The frequency of virulent genes and antimicrobial resistance patterns of diarrheagenic Escherichia coli isolated from stools of children presenting with diarrhea in a tertiary hospital in Abakaliki, Nigeria

Ebuka Elijah David,Doris Olachi Obasi,Ikechuku Okorie Igwenyi,Chidinma Nnenne David,Uket Nta Obeten,Muhammad Arfat Yameen,Arthur Chinedu Okafor,Uchenna Regina Ezeilo

doi:10.14202/ijoh.2020.147-152

Abstract

Aim: This study was aimed to determine the virulent genes and antibiotic resistance patterns among circulating diarrheagenic Escherichia coli (DEC) pathotypes in a tertiary care health center in east of Nigeria. Materials and Methods: Diarrheal stool samples were obtained from 80 children under 5 years and E. coli was isolated and identified using standard biochemical and molecular methods. Multiplex polymerase chain reaction (PCR) was used to detect eight virulent genes of DEC. Disk diffusion method was used to determine the antibiotic susceptibility of DEC. Results: DEC infection was observed in 54 (68%) children among which ial gene for enteroinvasive E. coli (EIEC) (40% [n=22]) was commonly detected followed by eltA/eltB for enterotoxigenic E. coli (ETEC) (30% [n=16]), pCVD for enteroaggregative E. coli (EAEC) (20% [n=11]), and eaeA/bfpA for typical enteropathogenic E. coli (EPEC) (10% [n=5]). The DEC isolates phenotypically exhibited resistance for ampicillin (AMP) (44 [81%]), followed by ciprofloxacin (CIP)/ levofloxacin (LEV) (28 [52%]), cefoxitin (FOX) (11 [20%]), and amoxicillin-clavulanic acid (AMC) (6 [11%]). About 60% isolates of stable toxins-ETEC were resistant to AMC, CIP, and LEV while all the labile toxin-ETEC exhibited resistance to AMP. About 60% (n=6) resistance were seen in EAEC against ampicillin, AMC, FOX, CIP, and LEV. In EIEC, all the isolates (n=22) were resistant to AMP while 50% (n=11) were resistant to both CIP and LEV. All EPEC (n=5) were resistant to AMP, FOX, CIP, and LEV. Conclusion: High frequency of virulent ial and eltA/eltB genes for EIEC and ETEC, respectively, suggests that they are the primary etiological agents of diarrhea in children among DEC pathotypes. Resistance of DEC to more than two classes of antibiotics indicate possible emergence of multidrug resistance.

Highlights

Escherichia coli are Gram-negative, oxidase-negative, rod-shaped bacteria from the family Enterobacteriaceae [1]
About 60% isolates of stable toxins-enterotoxigenic E. coli (ETEC) were resistant to AMC, CIP, and LEV while all the labile toxin-ETEC exhibited resistance to AMP
The aim of this study was to investigate the frequency of virulent genes and antimicrobial resistance patterns of diarrheagenic Escherichia coli (DEC) isolated from stools of children presenting with diarrhea in Alex Ekwueme Federal Teaching Hospital, Abakaliki (AE-FETHA), Ebonyi State, Nigeria

Summary

Introduction

Escherichia coli are Gram-negative, oxidase-negative, rod-shaped bacteria from the family Enterobacteriaceae [1]. E. coli are commensal bacteria found in the intestinal microflora of a variety of animals, including man. Extraintestinal pathogenic E. coli (ExPEC) causing a variety of infections, including urinary tract infections, meningitis, and septicemia [3,4]. InPEC strains of E. coli, known as diarrheagenic E. coli (DEC), are a major etiological agent of pediatric diarrhea, accounting for over 2 million deaths annually [5]. Infection with DEC causes an alteration of the movement of ions and water in the gastrointestinal tract by altering the balance between fluid-electrolyte absorption

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