Antimicrobial resistance patterns of diarrheagenic and non-diarrheagenic Escherichia coli isolates from Libyan children (original) (raw)
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International Journal of One Health, 2020
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.
PLOS ONE, 2023
Background Diarrhea is a serious health problem in children, with the highest mortality rate in sub-Saharan Africa. Diarrheagenic Escherichia coli (DEC) is among the major bacterial causes of diarrhea in children under age five. The present study aims to determine molecular epidemiology and antimicrobial resistance profiles of DEC and identify contributing factors for acquisition among children under age five in Central Ethiopia. Methods A health facility-centered cross-sectional study was conducted in Addis Ababa and Debre Berhan, Ethiopia, from December 2020 to August 2021. A total of 476 specimens, 391 from diarrheic and 85 from non-diarrheic children under age five were collected. Bacterial isolation and identification, antimicrobial susceptibility, and pathotype determination using polymerase chain reaction (PCR) were done. Results Of the 476 specimens analyzed, 89.9% (428/476) were positive for E. coli, of which 183 were positive for one or more genes coding DEC pathotypes. The overall prevalence of the DEC pathotype was 38.2% (183/476). The predominant DEC pathotype was enteroaggregative E. coli (EAEC) (41.5%, 76/183), followed by enterotoxigenic E. coli (21.3%, 39/183), enteropathogenic E. coli (15.3%, 28/183), enteroinvasive E. coli (12.6%, 23/183), hybrid strains (7.1%, 13/183), Shiga toxin-producing E. coli (1.6%, 3/183), and diffusely-adherent E. coli (0.6%, 1/183). DEC was detected in 40.7% (159/391) of diarrheic and 28.2% (24/85) in non-diarrheic children (p = 0.020). The majority of the DEC pathotypes were resistant to
Science Journal of University of Zakho, 2020
Background: A variety of diarrheagenic E coli (DEC) are responsible for causing different types of diarrhea in children especially in developing courtiers. Objectives: This study was primarily aimed to isolate and bacteriological characterizing of E coli from diarrheic infant stool and to investigate their antibiotic resistance patterns and then using molecular identification of DEC pathotypes for better discrimination. Methods: Total of 400 fresh stools specimens were collected from children with diarrhea in Heevi Hospital in Duhok city, Iraq. The samples were cultured on selective media such as (MacConkey and MacConkey sorbitol agar). Colonies were identified through biochemical reaction and VITEK 2 system and then antibiotic susceptibility profiles were determined. Results: A total of 349(87.2%) samples were yielded positive for growth of E coli. Out of these, 50 phenotypically-identified E coli were then subjected to PCR assay targeting certain virulence factors (alt, eae, sxt1 ...
Journal of Pure and Applied Microbiology, 2018
Diarrheagenic Escherichia coli still an important pathogen that cause diarrhea which lead to hospital admissions and death specially in children. In order to identify the common pathotypes of E. coli via investigate different virulence genes. A total of 210 stool samples were collected from children under five years presented with diarrhea from different hospitals and private clinics in Wasit province, Iraq, on the other hand, 40 stool samples were collected from healthy children considered as control group. regarding to culture, biochemical tests and API 20E results 100 isolates were supposed to be E. coli. The DNA were extracted to that 100 isolates from diarrheal cases and for 40 isolates of control, concentration of DNA samples were between (50-360 mg/µl) and the purity between (1.8-2). All isolates studied for detectionvirulence gene of five Diarrheagenic Escherichia Coli strains based on using multiplex Polymerase Chain Reaction technique, by amplified 13 primer (eaeA, bfpB, aggR, astA, pic, hly, stx1, stx2, invE, ipaH, elt, estIa, estIb), and showed the distribution of the strains and its susceptibility to antibiotics. The most frequent pathotypes was Enteropathogenic E.coli 19/42 (45.3%)) with 9 typical and 10 atypical, followed by Enteroaggregative E. coli 17/42 (40.5%), Enterotoxigenic E. coli 3/42 (7.1%), Enteroinvasive E. coli 3/42 (7.1%), and 0/42 (0%) in Shigatoxin producing E .coli and no DEC in all control patients. The highest resistance to antibiotics was (95.2%) to Amoxicillin and Ampicillin, respectively, Sulfa-Trimethoprim 92.9%, followed by 85.7% for Tetracycline and Cephalothin, Ceftriaxone 81% and Cefotaxim "clavulanic acid 71.4%. While the lowest resistance was to Chloramphenicol (19 %), Ciprofloxacin (16.7%), Amikacin (7.1%) and no resistance was detected toward Imipenem. We can conclude in this study, multiplex PCR is a swift, and accurate procedure can be used for Diarrheagenic E.coli identification and isolation successfully of strains.
