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. 2010 Jun 5;2(1):4.
doi: 10.1186/1757-4749-2-4.

Emerging trends in the etiology of enteric pathogens as evidenced from an active surveillance of hospitalized diarrhoeal patients in Kolkata, India

Gopinath Balakrish Nair  1 , Thandavarayan Ramamurthy, Mihir Kumar Bhattacharya, Triveni Krishnan, Sandipan Ganguly, Dhira Rani Saha, Krishnan Rajendran, Byomkesh Manna, Mrinmoy Ghosh, Keinosuke Okamoto, Yoshifumi Takeda
Affiliations

Emerging trends in the etiology of enteric pathogens as evidenced from an active surveillance of hospitalized diarrhoeal patients in Kolkata, India

Gopinath Balakrish Nair et al. Gut Pathog. .

Abstract

Background: This study was conducted to determine the etiology of diarrhoea in a hospital setting in Kolkata. Active surveillance was conducted for 2 years on two random days per week by enrolling every fifth diarrhoeal patient admitted to the Infectious Diseases and Beliaghata General Hospital in Kolkata.

Results: Most of the patients (76.1%) had acute watery diarrhoea in association with vomiting (77.7%) and some dehydration (92%). Vibrio cholerae O1, Rotavirus and Giardia lamblia were the important causes of diarrhoea. Among Shigella spp, S. flexneri 2a and 3a serotypes were most predominantly isolated. Enteric viruses, EPEC and EAEC were common in children <5 year age group. Atypical EPEC was comparatively higher than the typical EPEC. Multidrug resistance was common among V. cholerae O1 and Shigella spp including tetracycline and ciprofloxacin. Polymicrobial infections were common in all age groups and 27.9% of the diarrhoea patients had no potential pathogen.

Conclusions: Increase in V. cholerae O1 infection among <2 years age group, resistance of V. cholerae O1 to tetracycline, rise of untypable S. flexnerii, higher proportion of atypical EPEC and G. lamblia and polymicrobial etiology are some of the emerging trends observed in this diarrhoeal disease surveillance.

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Figures

Figure 1
Figure 1
Month-wise details on number of admitted and enrolled cases in the surveillance.
Figure 2
Figure 2
Flowchart showing the admission rates of diarrhoea, the number of cases enrolled in the active surveillance, sampling details and prevalence status of the pathogens.
Figure 3
Figure 3
Comparison of infection status by different enteric pathogens in < 5 and ≥5 age groups.
Figure 4
Figure 4
Estimation of infections by different enteric pathogens in two consecutive years.
Figure 5
Figure 5
Seasonality of predominant diarrhoeal pathogens in this hospital based surveillance.
Figure 6
Figure 6
Chart showing the list of bacterial, viral and parasitic pathogens that were examined during the active hospital based diarrhoea surveillance.
See this image and copyright information in PMC

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