Incidence of Enteroinvasive Escherichia Coli in Children with Diarrhoea and Evaluation of Apyrase based -Colorimetric Assay for its early Diagnosis.

Saraswathy, M P (2009) Incidence of Enteroinvasive Escherichia Coli in Children with Diarrhoea and Evaluation of Apyrase based -Colorimetric Assay for its early Diagnosis. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION : “The study of disease is really the study of man and his environment”- Park. Diarrhoea is a universal human experience. Diarrhoea is a symptom, not a disease in itself and it therefore may occur in a wide variety of conditions. In developing countries it is most commonly due to infectious cause. Acute infectious diarrhoea is one of the major causes of mortality in children, particularly in developing countries33. Diarrhoeal disorders account for a large proportion (18%) of childhood deaths, with estimated 1.8 million deaths per year Globally (World Health Organization 1999)110. Also diarrhoeal illnesses may have a Significant impact on psychomotor and cognitive development in young children. The WHO suspects that there are more than 700 million episodes of diarrhoea annually in children less than 5 years of age in developing countries. Mortality due to diarrhoea was approximately 3.3 million annually in the 1980s (World Health Organization 2006). Currently, diarrhoea has been reported to account for 1.6-2.5 million deaths annually. Therefore in conjunction with oral rehydration therapy, the development of a simple, inexpensive and reliable method for the early diagnosis of EIEC would reduce the duration and severity of diarrhoea and dysentery by early institution of antibiotic therapy. Indiscriminate use of antibiotics can also be avoided, since it leads to the development of antimicrobial resistance. This study describes the newly developed colorimetric assay that will be useful for specific and early detection of EIEC and Shigella species using readily available indigenous component reagents and equipments. AIMS OF THE STUDY : To study the incidence of Enteroinvasive Escherichia coli infection in children with diarrhoea and dysentery. To evaluate colorimetric assay for Apyrase enzyme as a diagnostic tool in the early diagnosis of EIEC diarrhoea. To compare colorimetric assay with Polymerase Chain Reaction and Sereny’s test. To determine the serotype of the EIEC isolates. To determine the antimicrobial susceptibility pattern of the isolates. To estimate the prevalence of Extended spectrum β-lactamase production among the EIEC isolates. MATERIALS AND METHODS : A total of 145 children, 0-5 years of age were included in the study. The patients were clinically examined and selected for the study after obtaining the history. Inclusion criteria : Children were included in the study if they had more than three loose stools in 24 hours or an episode of dysentery. Exclusion criteria : The following children were excluded from the study: 1. Children with diarrhoea due to food intolerance. 2. The children who acquired diarrhoeal illness after hospital admission. The proportional data of cross sectional study was tested using Pearson’s Chi-square(x2) analysis, Two sample binomial proportion test. Statistical analyses were carried out using Statistical Package for Social Sciences (SPSS) and Epi-info software. CONCLUSION : Incidence of EIEC in children with diarrhoea was 5.5%. Evaluation of colorimetric assay shows that this can be adopted as a diagnostic test to detect Apyrase enzyme of EIEC from stool samples. Besides this test is simple, less expensive and results can be obtained earlier, to start antibiotics promptly. Therefore further complications can be prevented. PCR targeting apy gene is more specific for diagnosing EIEC infection. Antibiogram should be done for all dysentery cases, since most of the strains showed multidrug resistance (75%) and ESBL production (50%). Amikacin and Cefoperazone-Sulbactum are recommended for severe cases of diarrhoea. O28 was frequently isolated serotype. Any disease for that matter “ Prevention is always better than Cure”. This can be achieved by promotion of exclusive breast feeding, improved water sanitation and promotion of personal and environmental hygiene.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Incidence ; Enteroinvasive Escherichia Coli ; Children ; Diarrhoea ; Apyrase Based -Colorimetric Assay ; Early Diagnosis.
Subjects: MEDICAL > Microbiology
Depositing User: Subramani R
Date Deposited: 03 Aug 2017 02:56
Last Modified: 03 Aug 2017 02:56

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