Role of Escherichia coli in acute diarrhoea in tribal preschool children of central India.

Five hundred and eighty preschool children belonging to tribal areas of Madhya Pradesh were followed up daily for the presence of diarrhoea for a period of 1 year. In all, 1236 episodes of diarrhoea were recorded with an average of 2.13 episodes per child per year. Stool samples were collected during 780 episodes. They were cultured to isolate Escherichia coli as well as non-E. coli enteropathogens. Ten different genes were detected to identify all diarrhoeagenic E. coli using multiplex polymerase chain reaction. Enteroaggregative E. coli was the commonest diarrhoeagenic E. coli and was isolated from 64 children, followed by enteropathogenic E. coli (27), enterotoxigenic E. coli (10) and enterohaemorrhagic E. coli (2). Other enteropathogens detected were bacteria such as Shigella sp, Vibrio cholerae and Salmonella sp, parasites such as Giardia lamblia and Entameba histolytica, and rotavirus. Most of the bacterial pathogens were multi-drug resistant. The study shows that diarrhoeagenic E. coli contribute significantly to the burden of acute diarrhoea in tribal preschool children.