Molecular and Epidemiologic Analysis of Diarrheal Pathogens in Children With Acute Gastroenteritis in Bangladesh During 2014-2019

摘要

Background: Diarrheal disease is one of the leading causes of childhood morbidity and mortality in the 21st century in developing countries. Mainly infants and young children develop diarrheal diseases. This study aims to determine the incidence of diarrheal pathogens in children in Bangladesh. Methods: During 2014 to 2019, 387 fecal specimens were collected from children with diarrhea in Bangladesh. Bacterial pathogens were detected by conventional bacteriologic, biochemical and molecular sequence analysis methods. DNA virus and RNA virus (diarrheal viruses) were detected using polymerase chain reaction and reverse transcriptase polymerase chain reaction, respectively and confirmed by molecular sequence analysis. Results: Bacterial infections were detected in 39.27% (152 of 387) of the stool samples.Escherichia coliwas the most prevalent (17.3%) followed byVibrio cholerae(13.5%),Salmonellaspp. (4.9%) andShigellaspp. (3.6%). From 387 fecal specimens tested, 42.4% (164 of 387) were positive for viral infections. Rotavirus was the most prevalent (26.3%), followed by adenovirus (5.7%), norovirus (5.4%) and human bocavirus (4.9%). Dual infection between rotavirus andE. coliaccounted for the largest portion of coinfection (48%). Diarrhea (77%) and abdominal pain (65%) were most common followed by vomiting (63%), fever (43%) and dehydration (39%).E. coliandV. choleraewere most resistant against ciprofloxacin (62.7%) and tetracycline (88.5%).qnrAandsul4resistance genes were isolated from these pathogens. Conclusions: Data from this study underline the high incidence of diarrheal pathogens and presence of antibiotics resistance genes in a pediatric population in Bangladesh.