Cyclospora, Salmonella (nontyphoidal), and Cryptosporidium were detected only among cases. Rotavirus, norovirus, and Plesiomonas were detected among 3% to 5% of cases and 1% of controls. Of the 50 ETEC strains isolated from 47 cases with diarrhea, 13 (26%) expressed LT, 17 (34%) expressed ST, and 20 (40%) expressed LT and ST enterotoxins. Among three

ETEC strains isolated from controls, two expressed LT and one expressed LT and ST. CFAs of 50 ETEC strains isolated from 47 cases and 3 controls in this study were examined. CFAs were detected among 31 of 47 (66%) and 1 of 3 of isolates from cases and controls, respectively. Among CFA-negative strains from cases, 12 of 16 expressed LT or LT/ST, while 4 expressed ST only. Nearly 80% of 283 bacterial NVP-BKM120 isolates tested were completely sensitive to either ciprofloxacin or azithromycin (Table 3). However, there

was widespread resistance for all enteric pathogens to ampicillin, trimethoprim–sulfamethoxazole, and nalidixic acid. With regard to ciprofloxacin, the most common pathogen isolated in cases, Campylobacter, was resistant in 71% of isolates with an additional 7% with intermediate sensitivity; 22% were completely sensitive. Shigella, ETEC, Aeromonas, Plesiomonas, nontyphoidal Salmonella, and EIEC isolates were sensitive to ciprofloxacin. Although Campylobacter had 0% resistance to azithromycin, there was intermediate sensitivity in 16% of ETEC and 35% of Shigella isolates, selleck screening library the second and third most common bacterial pathogens. Additionally, intermediate sensitivity to azithromycin was noted in a quarter to one-half of isolates of Salmonella (nontyphoidal), EPEC, Aeromonas, Plesiomonas, and EIEC and 100% of Yersinia enterocolitica isolates. Given the high proportion of ciprofloxacin-resistant

Campylobacter, we analyzed all 53 cases who reported taking FQs. Among these patients, Campylobacter (seven), Shigella (one), Salmonella (one), and ETEC (three) were isolated. All Campylobacter isolates were resistant to ciprofloxacin, whereas Shigella, Salmonella, and ETEC isolates remained sensitive. This study evaluates twice the number of cases than either of the two previous CIWEC-based studies. The increased risk of diarrhea from April to June in Nepal noted here agrees with prior studies. Campylobacter Methamphetamine has edged ahead of ETEC as the most common bacterial pathogen although the overall percentage is not significantly different from our previous studies (25% of all bacterial isolates vs 24% in 19885 and 21% in 19963). The biggest change is the decrease in ETEC (18% of bacterial isolates vs 44% in 19885). Another major difference is the number and variety of other bacterial pathogens found including Aeromonas, Plesiomonas, EPEC, EIEC, and Yersinia. Norovirus was not searched for in earlier studies and Cyclospora had not been identified as a pathogen until the early 1990s.