Abstract
Enteropathogenic Escherichia coli (EPEC) is a major cause of diarrhea in infants and children in developing countries. However, recent studies have shown its prevalence in developed countries. The purpose of this study was to evaluate the multi-drug resistant (MDR) of EPEC isolated from children less than five years old with diarrhea hospitalized in Kashan Shahid Beheshti hospital during 2009-10. Stool samples were collected from 313 children less than five years old with diarrhea at Shahid Beheshti Hospital, Kashan, Iran, from November 2009 to May 2010. Specimens were examined by polymerase chain reaction (PCR) test to determine the eae gene for detection of EPEC pathotype. The isolated multi-drug resistance pattern of EPEC was evaluated by disk diffusion agar. The antimicrobial disks used were ampicillin, nalidixic acid, ceftriaxone, ciprofloxacin, cefalexin, ceftazidime, streptomycin and imipenem. Of all 178 E. coli cases 51 (28.6%) EPEC pathotypes were isolated. The prevalence of EPEC was higher in children less than one year old. MDR rate in EPEC was 70.6%.The exact application of antibiogram test is necessary before antibiotic prescription for complete treatment and prevention of diarrhea caused by multi-drug resistant agents. Key words: Enteropathogenic Escherichia coli, multiple drugs resistant, children, diarrhea.
Highlights
Diarrheal illness is a major public health problem worldwide, with over 2 million deaths occurring each year, among infants younger than 5 yearsAbbreviations: AE, Attaching and effacing; Bfp, bundleforming pilus; EAF, Escherichia coli adherence factor; Enteropathogenic Escherichia coli (EPEC), enteropathogenic E. coli; LA, localized adherence; locus for enterocyte effacement (LEE), locus of enterocyte effacement; multi-drug resistant (MDR), multi-drug resistance; PCR, polymerase chain reaction; eae, EPEC attaching and effacing; Eosin methylene blue (EMB), eosin methylene blue; Triple sugar iron agar (TSI), triple sugar iron agar; DNA, deoxyribonucleic acid.(www.who.int)
The purpose of this study was to evaluate the multi-drug resistant (MDR) of EPEC isolated from children less than five years old with diarrhea hospitalized in Kashan Shahid Beheshti hospital during 2009-10
Enteropathogenic Escherichia coli (EPEC), one of the six E. coli diarrheagenic pathotypes, produces an adherence factor chromosomally encoded by the EPEC attaching and effacing gene located within the locus for enterocyte effacement (LEE) pathogenicity island (Moon et al, 1983; McDaniel and Kaper, 1997; Nataro and Kaper, 1998; Afset et al, 2004)
Summary
Diarrheal illness is a major public health problem worldwide, with over 2 million deaths occurring each year, among infants younger than 5 years(www.who.int). Enteropathogenic Escherichia coli (EPEC), one of the six E. coli diarrheagenic pathotypes, produces an adherence factor chromosomally encoded by the EPEC attaching and effacing (eae) gene located within the locus for enterocyte effacement (LEE) pathogenicity island (Moon et al, 1983; McDaniel and Kaper, 1997; Nataro and Kaper, 1998; Afset et al, 2004). EPEC induces a distinctive histopathology known as the attaching and effacing (A/E) lesion, which is characterized by the intimate attachment of bacteria to the epithelial surface and effacement of host enterocyte microvilli. There are three stages in EPEC pathogenesis: (i) initial adherence to the host cell, (ii) production and translocation of bacterial proteins through a needle complex via a type III secretory system, and (iii) intimate
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