Aetiology of hospital-acquired diarrhoea in under-five children from an urban hospital in East Delhi, India
Background & objectives: Majority of the studies of hospital-acquired diarrhoea conducted in Western countries have focused on the detection of Clostridium difficile in stool samples. Limited Asian and Indian literature is available on hospital-acquired diarrhoea. This study was aimed to describ...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Indian Journal of Medical Research |
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| Online Access: | http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2022;volume=156;issue=4;spage=624;epage=631;aulast=Singh |
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| author | Nupur Singh Dheeraj Shah Taru Singh Rumpa Saha Shukla Das Shyama Datt Piyush Gupta |
| author_facet | Nupur Singh Dheeraj Shah Taru Singh Rumpa Saha Shukla Das Shyama Datt Piyush Gupta |
| author_sort | Nupur Singh |
| collection | DOAJ |
| description | Background & objectives: Majority of the studies of hospital-acquired diarrhoea conducted in Western countries have focused on the detection of Clostridium difficile in stool samples. Limited Asian and Indian literature is available on hospital-acquired diarrhoea. This study was aimed to describe the aetiological profile for hospital-acquired diarrhoea in children aged below five years.
Methods: One hundred children aged one month to five years who developed diarrhoea (≥3 loose stools for >12 h) after hospitalization for at least 72 h were enrolled. Children who were prescribed purgatives or undergoing procedures such as enema and endoscopy or those with underlying chronic gastrointestinal disorders such as celiac disease and inflammatory bowel disease were excluded from the study. Stool samples from the enrolled children were subjected to routine microscopic examination, modified Ziel-Nielson (ZN) staining for Cryptosporidium and culture for various enteropathogens. Multiplex PCR was used to identify the strains of diarrhoeagenic Escherichia coli. Rotavirus detection was done using rapid antigen kit. Toxins (A and B) of C. difficile were detected using enzyme immunoassay.
Results: Of the 100 samples of hospital-acquired diarrhoea analysed, diarrhoeagenic E. coli (DEC) was found to be the most common organism, detected in 37 per cent of cases (enteropathogenic E. coli-18%, enterotoxigenic E. coli-8%, enteroaggregative E. coli-4% and mixed infections-7%). Cryptosporidium was detected in 10 per cent of cases. Rotavirus was detected in six per cent and C. difficile in four per cent of cases.
Interpretation & conclusions: The findings of this study suggest that the aetiological profile of hospital-acquired diarrhoea appears to be similar to that of community-acquired diarrhoea, with DEC and Cryptosporidium being the most common causes. The efforts for the prevention and management of hospital-acquired diarrhoea should, thus, be directed towards these organisms. |
| first_indexed | 2024-03-13T10:37:36Z |
| format | Article |
| id | doaj.art-f9509bed381d4791840fc8fd70ba2039 |
| institution | Directory Open Access Journal |
| issn | 0971-5916 |
| language | English |
| last_indexed | 2024-03-13T10:37:36Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Medical Research |
| spelling | doaj.art-f9509bed381d4791840fc8fd70ba20392023-05-18T05:47:41ZengWolters Kluwer Medknow PublicationsIndian Journal of Medical Research0971-59162022-01-01156462463110.4103/ijmr.IJMR_4138_20Aetiology of hospital-acquired diarrhoea in under-five children from an urban hospital in East Delhi, IndiaNupur SinghDheeraj ShahTaru SinghRumpa SahaShukla DasShyama DattPiyush GuptaBackground & objectives: Majority of the studies of hospital-acquired diarrhoea conducted in Western countries have focused on the detection of Clostridium difficile in stool samples. Limited Asian and Indian literature is available on hospital-acquired diarrhoea. This study was aimed to describe the aetiological profile for hospital-acquired diarrhoea in children aged below five years. Methods: One hundred children aged one month to five years who developed diarrhoea (≥3 loose stools for >12 h) after hospitalization for at least 72 h were enrolled. Children who were prescribed purgatives or undergoing procedures such as enema and endoscopy or those with underlying chronic gastrointestinal disorders such as celiac disease and inflammatory bowel disease were excluded from the study. Stool samples from the enrolled children were subjected to routine microscopic examination, modified Ziel-Nielson (ZN) staining for Cryptosporidium and culture for various enteropathogens. Multiplex PCR was used to identify the strains of diarrhoeagenic Escherichia coli. Rotavirus detection was done using rapid antigen kit. Toxins (A and B) of C. difficile were detected using enzyme immunoassay. Results: Of the 100 samples of hospital-acquired diarrhoea analysed, diarrhoeagenic E. coli (DEC) was found to be the most common organism, detected in 37 per cent of cases (enteropathogenic E. coli-18%, enterotoxigenic E. coli-8%, enteroaggregative E. coli-4% and mixed infections-7%). Cryptosporidium was detected in 10 per cent of cases. Rotavirus was detected in six per cent and C. difficile in four per cent of cases. Interpretation & conclusions: The findings of this study suggest that the aetiological profile of hospital-acquired diarrhoea appears to be similar to that of community-acquired diarrhoea, with DEC and Cryptosporidium being the most common causes. The efforts for the prevention and management of hospital-acquired diarrhoea should, thus, be directed towards these organisms.http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2022;volume=156;issue=4;spage=624;epage=631;aulast=Singhacute diarrhoea - clostridium difficile - escherichia coli - aetiology - nosocomial infections - prevention |
| spellingShingle | Nupur Singh Dheeraj Shah Taru Singh Rumpa Saha Shukla Das Shyama Datt Piyush Gupta Aetiology of hospital-acquired diarrhoea in under-five children from an urban hospital in East Delhi, India Indian Journal of Medical Research acute diarrhoea - clostridium difficile - escherichia coli - aetiology - nosocomial infections - prevention |
| title | Aetiology of hospital-acquired diarrhoea in under-five children from an urban hospital in East Delhi, India |
| title_full | Aetiology of hospital-acquired diarrhoea in under-five children from an urban hospital in East Delhi, India |
| title_fullStr | Aetiology of hospital-acquired diarrhoea in under-five children from an urban hospital in East Delhi, India |
| title_full_unstemmed | Aetiology of hospital-acquired diarrhoea in under-five children from an urban hospital in East Delhi, India |
| title_short | Aetiology of hospital-acquired diarrhoea in under-five children from an urban hospital in East Delhi, India |
| title_sort | aetiology of hospital acquired diarrhoea in under five children from an urban hospital in east delhi india |
| topic | acute diarrhoea - clostridium difficile - escherichia coli - aetiology - nosocomial infections - prevention |
| url | http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2022;volume=156;issue=4;spage=624;epage=631;aulast=Singh |
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