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Volume 6, Issue 9

Trends and antibiotic susceptibility patterns of diarrhoeal pathogens – experience over 14 years in southern India Open Access

Abstract

. Enteric pathogens contribute significantly to morbidity in a developing country such as India. Early and prompt diagnosis of diarrhoeal diseases can reduce the mortality rate, particularly in children. The pattern of sensitivity to antimicrobials for the common pathogens can vary from time to time. The present study was conducted to study the pathogen distribution and antimicrobial susceptibility pattern during the study period (January 2010 to December 2023).

. Studying the changing trend in the antimicrobial sensitivity pattern of diarrhoeal pathogens over a decade can help to plan future treatment options.

. This study was undertaken to provide insights into the changing pattern of pathogen distribution and antimicrobial susceptibility for enteric pathogens over 14 years.

. A retrospective observational cohort analysis was conducted on all the stool pathogens isolated from the samples received in the microbiology department of a tertiary care hospital from 2010 to 2023. The demographic details, stool microscopy, culture reports, and antimicrobial susceptibility patterns were noted.

. A total of 18 336 stool specimens were received in the microbiology laboratory between January 2010 and December 2023, of which 1354 specimens had diarrhoeal pathogens grown in culture. Out of these 1354 specimens, 591 (44%) had , 471 (35%) , 181 (13%) and 80 (6%) species. Among these pathogens, susceptibility to ceftriaxone was seen in 93% (552 isolates) of species, 89% (420 isolates) of species, and 95% (171 isolates) of ; 91% (73 isolates) of species were susceptible to chloramphenicol. Some major parasites were also observed on microscopy.

. Timely diagnosis of diarrhoeal pathogens can be life-saving for patients at the extremes of age, i.e. in children and the elderly. Pathogens can exhibit a changing susceptibility pattern to antibiotics, which should be regularly observed to plan future therapy.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): antimicrobials , changing pattern and diarrhoea
© 2024 The Authors
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License.
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2024-09-23
2026-02-18

