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

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

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

Nair et al. Gut Pathogens 2010, 2:4 /content/2/1/4 RESEARCH Open Access Emerging trends in the etiology of enteric Research pathogens as evidenced from an active surveillance of hospitalized diarrhoeal patients in Kolkata, India Gopinath Balakrish Nair*1, Thandavarayan Ramamurthy1, Mihir Kumar Bhattacharya1, Triveni Krishnan1, Sandipan Ganguly1, Dhira Rani Saha1, Krishnan Rajendran1, Byomkesh Manna1, Mrinmoy Ghosh2, Keinosuke Okamoto3 and Yoshifumi Takeda4 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. Background Diarrhoea is a syndrome that can be caused by different bacterial, viral and parasitic pathogens. Accurate under- standing of the cause of diarrhoea in a given setting is an onerous task that requires systematic m