J Infect Dev Ctries 2014; 8(5): 589-596. doi:10.3855/jidc.4077.
Introduction: Little information is available regarding the significance of enteroaggregative Escherichia coli (EAEC) in pediatric diarrhea in Egypt. Methodology: Escherichia coli was isolated from stool samples of 62 diarrheic and 43 non-diarrheic (control) Egyptian children. Samples were screened for genes specific for enteroaggregative E. coli (EAEC), enteropathogenic E. coli (EPEC), enterotoxigenic E. coli (ETEC), Shiga toxin-producing E. coli (STEC), and enteroinvasive E. coli (EIEC) using polymerase chain reaction (PCR). Diarrheagenic E. coli were grouped phylogenetically using PCR and tested for their susceptibility to antibiotics using the disk diffusion method. Isolates designated as EAEC were examined for eight virulence factors (VFs) using PCR. Results: EAEC was detected in 19 (30.7%) and 4 (9.3%), EPEC in 2 (3.2%) and 1 (2.3%), and ETEC in 2 (3.2%) and 0 (0.0%) diarrheic and control children, respectively; STEC and EIEC were not detected. Only EAEC was significantly isolated from diarrheic children compared with controls (p < 0.01, OR = 4.31).Three or more VFs (multivirulent isolates) were found in 52.6% and 50% of EAEC isolated from diarrheic children and controls, respectively. More than 73% (17/23) of EAEC isolates were identified as belonging to phylogenetic group D. Multiple-antibiotic resistance (resistance to three or more drugs) was observed in more than 91% of EAEC. Conclusions: Multivirulent EAEC is a significant causative agent of pediatric diarrhea in Egypt, with the majority of isolated EAEC belong to phylogenetic group D. Multiple-antibiotic resistance among EAEC has the potential to be a serious public health problem for the country.
Journal of Medical Microbiology, 2014
Diarrhoea continues to be one of the most common causes of morbidity and mortality among infants and children in developing countries. Diarrhoeagenic Escherichia coli (DEC) is an emerging agent among pathogens that cause diarrhoea. Between March 2011 and January 2012, a total of 600 stool specimens from children younger than 5 years of age (450 with and 150 without diarrhoea) were investigated for enteroaggregative E. coli (EAEC), enterohaemorrhagic E. coli (EHEC), enteropathogenic E. coli (EPEC) and enterotoxigenic E. coli (ETEC) using PCR. Antimicrobial susceptibility testing was performed following Clinical and Laboratory Standards Institute guidelines. The prevalence of DEC pathotypes was 30.4 % (137 patients) and 12 % (18 patients) in the diarrhoea group and the control group, respectively. The most frequently isolated pathotype in diarrhoeal children was ETEC. This pathotype was detected significantly more often in children with diarrhoea (14.4 %) than in children without diar...
BMC Microbiology, 2020
Background The treatment of Enterobacteriaceae family including diarrheagenic E. coli (DEC) has been increasingly complicated due to the emergence of resistant strains. Here we report on the phenotypic resistance profiles and ESBL genotype and virulence profiles of Enteroaggregative E. coli (EAEC) and Enteropathogenic E. coli (EPEC) isolated from children hospitalized with acute gastroenteritis in Qatar (AGE). Results E. coli were isolated and characterized from 76 diarrheagenic stool positive samples, collected from hospitalized children less than 10 years old. Isolates were tested for antibiotic susceptibility against eighteen clinically relevant antibiotics using E-test method. Conventional PCR was performed to detect genes encoding ESBL and virulence factors. Chi-square test was performed to compare the individual antibiotic resistance between EPEC and EAEC. A significant percentage (73.7%) of isolates were resistant to at least one antibiotic. Overall, high resistance (70%) was...
