Atypical enteropathogenic Escherichia coli associated with an acute diarrhoeal disease outbreak due to fermented soybean in Keifang, Mizoram, India: a challenge toward food safety and prevention efforts

Introduction: Foodborne and waterborne gastrointestinal disease outbreaks are frequently reported from the northeastern region of India. Methods: In the present study, an outbreak of acute gastroenteritis in Keifang village of Mizoram, India, was investigated following official notification through the state Integrated Disease Surveillance Program (IDSP) unit. Results: (aEPEC) was isolated from all 40 affected individuals and one food specimen. No other significant microbial pathogens, including bacteria, viruses, or parasites, could be detected in the specimens by any method. Discussion: All the aEPEC isolates were sensitive to most antimicrobials, except ampicillin and ceftazidime. Since all the infected patients consumed the same fermented soybean purchased from a single vendor, and aEPEC was isolated from both the patients and the fermented soybean, this suggests a strong correlation between the aEPEC isolates and the outbreak in Keifang, Mizoram, India, which was transmitted through fermented soybean.