Emerging trends in the etiology of enteric pathogens as evidenced from an active surveillance of hospitalized diarrhoeal patients in Kolkata, India.
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.
Nair
Gopinath Balakrish
GB
National Institute of Cholera and Enteric Diseases (NICED), P-33, CIT Road, Beliaghata, Kolkata 700010, West Bengal, India. gbnair_2000@yahoo.com.
Ramamurthy
Thandavarayan
T
Bhattacharya
Mihir Kumar
MK
Krishnan
Triveni
T
Ganguly
Sandipan
S
Saha
Dhira Rani
DR
Rajendran
Krishnan
K
Manna
Byomkesh
B
Ghosh
Mrinmoy
M
Okamoto
Keinosuke
K
Takeda
Yoshifumi
Y