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References

  1. Nair GB, Ramamurthy T, Bhattacharya MK, Krishnan T, Ganguly S et al. Emerging trends in the etiology of enteric pathogens as evidenced from an active surveillance of hospitalized diarrhoeal patients in Kolkata, India. Gut Pathog 2010; 2:4 [View Article] [PubMed]
     [Google Scholar]
  2. Moharana SS, Panda RK, Dash M, Chayani N, Bokade P et al. Etiology of childhood diarrhoea among under five children and molecular analysis of antibiotic resistance in isolated enteric bacterial pathogens from a tertiary care hospital, Eastern Odisha, India. BMC Infect Dis 2019; 19:1018 [View Article] [PubMed]
     [Google Scholar]
  3. Ahs JW, Tao W, Löfgren J, Forsberg BC. Diarrheal diseases in low- and middle-income countries: incidence, prevention and management. Open Infect Dis J 2010; 4:113–124 [View Article]
     [Google Scholar]
  4. Veeraraghavan B, Pragasam AK, Ray P, Kapil A, Nagaraj S et al. Evaluation of antimicrobial susceptibility profile in Salmonella typhi and Salmonella paratyphi A: presenting the current scenario in India and strategy for future management. J Infect Dis 2021; 224:S502–S516 [View Article] [PubMed]
     [Google Scholar]
  5. Olayinka A. Debate: antibiotics for diarrhoeal diseases. Int J Infect Dis 2023; 130:S40 [View Article]
     [Google Scholar]
  6. Neupane A, Parajuli P, Bastola R, Paudel A. Bacterial etiology of diarrhoeal disease in children and antibiogram of the isolates. Clin Microbiol 2017; 06:278 [View Article]
     [Google Scholar]
  7. Majowicz SE, Musto J, Scallan E, Angulo FJ, Kirk M et al. The global burden of nontyphoidal Salmonella gastroenteritis. Clin Infect Dis 2010; 50:882–889 [View Article] [PubMed]
     [Google Scholar]
  8. Jacob JJ, Solaimalai D, Rachel T, Pragasam AK, Sugumar S et al. A secular trend in invasive non-typhoidal Salmonella in South India, 2000-2020: identification challenges and antibiogram. Indian J Med Microbiol 2022; 40:536–540 [View Article] [PubMed]
     [Google Scholar]
  9. McDermott PF, Zhao S, Tate H. Antimicrobial resistance in nontyphoidal Salmonella. Microbiol Spectr 2018; 6: [View Article] [PubMed]
     [Google Scholar]
  10. Inbaraj S, Agrawal RK, Thomas P, Mohan C, Agarwal R K S et al. Antimicrobial resistance in Indian isolates of non typhoidal Salmonella of livestock, poultry and environmental origin from 1990 to 2017. Comp Immunol Microbiol Infect Dis 2022; 80:101719 [View Article] [PubMed]
     [Google Scholar]
  11. Jacob JJ, Solaimalai D, Muthuirulandi Sethuvel DP, Rachel T, Jeslin P et al. A nineteen-year report of serotype and antimicrobial susceptibility of enteric non-typhoidal Salmonella from humans in Southern India: changing facades of taxonomy and resistance trend. Gut Pathog 2020; 12:49 [View Article] [PubMed]
     [Google Scholar]
  12. Al Naiemi N, Zwart B, Rijnsburger MC, Roosendaal R, Debets-Ossenkopp YJ et al. Extended-spectrum-beta-lactamase production in a Salmonella enterica serotype typhi strain from the Philippines. J Clin Microbiol 2008; 46:2794–2795 [View Article] [PubMed]
     [Google Scholar]
  13. Rotimi VO, Jamal W, Pal T, Sovenned A, Albert MJ. Emergence of CTX-M-15 type extended-spectrum beta-lactamase-producing Salmonella spp. in Kuwait and the United Arab Emirates. J Med Microbiol 2008; 57:881–886 [View Article] [PubMed]
     [Google Scholar]
  14. Gokul BN, Menezes GA, Harish BN. ACC-1 beta-Lactamase-producing Salmonella enterica Serovar typhi, India. Emerg Infect Dis 2010; 16:1170–1171 [View Article] [PubMed]
     [Google Scholar]
  15. Menezes GA, Harish BN, Khan MA, Goessens WHF, Hays JP. Antimicrobial resistance trends in blood culture positive Salmonella typhi isolates from Pondicherry, India, 2005-2009. Clin Microbiol Infect 2012; 18:239–245 [View Article] [PubMed]
     [Google Scholar]
  16. Thapa BR, Ventkateswarlu K, Malik AK, Panigrahi D. Shigellosis in children from north India: a clinicopathological study. J Trop Pediatr 1995; 41:303–307 [View Article] [PubMed]
     [Google Scholar]
  17. Das A, Mandal J. Extensive inter-strain diversity among clinical isolates of Shigella flexneri with reference to its serotype, virulence traits and plasmid incompatibility types, a study from south India over a 6-year period. Gut Pathog 2019; 11:33 [View Article] [PubMed]
