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Background  This study was conducted to determine the etiology of diarrhoea in a hospital setting in Kolkata. Active surveillance was conducted for 2 years on two random days per week by enrolling every fifth diarrhoeal patient admitted to the Infectious Diseases and Beliaghata General Hospital in Kolkata.    Results  Most of the patients (76.1%) had acute watery diarrhoea in association with vomiting (77.7%) and some dehydration (92%).  Vibrio cholerae  O1, Rotavirus and  Giardia lamblia  were the important causes of diarrhoea. Among  Shigella  spp,  S. flexneri  2a and 3a serotypes were most predominantly isolated. Enteric viruses, EPEC and EAEC were common in children <5 year age group. Atypical EPEC was comparatively higher than the typical EPEC. Multidrug resistance was common among  V. cholerae  O1 and  Shigella  spp including tetracycline and ciprofloxacin. Polymicrobial infections were common in all age groups and 27.9% of the diarrhoea patients had no potential pathogen.    Conclusions  Increase in  V. cholerae  O1 infection among <2 years age group, resistance of  V. cholerae  O1 to tetracycline, rise of untypable  S. flexnerii , higher proportion of atypical EPEC and  G. lamblia  and polymicrobial etiology are some of the emerging trends observed in this diarrhoeal disease surveillance.

Emerging trends in the etiology of enteric pathogens as evidenced from an active surveillance of hospitalized diarrhoeal patients in Kolkata, India