Correlation between Escherichia coli resistant gene isolated from stool samples of children under five years and that from consumed water

Abstract

Diarrheagenic Escherichia coli (DEC) causes enteric infections and diarrhea, especially in young children. Kenya reports around 2.6 million cases and 7,000 deaths annually due to diarrhea. Antibiotic-resistant DEC strains are a significant public health concern, complicating treatment. The objective of this research was to correlate children's water consumption and antimicrobial-resistant DEC development. The study sampled 1124 children under five with diarrhea in Nakuru, Kenya, using a case-control design. Among 384 eligible children, 192 cases showed Amoxicillin-resistant DEC. Water samples from households were collected and analyzed for DEC presence. The samples were filtered, plated onto MacConkey agar, and subcultured onto Eosin Methylene Blue agar for further analysis. The DEC pathotypes were identified based on morphological and biochemical characteristics, and antibiotic resistance was assessed using the Kirby-Bauer disk diffusion method. The study revealed a strong correlation of 11.613 (95 % Confidence Interval [CI]: 6.495–20.765, p-value: 0.000) between microbial burden in vended water (water sold by vendors) used by different households consumption and antimicrobial resistance in DEC. Water sources showed a high prevalence of DEC, primarily Enteroaggregative, enteropathogenic, enterotoxigenic, and enteroinvasive E. coli. DEC isolates also exhibited varying antibiotic resistance, and genes like blaCTX-M, blaTEM, and blaSHV were identified using PCR. The Spearman correlation coefficient was one, showing that resistance genes in water and stool were perfectly correlated. The study emphasizes the significance of improving water quality, hygiene, and antibiotic-resistant bacteria control to prevent and manage DEC and infectious diseases in Kenya. To combat outbreaks, effective surveillance and rapid reaction procedures are essential. The findings help to shape public health policies and initiatives.