Introduction: Escherichia coli are frequently isolated from diarrheic children in the Federal Capital Territory Abuja, Nigeria, but their virulent properties are not routinely evaluated. Therefore, the etiology of childhood diarrheal disease attributable to diarrheagenic Escherichia coli (DEC) in Abuja, Nigeria remains unknown. Methodology: Stool specimens from 400 acute diarrheic children between 0 and 60 months of age were studied.E. coli strains isolated were evaluated by polymerase chain reaction (PCR) for nine virulence genes and HEp-2 cell adherence to detect and identify five distinct diarrheagenic E. coli categories. Results: Diarrheagenic E.coli was detected in 51 (12.8%) of the diarrheic children. The observed DEC pathotypes were enteropathogenic E. coli (EPEC) in 18 (4.5%) children, enterotoxigenic E. coli (ETEC) in 16 (4.0%), enteroaggrative E. coli (EAEC) in 8 (2.0%), enterohaemorrhagic E. coli (EHEC) in 6 (1.5%), and enteroinvasive E. coli (EIEC) in 3 (0.8%). Four (1.0 %) EPEC strains with only the eae+ gene that adhered diffusely to HEp-2 cell were identified as atypical EPEC. All the DEC categories except atypical EPEC were identified in children between 6 and 12 months of age. Conclusions: This study underscores the need for routine evaluation of diarrheic children for virulence properties of infectious DEC. Atypical EPEC are emerging among the DEC pathotypes isolated from childhood acute gastroenteritis in Abuja, Nigeria.
Introduction: Enteropathogenic Escherichia coli (EPEC) causes infectious diarrhea among children in developing countries. However, in Nigeria, due to limited laboratory resources, the genetic diversity of its virulence factors, which include intimin subtypes, remains undefined. Methodology: EPEC isolates from diarrheic children 60 months of age and younger in Abuja, Nigeria, were analyzed. Polymerase chain reaction (PCR) for EPEC virulence gene, Hep-2 cell adherence, and serotyping were performed. EPEC strains were further subtyped by PCR for the identification of intimin subtype genes α (alpha), β (beta), γ1 (gamma-1), and έ (epsilon). Antibiotic resistance and extended-spectrum beta-lactamase (ESBL) production was determined by Clinical and Laboratory Standards Institute guidelines. Results: Overall, 18 (4.5%) out of 400 children with acute diarrhea had EPEC infection. Typical EPEC (tEPEC) strains were detected in 14 (3.5%), whereas 4 (1.1%) were atypical EPEC (aEPEC). A total of 15 (83.3%) of the EPEC isolated belonged to β intimin subtype gene, while the remaining 3 EPEC isolates possessed the intimin έ subtype. No α and γ intimin subtypes were detected. Traditional EPEC serotypes O114:H14 were detected only in tEPEC strains. Marked resistance to β-lactam agents were observed but no ESBL-producing tEPEC or aEPEC was detected. Conclusions: This is the first report of intimin subtype genes in Abuja, Nigeria. EPEC isolates of diverse serotypes resistant to β-lactam antimicrobial agents were observed. These data will be useful in facilitating the characterization of intimin variants of EPEC and some Shiga toxin-producing E. coli (STEC) in humans and other animal species.
Background: Heat-labile (LT) and heat-stable (ST) toxin variants of enterotoxigenic Escherichia coli (ETEC) are enterotoxins associated with diarrhea among children in Abuja, Nigeria. Enterotoxigenic Escherichia coli is also known as a major etiological agent of diarrheal disease among travelers in developing countries. Continuous identification of commonly expressed bacterial components of ETEC can help extend the protective spectra of future candidate ETEC vaccines in Nigeria. Objectives: This study aimed to provide new insights into the distribution patterns of enterotoxins, colonization factor antigens (CFA phenotypes), and serotypes and to determine the antimicrobial susceptibility patterns of ETEC strains from children with acute diarrhea in Abuja, Nigeria. Methods: Escherichia coli strains, isolated from the stool samples of children aged 0 -60 months, were tested via polymerase chain reaction, ganglioside GM1 ELISA assay, hemagglutination assay, HEp-2 cell adherence assay, dot blot technique, and disc diffusion method for antimicrobial resistance. Results: Rnterotoxigenic Escherichia coli was detected in 16 (4.0%) out of 400 children with acute diarrhea. The toxigenic genotypes expressed by ETEC strains included LT toxin gene 6 (37.5%), ST toxin gene 6 (37.5%), and ST/LT gene 4 (25.0%). The CF phenotypes with major expression included CS2 (25.0%), CS3 (12.5%), and CFA1 (6.3%), with a probability value below 0.05 (P < 0.05). However, no CFA/CS was detected in 56.3% of ETEC strains. Multidrug resistance pattern of nalidixic acid-ciprofloxacin-amoxicillin-augmentincephalexin-cefuroxime was observed in 19% of ETEC strains. The most prevalent ETEC serotype was O8: H9 (n, 5). Based on the findings, ETEC infection peaked to 7.2% in July. Conclusion: Although ST and LT toxins seem to have equal distributions in the analyzed population, continuous identification of CFA phenotypes and toxins is necessary for the evaluation of ETEC vaccines in Nigeria.
