RESUMEN
Background & objectives: Majority of the studies of hospital-acquired diarrhoea conducted in Western countries have focused on the detection of Clostridium difficile in stool samples. Limited Asian and Indian literature is available on hospital-acquired diarrhoea. This study was aimed to describe the aetiological profile for hospital-acquired diarrhoea in children aged below five years. Methods: One hundred children aged one month to five years who developed diarrhoea (?3 loose stools for >12 h) after hospitalization for at least 72 h were enrolled. Children who were prescribed purgatives or undergoing procedures such as enema and endoscopy or those with underlying chronic gastrointestinal disorders such as celiac disease and inflammatory bowel disease were excluded from the study. Stool samples from the enrolled children were subjected to routine microscopic examination, modified Ziel- Nielson (ZN) staining for Cryptosporidium and culture for various enteropathogens. Multiplex PCR was used to identify the strains of diarrhoeagenic Escherichia coli. Rotavirus detection was done using rapid antigen kit. Toxins (A and B) of C. difficile were detected using enzyme immunoassay. Results: Of the 100 samples of hospital-acquired diarrhoea analysed, diarrhoeagenic E. coli (DEC) was found to be the most common organism, detected in 37 per cent of cases (enteropathogenic E. coli-18%, enterotoxigenic E. coli-8%, enteroaggregative E. coli-4% and mixed infections-7%). Cryptosporidium was detected in 10 per cent of cases. Rotavirus was detected in six per cent and C. difficile in four per cent of cases. Interpretation & conclusions: The findings of this study suggest that the aetiological profile of hospital- acquired diarrhoea appears to be similar to that of community-acquired diarrhoea, with DEC and Cryptosporidium being the most common causes. The efforts for the prevention and management of hospital-acquired diarrhoea should, thus, be directed towards these organisms.
RESUMEN
Currently, malaria ranks as the 5th major cause of death in developing countries. There are six human malarial parasites species, with Plasmodium falciparum (Pf) and P. vivax (Pv) being the most predominant. This study enrolled 165 outpatients of a tertiary care hospital of the northeast district of Delhi. Blood samples were taken and were examined for malaria by slide microscopy and rapid malarial antigen detection test. DNA extraction was done and PCR was performed for genus as well as species identification. A total of 60 (36.36%) malaria positive samples were identified among a total of 165 samples collected. P. vivax and P. falciparum were found to be present in 51.66 and 13.33% samples, respectively and 18.33% samples were positive for both the species on the basis of PCR analysis. The present study suggests that while the traditional methods for diagnosis of malarial infection are gold standard they will not be able to detect mixed infections with low parasite count