     [Google Scholar]
  18. Baker S, Scott TA. Antimicrobial-resistant Shigella: where do we go next?. Nat Rev Microbiol 2023; 21:409–410 [View Article] [PubMed]
     [Google Scholar]
  19. Madhavan A, Balakrishnan S, Vasudevapanicker J. Antibiotic susceptibility pattern of Shigella isolates in a tertiary healthcare center. J Lab Physicians 2018; 10:140–144 [View Article] [PubMed]
     [Google Scholar]
  20. Mandal J, Sangeetha V, Nivedithadivya D, Das A, Parija SC. Characterization of extended-spectrum β-lactamaseproducing clinical isolates of Shigella flexneri. J Health Popul Nutr 2013; 31:405–408 [View Article]
     [Google Scholar]
  21. Mandal J, Mondal N, Mahadevan S, Parija SC. Emergence of resistance to third-generation cephalosporin in Shigella--a case report. J Trop Pediatr 2010; 56:278–279 [View Article] [PubMed]
     [Google Scholar]
  22. Varghese SR, Aggarwal A. Extended spectrum beta-lactamase production in Shigella isolates – a matter of concern. Indian J Med Microbiol 2011; 29:76–78 [View Article]
     [Google Scholar]
  23. Bhattacharya D, Bhattacharjee H, Ramanathan T, Sudharma SD, Singhania M et al. Third-generation cephalosporin resistance in clinical isolate of Shigella sonnei in Andaman & Nicobar Islands, India. J Infect Dev Ctries 2011; 5:674–676 [View Article] [PubMed]
     [Google Scholar]
  24. Radice M, González C, Power P, Vidal M del C, Gutkind G. Third-generation cephalosporin resistance in Shigella sonnei, Argentina. Emerg Infect Dis 2001; 7:442–443 [View Article]
     [Google Scholar]
  25. Nguyen NTK, Ha V, Tran NVT, Stabler R, Pham DT et al. The sudden dominance of blaCTX-M harbouring plasmids in Shigella spp. circulating in southern Vietnam. PLoS Negl Trop Dis 2010; 4:e702 [View Article] [PubMed]
     [Google Scholar]
  26. Acikgoz ZC, Gulay Z, Bicmen M, Gocer S, Gamberzade S. CTX-M-3 extended-spectrum beta-lactamase in a Shigella sonnei clinical isolate: first report from Turkey. Scand J Infect Dis 2003; 35:503–505 [View Article] [PubMed]
     [Google Scholar]
  27. Das S, Saha R, Kaur IR. Trend of antibiotic resistance of Vibrio cholerae strains from East Delhi. Indian J Med Res 2008; 127:478–482 [PubMed]
     [Google Scholar]
  28. Legros D. Partners of the Global Task Force on Cholera Control Global cholera epidemiology: opportunities to reduce the burden of cholera by 2030. J Infect Dis 2018; 218:S137–S140 [View Article] [PubMed]
     [Google Scholar]
  29. Ramamurthy T, Pal A, Bhattacharya MK, Bhattacharya SK, Chowdhury AS et al. Serovar, biotype, phage type, toxigenicity & antibiotic susceptibility patterns of Vibrio cholerae isolated during two consecutive cholera seasons (1989-90) in Calcutta. Indian J Med Res 1992; 95:125–129 [PubMed]
     [Google Scholar]
  30. De R. Mobile genetic elements of Vibrio cholerae and the evolution of its antimicrobial resistance. Front Trop Dis 2021; 2:691604 [View Article]
     [Google Scholar]
  31. Mohanraj RS, Samanta P, Mukhopadhyay AK, Mandal J. Haitian-like genetic traits with creeping MIC of Azithromycin in Vibrio cholerae O1 isolates from Puducherry, India. J Med Microbiol 2020; 69:372–378 [View Article] [PubMed]
     [Google Scholar]
  32. Pal BB, Nayak SR, Khuntia HK. Epidemiology and antibiogram profile of Vibrio cholerae isolates between 2004–2013 from Odisha, India. Jpn J Infect Dis 2018; 71:99–103 [View Article]
     [Google Scholar]
  33. Faruque ASG, Alam K, Malek MA, Khan MGY, Ahmed S et al. Emergence of multidrug-resistant strain of Vibrio cholerae O1 in Bangladesh and reversal of their susceptibility to tetracycline after two years. J Health Popul Nutr 2007; 25:241–243 [PubMed]
     [Google Scholar]
  34. Yuan X-H, Li Y-M, Vaziri AZ, Kaviar VH, Jin Y et al. Global status of antimicrobial resistance among environmental isolates of Vibrio cholerae O1/O139: a systematic review and meta-analysis. Antimicrob Resist Infect Control 2022; 11:62 [View Article] [PubMed]
     [Google Scholar]
  35. Mandal J, Sangeetha V, Ganesan V, Parveen M, Preethi V et al. Third-generation cephalosporin-resistant Vibrio cholerae, India. Emerg Infect Dis 2012; 18:1326–1328 [View Article] [PubMed]
     [Google Scholar]
  36. Bhaskar M, Dinoop KP, Mandal J. Characterization of ceftriaxone-resistant Aeromonas spp. isolates from stool samples of both children and adults in Southern India. J Health Popul Nutr 2015; 33:26 [View Article] [PubMed]
