Original Research Article DOI: 10.18231/2455-1732.2018.0020 Santosh University Journal of Health Sciences, July-December, 2018;4(2):87-90 87 Detection of bacterial and intestinal parasitic infections among children under 5 years of age with acute gastroenteritis in a tertiary care hospital in NCR region Manish Kumar Singh 1 , Dakshina Bisht 2,* , Varun Goel 3 , Rishabh Tomar 4 , Alka Agrawal 5 1 Ph D Scholar, 2,5 Professor and Head, 3 Assistant Professor, 4 PG Student, 1-4 Dept. of Microbiology, 5 Dept. of Paediatrics, Santosh Medical College & Hospital (Santosh Deemed to be University, NCR Delhi ) Ghaziabad, Uttar Pradesh, India *Corresponding Author: Email: dakshinabisht@gmail.com Abstract Introduction: Acute gastroenteritis (AGE) accounts for millions of deaths each year in children, mostly in developing countries. Wide range of pathogens including parasites, bacteria and viruses are responsible for AGE. The aim of this study was to isolate the bacterial and intestinal parasites associated with AGE in children below 5 years of age. Materials and Methods: A cross sectional study was carried out in Department of Microbiology & Paediatrics Santosh Medical College and Hospital. 625 children with AGE were enrolled in the study. Stool samples were examined for the presence of parasites and cultured for microbial flora. Drug susceptibility testing for aerobic isolates was performed using Kirby-Bauer disc diffusion method according to CLSI guidelines. Results: Among the bacterial isolates maximum isolates were Escherichia coli 291 (46.56 %), of which 32 (5.12 %) samples were identified as Enterohaemorrhagic E.coli (EHEC), 48 (7.68 %) isolates were identified as Shigella spp. while parasites included Entamoeba histolytica 21 (3.36 %), followed by Giardia lamblia 14 (2.24 %), 81.78 E.coli isolates were sensitive to Ampicillin. All the Salmonella spp. isolates were sensitive to Co-trimoxazole. Conclusion: Most frequently bacterial and parasitic isolates were E.coli Salmonella spp. and Entamoeba histolytica. This gives pre requisite for planning and evaluating interventional programmes associated with diarrhoeal illness and their antimicrobial sensitivity pattern for effective treatment and to decrease disease burden. Keywords: Acute Gastroenteritis (AGE), Diarrhoea, Antimicrobial resistance, Intestinal parasites. Introduction The aetiology of AGE is variable with two main entities: infectious and non-infectious, with the former being the most common. In children acute diarrhoea may have a non-enteric origin, including a range of other infections such as urinary tract infection, pneumonia, otitis media and bacterial sepsis. Non- infectious diarrhoea can result from the intake of toxic food, chemicals, lactose, gluten intolerance or malignancy. Globally two billion cases of diarrhoeal disease occur every year. 1 Diarrhoeal disease in developing countries continues to be a big public health problem, where they are estimated to be responsible for 2.5 million infant death per year. 2 In India one third of total paediatric admission in hospital are due to diarrhoeal disease. 3 It is also the cause of death in almost 23% of Indian children who die before the age of five years. 4 Diarrhoeagenic Escherichia coli represents a leading cause of paediatric diarrhoea while Shigella spp. causes 164.7 million cases of diarrhoea of which 163.2 million occur in developing countries with 1.1 million death each year worldwide mostly in developing countries. 5 Among the other bacteria Campylobacter jejunii, Salmonella spp. and Vibrio cholerae are also known to cause gastroenteritis. Among parasitic species of particular importance are Entamoeba histolytica, Giardia lamblia, Cryptosporidium parvum and Strongyloides stercoralis. Among viral pathogens Rotavirus, Norovirus, Astrovirus, Sapovirus, Adenovirus have been associated with AGE. Most reliable way to diagnose these infections is by detection and identification of the infecting agent. Laboratory diagnosis includes a basic step in the evaluation of disease process at times confirming a presumptive diagnosis or providing evidence of an unsuspected agent of disease. However failure to demonstrate or recover a parasite does not exclude the possibility of infection. Many of these parasites, especially the protozoa can be identified only by microscopic examination. Treatment of infections depends on the infective agent and antimicrobial therapy is not required in some cases as it increases further complications. 6 The objective of this study was to investigate the microbiological profile of AGE and also analyse the susceptibility pattern of aerobic bacterial isolates. Materials and Methods A cross sectional study was carried out from November 2013 to December 2016 in the Department of Microbiology & Paediatrics, Santosh Medical College and Hospital. Ethical clearance was obtained from the Institutional Ethical Committee. As per the inclusion criteria the children included with age group less than 5 years with acute gastroenteritis/diarrhoea considered as passage of loose watery stools or an