Abstract
Enteropathogenic Escherichia coli is an important causative agent of diarrhea in both developed and developing countries. We assessed the antibiotic resistance profile and the ability of 71 Enteropathogenic Escherichia coli (EPEC) isolates from children in the age group 6 years, or younger, to form biofilm. These children were hospitalized in Cosme and Damião Children Hospital in Porto Velho, Western Brazilian Amazon, between 2010 and 2012, with clinical symptoms of acute gastroenteritis. The highest frequency of atypical EPEC (aEPEC) isolates reached 83.1% (59/71). Most EPEC isolates presented Localized Adherence Like (LAL) pattern in HEp-2 cells (57.7% - 41/71). Biofilm production was observed in 33.8% (24/71) of EPEC isolates, and it means statistically significant association with shf gene (p = 0.0254). The highest antimicrobial resistance rates and a large number of multiresistant isolates 67.6% (48/71), regarded cefuroxime (CXM), ampicillin (AMP), trimethoprim-sulfamethoxazole (SXT) and tetracycline (TET), respectively, mainly in typical EPEC (tEPEC). Furthermore, 96% (68/71) of EPEC isolates in the present study were resistant to at least one antibiotic, whereas only 3 isolates were sensitive to all the tested drugs. Based on our findings, there was increased aEPEC identification. EPEC isolates showed high resistance rate; most strains showed multiresistance; thus, they work as warning about the continuous need of surveillance towards antimicrobial use. Besides, the ability of forming biofilm was evidenced by the EPEC isolates. This outcome is worrisome, since it is a natural resistance mechanism of bacteria.
Highlights
Enteropathogenic Escherichia coli is an important causative agent of diarrhea in both developed and developing countries
Enteropathogenic Escherichia coli (EPEC) is an important causative agent of diarrhea in both developed and developing countries [1,2]. This diarrheagenic E. coli pathotype is capable of causing diarrhea due to specific virulence determinants found within a chromosomal pathogenicity island named Locus of Enterocyte Effacement (LEE) and to a plasmid named EPEC Adherence Factor (EAF) [3]
EPEC is divided into two categories, namely: typical EPEC and atypical EPEC, which are based on EAF presence and absence - respectively, which is the main difference between the two groups [3]
Summary
Enteropathogenic Escherichia coli is an important causative agent of diarrhea in both developed and developing countries. Methodology: We assessed the antibiotic resistance profile and the ability of 71 Enteropathogenic Escherichia coli (EPEC) isolates from children in the age group 6 years, or younger, to form biofilm. These children were hospitalized in Cosme and Damião Children Hospital in Porto Velho, Western Brazilian Amazon, between 2010 and 2012, with clinical symptoms of acute gastroenteritis. EAF gives EPEC the ability to produce localized adherence (LA), which is a typical adherence model observed in cell cultures after 3-hour incubation. This phenotype results from "bundle-forming pilus" (BFP), which is a type IV fimbria found in tEPEC strains, only [4]. It is encoded into a Type III secretion system (TTSS) of proteins involved in the intimate adhesion process and in ESPs (EPEC secreted proteins) [5]
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