Prevalence and Drug-Resistance Patterns of Enterotoxigenic <i>Escherichia coli</i> and <i>Shigella</i> Species among Children with Diarrhea in Merida City, Mexico

Abstract

Enterotoxigenic Escherichia coli (ETEC) and Shigella are two of the leading causes of diarrhea among children in developing countries. The prevalence of ETEC and Shigella species resistant to antimicrobial agents is increasing. The aim of this study was to determine prevalence and antimicrobial resistance patterns of ETEC and Shigella species among under-five children with diarrhea in an urban region of southeastern Mexico. A cross-sectional study was conducted among under-five children with acute diarrhea from January 2013 to January 2014 at Merida city. Isolation, identification and antimicrobial susceptibility test of ETEC and Shigella species were performed using standard bacteriological protocols. Of 200 stool samples collected, 18 (9.0%) ETEC and 12 (6.0%) Shigella strains were isolated. Among 12 Shigella species Shigellaflexneri founded as 8 (66.7%), followed by Shigellaboydii 4 (33.3%). One hundred percent of ETEC and Shigella isolates showed resistance to ampicillin, carbenicillin and cephalothin. Also, high frequency of resistance for both ETEC and Shigella isolates was observed to nitrofurantoin (100%, 83.3%), respectively. However, when we analyzed the resistance patterns of Shigella by species, S. boydii showed more resistance (8 of 12 antimicrobials tested) in comparison to S. flexneri isolates. Multidrug resistance (MDR) (≥3 drugs) was observed among all ETEC and Shigella isolates, being the aminoglycosides the more effective drugs against these pathogens. In conclusion, these findings indicate that ETEC and Shigella spp. are important etiological agents of diarrhea among under-five children and a high rate of drug resistance, including MDR, to the commonly used drugs was observed in our region.

Prevalence, antimicrobial resistance pattern, and associated factors of Salmonella and Shigella among under five diarrheic children attending public health facilities in Debre Markos town, Northwest Ethiopia

“…The prevalence of culture-confirmed Shigella species was 8.6% (95% CI: 4.9–12.3%) which is comparable with reports from different areas of Ethiopia; Bahir Dar 9.5% ( 26 ), Addis Ababa 9.1% ( 11 ), Dire Dawa 5.6% ( 13 ), Hawassa 7% ( 12 ), and Hosanna 8.3% ( 17 ). It is also in agreement with studies in different countries; Kenya 7.4% ( 48 ), another study from Kenya 5% ( 38 ), Mexico 6% ( 49 ), and Iran 8.9% ( 43 ). Moreover, it is also in line with a meta-analysis done in Sub-Saharan Africa 9.6% ( 23 ).…”

Construction of the ETECFinder database for the characterization of enterotoxigenic Escherichia coli (ETEC) and revision of the VirulenceFinder web tool at the CGE website

“…The European Food Safety Authority reports that multidrug-resistant E. coli is considered an important hazard to public health. The indication associated with most antimicrobial use is post-weaning diarrhea caused by ETEC ( 5 ), and recent studies show that there is an increase in antibiotic resistance seen in ETEC infecting humans ( 6 – 9 ). The presence of multidrug-resistant pathogenic bacteria, including ETEC, in raw vegetables and minimally processed fresh vegetables, is a significant public health concern ( 10 ).…”

Construction of the ETECFinder database for the characterisation of enterotoxigenicEscherichia coli(ETEC) and revision of theVirulenceFinderwebtool at the CGE website

“…The European Food Safety Authority (EFSA) reports that multidrug-resistant (MDR) E. coli is considered an important hazard to public health. The indication associated with most antimicrobial use is post-weaning diarrhea (PWD) caused by ETEC (5) and recent studies show that there is an increase in antibiotic resistance seen in ETEC infecting humans (6)(7)(8)(9). The presence of multidrugresistant pathogenic bacteria, including ETEC, in raw vegetables and minimally-processed fresh vegetables, is a significant public health concern (10).…”