Medical Laboratory Journal, 2018
Background and Objectives: Diarrheagenic Escherichia coli (DEC) pathotypes are important causes of diarrhea among children in developing countries. The objective of this study was to determine the frequency and antibiotic resistance pattern of DEC pathotypes in children aged less than 10 years. Methods: This cross-sectional study was done on 300 E. coli strains isolated from diarrheic stool samples of children aged less than 10 years who were admitted to hospitals and central laboratory in Zahedan, between July and October 2016. DEC pathotypes were identified by standard biochemical testing and phenotypic testing using polyvalent antiserums. Antibiotic resistant pattern of these strains was evaluated against 11 different antibiotics by the agar disk diffusion method according to the Clinical and Laboratory Standards Institute guidelines. Results: Of the 300 E. coli isolates, 89 (29.6%) were found positive for DEC using polyvalent antiserums. In this study, 35 cases (39.3%) reacted with antiserum 1, 21 cases (25.8%) reacted with the antiserum 2, and 31 cases (34.8%) reacted with antiserum 3. The highest rate of resistance was observed against ampicillin (94.8%), tetracycline (87.2%), and co-trimoxazole (70.5%). In addition, the lowest rate of resistance was related to imipenem (1%) and ciprofloxacin (8.9%). Conclusion: DEC pathotypes are the important causes of diarrhea among children admitted to hospitals of Zahedan. Considering the high rate of antibiotic resistance among these pathotypes in this region, prescription of antibiotics should be based on accurate detection of these strains.
Egyptian Academic Journal of Biological Sciences E. Medical Entomology & Parasitology, 2022
Escherichia coli (E. coli) is one of the most frequent opportunistic pathogens. We aimed to carry out this study on antimicrobial resistance pattern and phylogenetic background of E. coli isolated from children who have diarrhea in different hospitals of the Iraqi Kurdistan region. A total of 200 fecal samples of children (52.5% male and 47.5% female) were included. Stool samples were cultured on selective media to isolate E. coli bacteria. The antibiotic susceptibility testing and molecular characterization of the isolates were carried out. Antimicrobial susceptibility testing was performed by disc diffusion test disc PCR was used to detect five antimicrobial resistance genes coding for β-lactamases (blaTEM, and blaCTX, blaOXA, blaSHV, blaCMY) to study phylogenetic grouping of E. coli. The Escherichia coli were highly resistant to β-lactam antibiotics, and the highest resistance was seen to Cefotaxime (45.4%). According to the phylogenetic grouping of E. coli isolates, group B2 was the dominant group and blaOXAgene (57.5%) was the predominant resistance genes among E. coli isolates. This study demonstrated the clinical concern of E. coli in children. The E. coli are highly resistance to common beta-lactam antibiotics and there are high rates of the resistance genes among E. coli isolates in children. An antibiotic surveillance would be useful continuously control and prevention of infectious diarrhea in children.
Abstract In Thi Qar there are relatively few studies have been done to reveal and classify diarrheagenic Escherichia coli (DEC) strains among children with diarrhea. This study focused genetically at investigating DEC among hospitalized children under 2 years in Thi Qar city. A total of 200 children (Below 12 years) with diarrhea and 75 without diarrhea were their stools investigated using culture on MacConkey and EMB agar, and E. coli isolates were examined for detection of diarrheagenic E. coli types, antimicrobial susceptibility pattern. Virulence genes detected using PCR. A multiplex PCR system method was used to detect a species specific gene for E.coli and ten different virulence genes for detection of five pathogroups of DEC namely enteroaggregative- (EAEC), enteropathogenic- (EPEC), enterotoxigenic- (ETEC), enteroinvasive- (EIEC) and enterohemorghagic- Escherichia coli (EHEC). The study has indicated that diarrheagenic E. coli isolates were found mostly in stools of children with diarrhea. DEC diarrhoeagenic E. coli was significantly detected among diarrheic children (44.8%) compared with control children (16.4%). Of the DEC pathotypes examined, EAEC was found in (64.73%), ETEC in (19.5%), EPEC in (10.5%) and EHEC in (5.27%) of diarrheic. Virulence-gene factors in DEC isolated from children with diarrhea and from controls. The distribution of virulence gene was; pCVD432 93.6%, 87.3%; eaeA 64.2%, 8.5%; bfpA 59.1%, 2.05%; stx1 22.8%, 0.8%; stx2 18.6%, 0%; estA1 heat-stable (ST) 8.14%, 1.3%; estA2-4 heat-stable (ST) 14.6%, 0.2%; eltB heat-labile (LT) 43.1%, 0.4% in DEC and control children respectively. This study revealed high incidence of diarrheagenic E. coli isolates and high prevalence of antimicrobial resistance among normal intestinal E. coli with typical EAEC and typical EPEC predominating. The use of primers for both variants of ST useful to detect the sensitivity for detection of ETEC strains of hospitalized children in Thi Qar. Key words: Diarrheagenic, , Escherichia coli, Virulence genes, Phylogenetic grouping, Antibiotic susceptibility, Thi Qar, DEC, EPEC, EHEC, ETEC, EAEC.