Indian Journal of Microbiology Research


Microbial etiology of acute gastroenteritis in pediatric patients in Western India


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Author Details: Ashwini Kacharu Dedwal, Sae Satish Pol, Sujata Sudhir Ranshing, Shobha Dattatray Chitambar, Renu Sat

Volume : 4

Issue : 2

Online ISSN : 2394-5478

Print ISSN : 2394-546X

Article First Page : 224

Article End Page : 226


Abstract

Introduction: Acute gastroenteritis is a major cause of illness and death among infants and young children worldwide. According to the World Health Organization (WHO), an estimated 2.5 billion cases of diarrhea occur among children under 5 years of age each year. Nearly one in five pediatric deaths (about 1.5 billion each year) is due to diarrhea. Present study was thus drawn to identify microbial etiology of acute gastroenteritis in pediatric patients in Western India.
Materials and Method: This was Prospective laboratory based study approved by Institutional Ethical committee. 100 stool samples were collected from children admitted with acute diarrhea of 72 hours or less duration in 1- 60 months of age over a period of one year. Bacteria were identified by standard Microbiological methods and serotyping of isolated Escherichia coli (E. coli) was done. Rotavirus antigen was detected by Enzyme Linked Immunosorbant Assay (ELISA) followed by genotyping by Reverse Transcriptase Polymerase chain Reaction (RT-PCR) and Multiplex PCR. Parasitic identification was done by microscopy.
Results: 74% of children with diarrhea were in the age group of 7 to 12 months. Watery diarrhea (94%) was the commonest clinical presentation, followed by vomiting (78%), fever (78%), and dehydration (74%). Pathogenic bacteria were isolated in 51% of samples. Escherichia coli was most common (48%) followed by Shigella flexneri (2%) and Vibrio cholerae (1%). The most prevalent E. coli type was Enterotoxigenic Escherichia coli (ETEC) (20.8%) followed by Enteropathogenic Escherichia coli (EPEC)(16.7%), Enterohaemorrhagic Escherichia coli (EHEC) (4.1%), and STEC (2.1%). The most prevalent serotypes of ETEC were O27, O23, and O169. Among EPEC most prevalent serotypes were O90, O26. The most prevalent EHEC strain found in this study was O71. Rotavirus was detected in 35% of patients. Most prevalent Rotavirus genotype was G9P[4] (28.6%) followed by G2P[4] (21.4%), G1P[8] (21.4%), G12P[6] (14.3%), G9P[8] (7.1%). Parasitic etiology was detected in 5% of cases. Coinfection of E.coli and Rotavirus was detected in 23% of children. Rotavirus was most commonly associated with EPEC (25.7%) followed by ETEC (17.1%).
Conclusion: In the present study, E. coli was the commonest microorganism followed by Rotavirus. Thus, the importance of safe water and food hygiene would be most important intervention to prevent acute gastroenteritis in children along with Rotavirus vaccine.

Keywords:
Rotavirus, E. coli, WHO, NIV, ETEC, EPEC, EHEC, STEC