Abstract
BackgroundDiarrhoea, affecting children in developing countries, is mainly caused by diarrheagenic Escherichia coli (DEC). This study principally aimed to determine the prevalence of DEC pathotypes and Extended-spectrum β-lactamase (ESBL) genes isolated from children under 5 years old with diarrhea.MethodsA total of 320 diarrhoea stool samples were investigated. E. coli isolates were investigated for genes specific for enterotoxigenic E. coli (ETEC), enteropathogenic E. coli (EPEC), enteroaggregative E. coli (EAEC), enteroinvasive E. coli (EIEC) and enterohemorrhagic E. coli (EHEC) using polymerase chain reaction (PCR). Furthermore, antimicrobial susceptibility testing, detection of antibiotic resistance-genes and phylogenetic typing were performed.ResultsOver all, DEC were isolated from 66/320 (20.6%) of the children with diarrhoea. EAEC was the predominant (47%), followed by typical EPEC (28.8%) and atypical EPEC (16.6%). Co-infection by EPEC and EAEC was detected in (7.6%) of isolates. However, ETEC, EIEC and EHEC were not detected. Phylogroup A (47%) and B2 (43.9%) were the predominant types. Multidrug-resistance (MDR) was found in 55% of DEC isolates. Extended-spectrum β-lactamase (ESBL) genes were detected in 24 isolates (24 blaTEM and 15 blaCTX-M-15). Only one isolate harbored AmpC β-lactamase gene (DHA gene).ConclusionThe study concluded that, EAEC and EPEC are important causative agents of diarrhoea in children under 5 years. MDR among DEC has the potential to be a big concern.
Highlights
Diarrhoea, affecting children in developing countries, is mainly caused by diarrheagenic Escherichia coli (DEC)
The detected pathotypes in Diarrheagenic Escherichia coli (DEC) strains In the current study, 31/66 (47%) of isolates were identified as enteroaggregative E. coli (EAEC), 19/66 (28.8%) of isolates were identified as typical EPEC (tEPEC) and 11/66 (16.6%) of isolates were identified as atypical enteropathogenic E. coli (EPEC) (aEPEC)
enterohemorrhagic E. coli (EHEC), enterotoxigenic E. coli (ETEC) and enteroinvasive E. coli (EIEC) were not detected in the study isolates (Fig. 1)
Summary
Diarrhoea, affecting children in developing countries, is mainly caused by diarrheagenic Escherichia coli (DEC). This study principally aimed to determine the prevalence of DEC pathotypes and Extended-spectrum βlactamase (ESBL) genes isolated from children under 5 years old with diarrhea. Diarrheagenic Escherichia coli (DEC) is a very important cause of pediatric diarrhoea [2], in developing countries, where these organisms are the main cause of diarrhoea affecting children under 5 years old [3]. The EAEC, which is an emerging cause of diarrhoea in adults and children worldwide [7], can be determined by the plasmid-encoded gene probe pCVD432 which explain the aggregative phenotype [8]. The present study aimed to determine the prevalence, phylogenetic types and resistance patterns of DEC pathotypes among children under 5 years old with acute diarrhoea in Minia, South Egypt
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