     [Google Scholar]
  37. Pintor-Cora A, Tapia O, Elexpuru-Zabaleta M, Ruiz de Alegría C, Rodríguez-Calleja JM et al. Cytotoxicity and antimicrobial resistance of Aeromonas strains isolated from fresh produce and irrigation water. Antibiotics 2023; 12:511 [View Article] [PubMed]
     [Google Scholar]
  38. Chen P-L, Tsai P-J, Chen C-S, Lu Y-C, Chen H-M et al. Aeromonas stool isolates from individuals with or without diarrhea in southern Taiwan: predominance of Aeromonas veronii. J Microbiol Immunol Infect 2015; 48:618–624 [View Article] [PubMed]
     [Google Scholar]
  39. Aravena-Román M, Inglis TJJ, Henderson B, Riley TV, Chang BJ. Antimicrobial susceptibilities of Aeromonas strains isolated from clinical and environmental sources to 26 antimicrobial agents. Antimicrob Agents Chemother 2012; 56:1110–1112 [View Article] [PubMed]
     [Google Scholar]
  40. Chang BJ, Bolton SM. Plasmids and resistance to antimicrobial agents in Aeromonas sobria and Aeromonas hydrophila clinical isolates. Antimicrob Agents Chemother 1987; 31:1281–1282 [View Article] [PubMed]
     [Google Scholar]
  41. Ko WC, Yu KW, Liu CY, Huang CT, Leu HS et al. Increasing antibiotic resistance in clinical isolates of Aeromonas strains in Taiwan. Antimicrob Agents Chemother 1996; 40:1260–1262 [View Article] [PubMed]
     [Google Scholar]
  42. McNicol LA, Aziz KM, Huq I, Kaper JB, Lockman HA et al. Isolation of drug-resistant Aeromonas hydrophila from aquatic environments. Antimicrob Agents Chemother 1980; 17:477–483 [View Article] [PubMed]
     [Google Scholar]
  43. Mohan B, Sethuraman N, Verma R, Taneja N. Speciation, clinical profile & antibiotic resistance in Aeromonas species isolated from cholera-like illnesses in a tertiary care hospital in north India. Indian J Med Res 2017; 146:S53–S58 [View Article] [PubMed]
     [Google Scholar]
  44. Mason LCE, Greig DR, Cowley LA, Partridge SR, Martinez E et al. The evolution and international spread of extensively drug resistant Shigella sonnei. Nat Commun 1983; 14: [View Article]
     [Google Scholar]
  45. Juthani R, Das A, Doss K, Mandal J. Exploring the use of Congo red agar in improving the serotyping of non-serotypeable Shigella with In-silico evidence. Indian J Med Microbiol 2023; 44:100381 [View Article] [PubMed]
     [Google Scholar]
  46. Das A, Doss K, Mandal J. CRISPR-cas heterogeneity and plasmid incompatibility types in relation to virulence determinants of Shigella. J Med Microbiol 2022; 71: [View Article] [PubMed]
     [Google Scholar]
  47. Chen S, Liu H, Liang W, Hong L, Zhang B et al. Insertion sequences in the CRISPR-Cas system regulate horizontal antimicrobial resistance gene transfer in Shigella strains. Int J Antimicrob Agents 2019; 53:109–115 [View Article] [PubMed]
     [Google Scholar]
  48. Biswas M, Biswas S, Gupta B, Mascellino MT, Rakshit A et al. Changing paradigms in antibiotic resistance in Salmonella species with focus on fluoroquinolone resistance: a 5-year retrospective study of enteric fever in a Tertiary Care Hospital in Kolkata, India. Antibiotics 2022; 11:1308 [View Article] [PubMed]
     [Google Scholar]
  49. Mandal J, Biswal N, Shanmugam L, Joseph NM. Study of prevalence of Campylobacter gastroenteritis among pediatric population using a multiplex PCR in a Tertiary Care Hospital in Puducherry, South India. J Gastrointest Infect 2022; 11:9–14 [View Article]
     [Google Scholar]
  50. Mabbott NA. The influence of parasite infections on host immunity to co-infection with other pathogens. Front Immunol 2018; 9:2579 [View Article] [PubMed]
     [Google Scholar]
  51. Reynolds LA, Redpath SA, Yurist-Doutsch S, Gill N, Brown EM et al. Enteric helminths promote salmonella coinfection by altering the intestinal metabolome. J Infect Dis 2017; 215:1245–1254 [View Article] [PubMed]
     [Google Scholar]
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Trends and antibiotic susceptibility patterns of diarrhoeal pathogens – experience over 14 years in southern India
Access Microbiology 6, 000818.v3 (2024); https://doi.org/10.1099/acmi.0.000818.v3
/content/journal/acmi/10.1099/acmi.0.000818.v3
/content/journal/acmi/10.1099/acmi.0.000818.v3
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