Multiple etiologies of infectious diarrhea and concurrent infections in a pediatric outpatient-based screening study in Odisha, India
Abstract Background There are multiple etiologies responsible for infectious gastroenteritis causing acute diarrhea which are often under diagnosed. Also acute diarrhea is one of the major causes of morbidity and mortality among children less than 5 years of age. Methods In our study, fecal samples...
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| Format: | Article |
| Language: | English |
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BMC
2017-04-01
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| Series: | Gut Pathogens |
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| Online Access: | http://link.springer.com/article/10.1186/s13099-017-0166-0 |
| _version_ | 1819060123092385792 |
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| author | Arpit Kumar Shrivastava Subrat Kumar Nirmal Kumar Mohakud Mrutyunjay Suar Priyadarshi Soumyaranjan Sahu |
| author_facet | Arpit Kumar Shrivastava Subrat Kumar Nirmal Kumar Mohakud Mrutyunjay Suar Priyadarshi Soumyaranjan Sahu |
| author_sort | Arpit Kumar Shrivastava |
| collection | DOAJ |
| description | Abstract Background There are multiple etiologies responsible for infectious gastroenteritis causing acute diarrhea which are often under diagnosed. Also acute diarrhea is one of the major causes of morbidity and mortality among children less than 5 years of age. Methods In our study, fecal samples (n = 130) were collected from children (<5 years) presenting with symptoms of acute diarrhea. Samples were screened for viral, bacterial, and parasitic etiologies. Rotavirus and Adenovirus were screened by immunochromatographic tests. Diarrheagenic Escherichia coli (EPEC, EHEC, STEC, EAEC, O157, O111), Shigella spp., Salmonella spp., Vibrio cholera, Cryptosporidium spp., and Giardia spp. were detected by gene-specific polymerase chain reaction. Results Escherichia coli was detected to be the major etiological agent (30.07%) followed by Rotavirus (26.15%), Shigella (23.84%), Adenovirus (4.61%), Cryptosporidium (3.07%), and Giardia (0.77%). Concurrent infections with two or more pathogens were observed in 44 of 130 (33.84%) cases with a predominant incidence particularly in <2-year-old children (65.90%) compared to children of 2–5 years age group (34.09%). An overall result showed significantly higher detection rates among children with diarrhea in both combinations of two as well as three infections concurrently (p = 0.004915 and 0.03917, respectively). Conclusion Suspecting possible multiple infectious etiologies and diagnosis of the right causative agent(s) can aid in a better pharmacological management of acute childhood diarrhea. It is hypothesized that in cases with concurrent infections the etiological agents might be complementing each other’s strategies of pathogenesis resulting in severe diarrhea that could be studied better in experimental infections. |
| first_indexed | 2024-12-21T14:21:59Z |
| format | Article |
| id | doaj.art-5b95faf45c12434fbed6f2cd8e625ec2 |
| institution | Directory Open Access Journal |
| issn | 1757-4749 |
| language | English |
| last_indexed | 2024-12-21T14:21:59Z |
| publishDate | 2017-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Gut Pathogens |
| spelling | doaj.art-5b95faf45c12434fbed6f2cd8e625ec22022-12-21T19:00:45ZengBMCGut Pathogens1757-47492017-04-019111210.1186/s13099-017-0166-0Multiple etiologies of infectious diarrhea and concurrent infections in a pediatric outpatient-based screening study in Odisha, IndiaArpit Kumar Shrivastava0Subrat Kumar1Nirmal Kumar Mohakud2Mrutyunjay Suar3Priyadarshi Soumyaranjan Sahu4Infection Biology Laboratory, School of Biotechnology, KIIT UniversityInfection Biology Laboratory, School of Biotechnology, KIIT UniversityKalinga Institute of Medical Sciences, KIIT UniversityInfection Biology Laboratory, School of Biotechnology, KIIT UniversityInfection Biology Laboratory, School of Biotechnology, KIIT UniversityAbstract Background There are multiple etiologies responsible for infectious gastroenteritis causing acute diarrhea which are often under diagnosed. Also acute diarrhea is one of the major causes of morbidity and mortality among children less than 5 years of age. Methods In our study, fecal samples (n = 130) were collected from children (<5 years) presenting with symptoms of acute diarrhea. Samples were screened for viral, bacterial, and parasitic etiologies. Rotavirus and Adenovirus were screened by immunochromatographic tests. Diarrheagenic Escherichia coli (EPEC, EHEC, STEC, EAEC, O157, O111), Shigella spp., Salmonella spp., Vibrio cholera, Cryptosporidium spp., and Giardia spp. were detected by gene-specific polymerase chain reaction. Results Escherichia coli was detected to be the major etiological agent (30.07%) followed by Rotavirus (26.15%), Shigella (23.84%), Adenovirus (4.61%), Cryptosporidium (3.07%), and Giardia (0.77%). Concurrent infections with two or more pathogens were observed in 44 of 130 (33.84%) cases with a predominant incidence particularly in <2-year-old children (65.90%) compared to children of 2–5 years age group (34.09%). An overall result showed significantly higher detection rates among children with diarrhea in both combinations of two as well as three infections concurrently (p = 0.004915 and 0.03917, respectively). Conclusion Suspecting possible multiple infectious etiologies and diagnosis of the right causative agent(s) can aid in a better pharmacological management of acute childhood diarrhea. It is hypothesized that in cases with concurrent infections the etiological agents might be complementing each other’s strategies of pathogenesis resulting in severe diarrhea that could be studied better in experimental infections.http://link.springer.com/article/10.1186/s13099-017-0166-0DiarrheaInfectious diarrheaChildrenConcurrent infectionCo-infectionOdisha |
| spellingShingle | Arpit Kumar Shrivastava Subrat Kumar Nirmal Kumar Mohakud Mrutyunjay Suar Priyadarshi Soumyaranjan Sahu Multiple etiologies of infectious diarrhea and concurrent infections in a pediatric outpatient-based screening study in Odisha, India Gut Pathogens Diarrhea Infectious diarrhea Children Concurrent infection Co-infection Odisha |
| title | Multiple etiologies of infectious diarrhea and concurrent infections in a pediatric outpatient-based screening study in Odisha, India |
| title_full | Multiple etiologies of infectious diarrhea and concurrent infections in a pediatric outpatient-based screening study in Odisha, India |
| title_fullStr | Multiple etiologies of infectious diarrhea and concurrent infections in a pediatric outpatient-based screening study in Odisha, India |
| title_full_unstemmed | Multiple etiologies of infectious diarrhea and concurrent infections in a pediatric outpatient-based screening study in Odisha, India |
| title_short | Multiple etiologies of infectious diarrhea and concurrent infections in a pediatric outpatient-based screening study in Odisha, India |
| title_sort | multiple etiologies of infectious diarrhea and concurrent infections in a pediatric outpatient based screening study in odisha india |
| topic | Diarrhea Infectious diarrhea Children Concurrent infection Co-infection Odisha |
| url | http://link.springer.com/article/10.1186/s13099-017-0166-0 |
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