Genetic diversity of bacterial pathogens in children with acute gastroenteritis in Bangladesh during 2014-2019

Abstract

Background: Acute gastroenteritis is still the health burden in developed and developing countries. From different etiological agents, bacteria and viruses are considered to be significant enteropathogens of acute gastroenteritis in children worldwide including Bangladesh. Among these diarrheal bacteria, Escherichia coli, Non Typhoidal Salmonella, Shigella spp. and Vibrio cholerae are some of the major enetropathogens. Antibiotics are mostly used for the treatment of bacterial pathogens. Antibiotic resistance property of the above mentioned bacterial pathogens is a true hindrance in treatment of diarrheal diseases. Methods and materials: The study was carried on 387 fecal specimens, collected from all children of acute gastroenteritis in four clinics encompassing three localities (Savar, Cattogram and Sirajganj) in Bangladesh from January 2014 to January 2019. For diarrheagenic bacterial pathogens, conventional bacterial identification and molecular characterization methods were used. Prevalence of antibiotic resistance bacterial pathogens were also determined. Sequence data were analyzed by Chromas 2.32, BioEdit and other software. Results: A total of 387 fecal specimens were tested for bacterial and viral pathogens. 39.27% (152 of 387) of the samples were positive for bacterial pathogens and 42% (164 of 387) for viral pathogens. Among diarrheagenic bacterial pathogens, E.coli was the most prevalent (17.3%, 67 of 387) followed by V. cholerae (13.5%, 52 of 387), Salmonella spp. (4.9%, 19 of 387) and Shigella spp. (3.6%, 14 of 387), respectively. We found 50% to 80% isolates of V. cholerae were resistance against the tested antibiotics. While 20% to 60% of E. coli isolates were resistance against those antibiotics. Molecular analysis of antibiotic resistance genes confirmed the presence of qnrA and sul4 resistance elements in diarrheal pathogenic bacteria. To far our knowledge, the report of sul4 in this study is first in Bangladesh. Conclusion: This study will help to better understand the overall bacterial pathogens involved in infants and children diarrheal diseases in Bangladesh. This research work also confirmed the presence of antibiotic resistance bacterial pathogens with unique resistance gene in diarrheal pediatric population in Bangladesh. This study will also provide information for the betterment of detection methods, prevention and treatment strategies for diarrheal diseases in Bangladesh.