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Published on: February 17, 2023
Clinical study of acute childhood diarrhoea caused by bacterial enteropathogens
Vyas Kumar Rathaur1, Monika Pathania2, Aparna Jayara3
1Assistant Professor, Department of Paediatrics, VCSGGMS&RI , Srikot, Srinagar, Uttrakhand, India .
Insights
Escherichia coli is the most common bacterial cause of acute childhood diarrhea in India. Salmonella contributes to severe dehydration, while Shigella shows high antibiotic resistance.
Area of Science:
- Pediatrics
- Microbiology
- Infectious Diseases
Background:
- Limited studies on bacterial enteropathogenesis of childhood diarrhea in India.
- Acute childhood diarrhea remains a significant health concern.
Purpose of the Study:
- Determine the prevalence of bacterial enteropathogens causing acute childhood diarrhea.
- Correlate bacterial isolates with clinical features.
Main Methods:
- Bacteriological analysis of stool samples from 280 children under 12 with acute diarrhea.
- Microscopy, culture, biochemical tests, and antimicrobial sensitivity testing (Kirby Bauer-disk diffusion).
Main Results:
- Escherichia coli (44.2%) was the predominant pathogen, followed by Shigella (28.2%) and Salmonella (13.6%).
- Diarrhea predominantly affected children aged 1-3 years, except for Klebsiella (infants <6 months).
- Most isolates were resistant to Co-trimoxazole; Shigella showed high resistance, while Salmonella had least resistance. No resistance to Cefotaxime, Cefuroxime, or Azetronam.
Conclusions:
- Escherichia coli is the primary bacterial cause of childhood diarrhea in India.
- Salmonella is associated with severe dehydration and symptoms like fever and frequent stools.
- Shigella exhibits high antibiotic resistance, whereas Salmonella shows the least resistance.
Objective:
There are not a large number of studies in India which can enlighten us regarding acute childhood diarrhoea and far lesser in number when it comes to its bacterial enteropathogenesis. The present study is specially targeted to determine the prevalence of various bacterial enteropathogens causing acute childhood diarrhoea and to find out their respective pattern of clinical features.
Method:
All children under 12 years of age enrolled between 1st June, 2012 and 31st July 2012, in the Outpatient department, Inpatient department of pediatrics section and casualty of hospital, who presented with acute diarrhoea. Data collected by mean of study questionnaire. Stool sample were processed for bacteriological analysis. In 280 samples bacteria were isolated with the help of microscopy, culture and biochemical reactions. The isolates obtained were tested for antimicrobial sensitivity over Mueller Hinton agar by Kirby Bauer-disk diffusion method.
Results:
Out of 280 children frequency of diarrhoeagenic bacteria isolated from the samples showed that Escherichia coli was recorded as the predominant bacteria with 44.2% of prevalence followed by Shigella, Salmonella, Klebsiella and Campylobacter with 28.2%, 13.6%, 7.8% and 6.1% respectively. Patients falling in the age group of 1-3 years. were the major sufferers of diarrhoea due to all etiologies except Klebsiella which mainly had impact on the patients below six months. Majority of isolated bacterial agents were resistant to Co-trimoxazole and Shigella being highly resistant enteropathogen isolated. Salmonella spp. were least resistant isolates. None of the isolates were resistant to Cefotaxime, Cefuroxime and Azetronam.
Conclusion:
RESULTS of study reveal that Escherichia coli is a predominant bacterial enteropathogen causing diarrhoea and Salmonella is a major contributor to the diarrhoea causing severe dehydration and to the clinical features like fever, vomiting and more than 10 times of frequency of stools. Shigella is among highly resistant isolates while Salmonella isolates had least resistance to majority of antibiotics.
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