Frequency and antimicrobial resistance of diarrhoeagenic Escherichia coli from young children in Iran

Abstract

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 diarrhoea (5.3 %). EAEC and EPEC were detected with slightly higher frequencies in children with (8 and 4.2 %, respectively) than in children without (4.6 and 2 %, respectively) (P.0.05) diarrhoea. EHEC was only detected in children with diarrhoea (3.8 %). Of the children from the diarrhoea group, 10 % were colonized with more than one DEC pathotype. The DEC isolates exhibited high-level resistance to erythromycin (100 %), azteronam (80.7 %), amoxicillin (74.4 %) and tetracycline (69.3 %), and 86.4 % of isolates were multidrug resistant. In conclusion, ETEC continues to be an important agent associated with diarrhoea in children from Tabriz, Iran.

Frequency and Antibiotic Resistance Pattern of Diarrheagenic Escherichia coli (DEC) Strains Isolated from Children Aged Less Than 10 Years

“…However, in our study, most identified serotypes reacted with antiserum 2. In a study conducted by Haggi et al on children aged less than five years, most isolated were ETEC and resistant to erythromycin and azithromycin but sensitive to imipenem (24). In a similar study on antibiotic resistance pattern in DEC strains, the highest rate of antibiotic resistance was related to ampicillin and co-trimoxazole, while the lowest rate of resistance was observed against ciprofloxacin (25).…”

A Survey of the Epidemiology and Antibiotic Resistance Patterns of Enteropathogens Isolates in an Iranian Hospital

“…and Shigella spp., are the most common bacterial agents of infectious diarrhea in Iran and other developing countries (9). EPEC is among the most common pathogens infecting children under five years of age in developing countries, but the prevalence may vary depending on differences in the study population, age group, diagnostic criteria, and diagnostic tools used (13)(14)(15). Various studies carried out in Iran and abroad have shown a significant association between EPEC and children's diarrhea compared to the controls (16).…”

Characterization of diarrheagenic E. coli causing a diarrheal outbreak in the south of Iran, Summer 2015

“…Diarrheagenic E. coli has been considered as one of the most common causative agents for diarrhea among sporadic cases across the country both in children and adults [13][14][15][16]. To our knowledge this is the first report of diarrheagenic E. coli as a causative agent of gastroenteritis outbreak in Iran.…”