Introduction: In Nigeria, acute gastroenteritis in children under five years of age is a major cause of mortality and morbidity; identification and characterization of microbial agents of acute gastroenteritis, including Salmonella, remains a powerful tool for effective management, surveillance, and control. Methodology: Diarrheal stool samples were directly plated onto differential and selective media to isolate Salmonella. Extended-spectrum beta-lactamases were screened using the double disk diffusion technique and by PCR targeting the bla TEM and bla CTX-M genes. Pulsed-field gel electrophoresis (PFGE) was performed usingthe PulseNet Canada Laboratory protocol for molecular subtyping using the restriction enzymes XbaI and BlnI. Results: The serotypes identified were Salmonella enterica serovar Zanzibar (n = 5), Salmonella Brancaster (n = 3), and one isolate of Salmonella Enteritidis (phage type 1). The following levels of resistance were found among the Salmonella strains: amoxicillin, five strains (55.6%); amoxicillin-clavulanic acid, two strains (22.2%); cephalexin, five strains (55.6%); and cefuroxime, five strains (55.6%). Intermediate resistance was found in five strains (55.6%) only to amoxicillin-clavulanic acid. All isolates were susceptible to nalidixic acid, ciprofloxacin, and ceftriaxone, and no ESBL-producing Salmonella were detected. Conclusions: Our findings demonstrated the involvement of three Salmonella serovars in acute gastroenteritis; resistance to penicillins and cephalosporins was common.
Background: Empirically, exclusive breastfeeding has proved invaluable in the reduction of mother-to-child transmission of human immunodeficiency virus and infant mortality particularly of children under-five years. Regrettably, breastfeeding practice is not widespread in most resource-poor sub-Saharan countries in Africa including Nigeria. Objective: This study assessed the practice of exclusive breastfeeding of infants for the first-six months of life by HIV-positive mothers after receiving care for prevention of mother-to-child transmission. Methods: Between February 2019 and September 2021, a cross-sectional descriptive study was conducted among 388 HIV-positive mothers receiving care for prevention of mother-to-child transmission of HIV at the Gwarinpa General Hospital in Abuja Municipal Area Council. HIV-positive mothers were enrolled and assessed for their practice of exclusive breastfeeding for the first-six months of the infant life. Structured questionnaires were used to survey for their socio-demographics, reproductive history, HIV and exclusive breastfeeding characteristics. Data were analyzed using Statistical Package for Social Science version SPSS 24. Results: Overall, 68% of the HIV-positive mothers practiced exclusive breastfeeding for the first six months of life. Majority, 83% of the HIV-positive mothers had knowledge of the nutritional benefits of breast milk in the first-six months of infant’s life. In addition, 75% of them are aware that babies exclusively breastfed are healthier than those not so breastfed. Religious beliefs and education status positively influenced exclusive breastfeeding in 82% and 55% of the mothers respectively. However, 69% of HIV-positive mothers attest they had no communal norms and taboos against exclusive breastfeeding. In contrast, mothers’ occupation negatively influenced exclusive breastfeeding in 36% of the studied subjects. Conclusion: This study found a significant increase in the rate of exclusive breastfeeding by HIV-positive mothers. It is evident that the practice of exclusive breastfeeding by HIV-positive mothers is dependent on their level of knowledge and awareness of its benefits in the first-six months of infant’s life.
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