff et al., 1999). Unlike other acute diarrhoeal illnesses that require adequate fluid replacement by either oral or intravenous rehydration, shigellosis needs antimicrobial therapy to reduce the duration of the illness and to prevent transmission to close contacts. Shigella spp. have developed perpetual resistance to ampicillin and trimethoprimsulfamethoxazole, which have been used in paediatric cases during the past two decades. Fluoroquinolones, ceftriaxone and pivmecillinam are the antibiotics currently recommended by the World Health Organization for the treatment of dysentery in children, as these drugs are effective at reducing mortality caused by Shigella spp. (Traa et al., 2010). These drugs are also effective among immunocompromised children, including neonatal patients, suffering from infections caused by multi-drugresistant strains of Salmonella and Shigella spp. (Leibovitz, 2006). The use of antimicrobials for the treatment of shigellosis varies from country to country. Pivmecillinam is not the drug of choice for the treatment of diarrhoea in many countries, but is being used in Bangladesh (Rahman et al., 2007). Ceftriaxone is an ideal drug for the treatment of shigellosis in regions where fluoroquinolone resistance is common. The American Academy of Pediatrics and the Infectious Diseases Society of America recommend azithromycin as an alternativ...

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“…Salmonella was also commonly found in our patients, but no typhoidal specimens were isolated. In our sample, E. coli was the least frequent causative agent of acute diarrhea; however, it is more important to the epidemiology of diarrhea in poorer areas [10,11] [12], while it is much more common in other countries [13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Epidemiological and microbiological aspects of acute bacterial diarrhea in children from Salvador, Bahia, Brazil

Diniz-Santos¹,

Santana²,

Barretto³

et al. 2005

Braz J Infect Dis

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In the few cases of acute childhood diarrhea that require antimicrobial therapy, the correct choice of the drug depends on detailed previous knowledge of local strains. In order to establish such parameters in our city, we reviewed the results of all 260 positive stool cultures of children between 0 and 15 years of age during two years at a pediatric tertiary care facility in Salvador, Brazil. Bacterial strains had been presumptively identified by culturing in selective media and by biochemical testing, and their antimicrobial susceptibility patterns were automatically detected by the MicroScan Walkaway System. Data about patients' sex and age, monthly distribution of the cases, pathogens isolated and their antimicrobial resistance patterns were recorded. Males corresponded to 55.4% of our sample, and most of our patients (42.7%) were between one and four years of age. Shigella was the commonest pathogen, being found in 141 (54.3%) cultures, while Salmonella was found in 100 (38.4%) cultures and Enteropathogenic E. coli in 19 (7.3%). Salmonella was the main causal agent of diarrhea in children younger than five years old, whereas Shigella was the most frequent pathogen isolated from the stools of children between five and 15 years old. The peaks of incidence correspond to the periods of school vacations. Shigella specimens presented a very high resistance rate to trimethoprim-sulfamethoxazole (90.1%) and to ampicillin (22.0%), while Salmonella presented very low resistance rates to all drugs tested. These data are useful for practitioners and they reinforce the need for continuous microbiological surveillance.

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Prospective study of the incidence of diarrhoea and prevalence of bacterial pathogens in a cohort of Vietnamese children along the Red River

Cited by 45 publications

References 22 publications

DiarrheagenicEscherichia coliandShigellaStrains Isolated from Children in a Hospital Case-Control Study in Hanoi, Vietnam

DiarrheagenicEscherichia coliandShigellaStrains Isolated from Children in a Hospital Case-Control Study in Hanoi, Vietnam

Genetic characteristics and changing antimicrobial resistance among Shigella spp. isolated from hospitalized diarrhoeal patients in Kolkata, India

Epidemiological and microbiological aspects of acute bacterial diarrhea in children from Salvador, Bahia, Brazil

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