Follow-Up Trends of Bacterial Etiology of Diarrhoea and Antimicrobial Resistance in Urban Areas of Bangladesh

Abstract

Background: Diarrhoea is considered as the most widespread illness occurring in Bangladesh. In addition, the growing antimicrobial resistance of diarrhoeal pathogens in this developing country hardens physicians to supervise patients effectively. Objectives: In our study, we retrospectively analysed the data of a diarrhoeal pathogens and their antimicrobial resistant patterns isolated from diarrhoeal patients attending Dhaka Hospital, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka and domiciliary patients of Dhaka city of Bangladesh. Patients and Methods: During a six-year period (2009 - 2014), a total of 90207 diarrhoeal specimens were collected from patients to screen bacterial etiology by standard culture methods. Antimicrobial susceptibility testing was performed for culture-positive selected diarrhoeal pathogens using disk diffusion method. Results: One or more potential pathogens were identified in 20467 (23%) patients, more often from under-five children. The most predominant etiological agent was Vibrio spp. (33.23%), followed by Campylobacter spp. (26.04%), Shigella spp. (19.12%), Aeromonas spp. (12.21%), Salmonella spp. (6.74%) and Plesiomonas shigelloides (2.66%). Among children under the age of five, Campylobacter spp., Vibrio spp. and Shigella spp. were more common. V. cholerae O1 El Tor biotype was the predominant pathogen (90.75%) among all the Vibrio spp. isolated. High prevalence of multiple antibiotic resistances towards ampicillin (AM), ciprofloxacin (CIP) and co-trimoxazole (SXT) was common among Vibrio spp., Shigella spp. and Campylobacter spp. Beside, correlation with previous data from 2005 - 2008 showed that resistant percentages of Shigella spp., Campylobacter spp., Salmonella spp. to these antibiotics are increasing with time (P < 0.001). Conclusions: These findings underscored the importance of monitoring and developing guidelines for better management of infectious diarrhoea in Bangladesh and elsewhere.