Acute gastroenteritis in Nepal with reference to shigellosis and enteropathogenic Escherichia coli.
Salman KHAN 1, Priti SINGH 2, Ashish ASTHANA 3, Mukhtar ANSARI 4
1 Department of Microbiology, 2 Department of Biochemistry, Nepalgunj Medical College, Nepal
3 Department of Microbiology, Neta ji Subhash Chandra bose subharti Medical College, Swami Vivekanand Subharti University, India, and 4 Department of Pharmacology, National Medical College, Nepal.
ABSTRACT
Introduction: Shigellae play an important role in acute gastroenteritis. We report here the findings of Shigella species and relative risk of co-infection with enteropathogenic Escherichia coli (EPEC) among patients treated for acute gastroenteritis in the mid and far western region of Nepal. Materials and Methods: 507 patients with acute gastroenteritis who presented to the outpatients and inpatients departments of the Nepalgunj Medical College and Teaching Hospital in Banke in Nepal between September 2011 to April 2013 were included in this study. Stool specimens were collected and processed for Shigella species and Escherichia coli (E. coli), following standard bacteriological methods at the Central Laboratory of Microbiology. Results: One hundred seventy two isolates were identified as Shigella species (n=69, 40.1%) and E. coli (n=103, 59.9%). Among the Shigella isolated, S. flexneri, S. dysenteriae, S. boydii and S. sonnei accounted for 42.0%, 27.5%, 21.7% and 8.7% respectively. The majority was from children (1-10 years old) accounting for 42.0% (n=29), statistically significant (p<0.05) compared to the other age groups. Of the E. coli isolates, 11 were EPEC, and seven patients also had Shigella species isolated in patients aged in the 1–10 years (28.6%), 11–20 years (42.9%) and 21-30 years (28.6%). Conclusions: The study revealed the endemicity of Shigellosis with S. flexneri being the predominant serogroup. Children were at a higher risk. The continuous analysis and periodic reporting of Shigella species is important in proper therapy of Shigellosis.
Keywords: Epidemiology, dysentery, Shigellosis, gastroenteritis
Correspondence author: Salman KHAN, Department of Microbiology, Nepalgunj medical college, Chisapani Banke, Nepal
Tel: 009779848354981
E mail: salman186631@gmail.com
Brunei Int Med J. 2014; 10 (2): 92-97