Document Type : New and original researches in the field of Microbiology.
Authors
1
Medical microbiology and immunology Department, faculty of medicine, Mansoura University, Egypt
2
Pediatric Gastroenterology and Hepatology Unit, Mansoura University Children's Hospital, Mansoura
3
Clinical Pathology Department, Faculty of Medicine, Mansoura University, Egypt
4
Clinical Pathology Department, Faculty of Medicine, Assuit University, Egypt
5
Clinical Pathology Department, Faculty of Medicine, Mansoura University, Egyp
Abstract
Background: Pathogenic Escherichia coli (E. coli) represents an important etiology of acute gastroenteritis in children. Among the pathogenic E.coli, enteropathogenic E.coli (EPEC) is associated with acute gastroenteritis in children. Objectives: The present study aims to detect the presence of t typical EPEC and atypical EPEC in children with community acquired diarrhea in age ≤ 5 years old by polymerase chain reaction for eae, bfp, Stx genes Also, to determine the presence of ESBL by phenotypic method and by polymerase chain reaction for TEM, PER, CTX-M genes. Methodology: The isolated E.coli were subjected to antimicrobial susceptibility test by the disc diffusion method according to clinical laboratory standard guidelines (CLSI) . E.coli with resistance to cefotaxime were examined for the presence of ESBL by the double discs method. Polymerase Chain Reaction was done to detect EPEC; eae, bfp, Stx genes and ESBL; TEM, PER, CTX-M genes. Results: A total of 290 isolates of E. coli were isolated from children with community acquired diarrhea, EPEC was identified by the presence of eaeA gene in 115 isolates of E.coli. Typical EPEC with eaeA+, bfp +, stx – genotype profile was detected in 81 (70.4%) of EPEC and atypical EPEC with eaeA+, bfp –, stx – genotype profile was detected in 34 (29.6%) of EPEC isolates. The most frequent detected ESBL genes in EPEC were CTX-M (46.9%) followed by PER (11.3%) and TEM (9.6%.). There was a significant increase in resistance to ampicillin, cefuroxime, cefotaxime, ciprofloxacin, gentamicin, Trimethoprim/sulfamethoxazole, amikacin in EPEC compared to non EPEC. Moreover, there was a significant increase in ESBL in EPEC (P=0.0001) compared to non EPEC isolates. Conclusion: The current study highlights the presence of EPEC as a common pathogen in children with acute gastroenteritis. The typical EPEC was more common than atypical EPEC genotype. The ESBL was significantly associated with EPEC with the common gene CTX-M. Knowledge of antimicrobial resistance of EPEC and other diarrheagenic E.coli is important in selecting the appropriate therapy in serious diarrheagenic Escherichia coli infections and performing local antimicrobial guidelines.
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