Detection of Diarrheagenic E. Coli Among Children Under ‎‏5‏‎ Year’s Age in Tikrit City of Iraq by Using Single Multiplex PCR ‎technique

Abstract

A variety of diarrheagenic E coli (DEC) are responsible for causing diarrhea in children under five years age especially in developing courtiers. The aim of this study was to isolate and bacteriological characterizing of DEC from diarrheic children's stool and using molecular identification of DEC pathotypes for better discrimination and investigate their antibiotic resistance patterns. Total of 200 fresh stools specimens were collected from children with diarrhea in Salah Aldin Hospital in Tikrit city, Iraq. The samples were cultured on selective media such as (MacConkey and EMB). Colonies were identified through biochemical reaction and api 20E system and then antibiotic susceptibility profiles were determined. E. coli were isolated and characterized from 200 diarrheagenic stool positive samples, collected from hospitalized children less than 5 years old. A total of 75(40.5%) samples were yielded positive for growth of E. coli Out of these, 46 genotypically-identified DEC were then subjected to multiplex PCR assay targeting certain virulence factors ( SHIG, bfpA, eae, LT, ST, EA, vt1, vt2, daaE, uidA ) for discrimination of pathotyes. 21/46(45.7%) EPEC with 18 atypical and 3 typical, 11/46(24%) ETEC, 3/46 /(6.5%) EAEC, 2/46 (4.3%) for EIEC was detected, 2/46(4.3%) EHEC was also detected, while no DAEC was detected, Also mix pathotypes were detected, more than one pathotype was observed in a number of samples 7/46(15.2%), 5 (aEPEC + ETEC), 2 (aEPEC + EAEC). Moreover, all pathotypes expressed high resistant to Cefotaxime, ampicillin, Piperacillin, Azitromycin, Amikacin. while little resistance to Imipenem, Meropenem, Ciprofloxacin, Norfloxacin was observed. The study concludes EPEC is the dominant pathotype between DEC pathotypes in our society that causes diarrhea in children, and emphasizes the importance of using mPCR assay for best discrimination.

Characteristics of Pathogenic Escherichia coli Associated with Diarrhea in Children under Five Years in Northwestern Ethiopia

“…In this study, the proportion of EAEC was found to be 10.3%, which contradicts findings in Nigeria [77], China [78], and Qatar [79]. However, these findings are close to the proportions (3.8%) and (6.5%) reported by Mabika et al [50] in Gabon and Shatub et al [51] in Iraq. The disparity in EAEC prevalence reported in these studies may be due to differences in sample types and geographical areas.…”

“…The proportion of DEC detected in this study was higher than the 20.6% to 36.4% reported from Iran [ 47 ], Kenya [ 48 ], and Egypt [ 49 ]. A similar finding with a higher frequency of pathogenic E. coli was documented in Nigeria [ 46 ], Gabon [ 50 ], Iraq [ 51 ], Guinea Bissau [ 52 ], and Sudan [ 53 ].…”

“…Furthermore, Bonkoungou et al [81] found 1% of STEC strains in human diarrheic stool samples in Ouagadougou, Burkina Faso. We detected 7.7% of EHEC strains, slightly higher than a study by Shatub et al [51] that reported a detection rate of 4.3%. In contrast, Al-Dulaimi et al [82] and Abbasi et al [17] revealed a comparable prevalence of EHEC, with 7.8% and 9.3%, respectively.…”