Trends and antibiotic susceptibility patterns of diarrhoeal pathogens - an experience of fourteen years in Southern India

INTRODUCTION: Enteric pathogens contribute largely to morbidity in a developing country like India. Early and prompt diagnosis of diarrhoeal diseases can reduce the mortality rate, particularly in children.  The pattern of sensitivity to antimicrobials for the common pathogens can vary from time to time. The present study was conducted to study the pathogen distribution and antimicrobial susceptibility pattern during the study period (January 2010 to December 2023). HYPOTHESIS/GAP STATEMENT: Studying the changing trend in the antimicrobial sensitivity pattern of diarrhoeal pathogens over a decade can help to plan future treatment options. AIM: This study was undertaken to provide insight into the changing pattern of pathogen distribution and antimicrobial susceptibility of enteric pathogens over 14 years. METHODS: A retrospective observational cohort analysis was conducted on all the stool pathogens isolated from the samples received in the Microbiology department of a tertiary care hospital from the year 2010 to 2023. The demographic details, stool microscopy, culture reports, and antimicrobial susceptibility patterns were noted. RESULTS:  A total of 18336 stool specimens were received in the Microbiology laboratory between January 2010 to December 2023, of which 1354 specimens had diarrhoeal pathogens grown in culture. Out of these 1354 specimens, 591(44%)had Salmonella, 471 (35%) Shigella,181 (13%)Vibrio cholerae, and 80(6%) had Aeromonas species. Among these pathogens, susceptibility to Ceftriaxone was seen in 93% (552 isolates) of Salmonella species, 89% (420 isolates) of Shigella species, and in 95 %(171 isolates) of Vibriocholerae; 91%(73 isolates) of Aeromonas species were susceptible to Chloramphenicol. Some major parasites were also observed on microscopy. CONCLUSION: Timely diagnosis of diarrhoeal pathogens can be life-saving for patients belonging to extremes of age. Pathogens can exhibit a changing susceptibility pattern to antibiotics which should be regularly observed to plan future therapy.