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Jahantigh M, Seyedzayi N. Dominant EAEC and Widespread Antibiotic Resistance among Diarrheagenic Escherichia coli in Children with Acute Diarrhea in Zahedan, Iran. JoMMID 2024; 12 (1) :59-66
URL: http://jommid.pasteur.ac.ir/article-1-545-en.html
Dominant EAEC and Widespread Antibiotic Resistance among Diarrheagenic Escherichia coli in Children with Acute Diarrhea in Zahedan, Iran
Mojdeh Jahantigh * , Nasrin Seyedzayi
Infectious Diseases and Tropical Medicine Research Center, Research Institute of Cellular and Molecular Sciences in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran
Abstract:   (721 Views)
Introduction: Diarrheal disease is a major cause of morbidity and mortality among children under the age of 10 worldwide, particularly in low- and middle-income countries. Diarrheagenic Escherichia coli (DEC) is a common cause of gastroenteritis in children. This study investigated the frequency, virulence markers, and antibiotic resistance patterns of DEC in children below 10 years with acute diarrhea in Zahedan, Iran. Methods: In this cross-sectional study, 300 E. coli isolates were collected from stool samples of children aged below 10 years with diarrhea who presented to hospitals and clinical laboratories in Zahedan. DEC pathotypes were identified using multiplex PCR and confirmed by standard biochemical tests and polyvalent antisera. Results: Of the 300 E. coli isolates examined, 89 (29.6%) were identified as diarrheagenic E. coli (DEC) using polyvalent antisera targeting known DEC pathotypes. Enteroaggregative E. coli (EAEC) was identified in 31 isolates (34.83%) based on reaction with antiserum No. 1. Enterotoxigenic E. coli (ETEC) was identified in 35 isolates (39.33%) based on reaction with antiserum No. 2. Enteropathogenic E. coli (EPEC) was identified in 23 isolates (25.84%) based on reaction with antiserum No. 3 (anti-coli3). Multiplex PCR identified the most common pathotype as EAEC (37.6%), followed by EPEC (21.7%), ETEC (15.9%), and EIEC (11.5%). Statistical analysis revealed no significant correlation between the presence of specific virulence genes (e.g., eae, pcvd432, elt, est, and iaH) and antibiotic resistance patterns in the DEC isolates. Conclusion: Given the distribution of DEC pathotypes among children in Zahedan and their increased antibiotic resistance, antibiotic treatment should be guided by molecular typing and antimicrobial susceptibility testing of isolates, when appropriate.
Keywords: Diarrheagenic E. coli (DEC), Antibiotic resistance, Enteroaggregative E. coli (EAEC), Children, Zahedan, Multiplex PCR
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Type of Study: Original article | Subject: Epidemiologic studies including microbial genotyping, phenotyping and serotyping
Received: 2023/05/8 | Accepted: 2024/05/21 | Published: 2024/06/8
References
1. Jafari A, Aslani M, Bouzari S. Escherichia coli: a brief review of diarrheagenic pathotypes and their role in diarrheal diseases in Iran. Iran J Microbiol. 2012; 4 (3): 102-17.
2. Schultsz C, Van den Ende J, Cobelens F, Vervoort T, Van Gompel A, Wetsteyn J, et al. Diarrheagenic Escherichia coli and acute and persistent diarrhea in returned travelers. J Clin Microbiol. 2000; 38 (10): 3550-4. [DOI:10.1128/JCM.38.10.3550-3554.2000] [PMID] []
3. Bueris V, Sircili MP, Taddei CR, Santos MFd, Franzolin MR, Martinez MB, et al. Detection of diarrheagenic Escherichia coli from children with and without diarrhea in Salvador, Bahia, Brazil. Mem Inst Oswaldo Cruz. 2007; 102 (7): 839-44. [DOI:10.1590/S0074-02762007005000116] [PMID]
4. Omolajaiye S, Afolabi K, Iweriebor B. Pathotyping and antibiotic resistance profiling of Escherichia coli isolates from children with acute diarrhea in amatole district municipality of Eastern Cape, South Africa. Biomed Res Int. 2020; 4250165. [DOI:10.1155/2020/4250165] [PMID] []
5. Podewils LJ, Mintz ED, Nataro JP, Parashar UD. Acute infectious diarrhea among children in developing countries. Semin Pediatr Infect Dis. 2004; 15 (4): 155-68. [DOI:10.1053/j.spid.2004.05.008] [PMID] []
6. Hien BTT, Scheutz F, Cam PD, Serichantalergs O, Huong TT, Thu TM, et al. Diarrheagenic Escherichia coli and Shigella strains isolated from children in a hospital case-control study in Hanoi, Vietnam. J Clin Microbiol. 2008; 46 (3): 996-1004. [DOI:10.1128/JCM.01219-07] [PMID] []
7. Zamanzad B, Validi M, Kheiri S, Maghsoudi R. The prevalence and antibacterial susceptibility pattern of Enteropathogenic Escherichia coli (EPEC) strains isolated from less than 5 years old children with diarrheal hospitalized in Shahrekord Hajar hospital-2007. J Shahrekord Univ Med Sci. 2010; 11 (4): 11-8.
8. Altwegg M, Perschil I, Gruner E. Molecular biology detection and antibiotic sensitivities of Shigella spp. and entero-invasive Escherichia coli (EIEC) in patients returning from the tropics. Praxis. 1997; 86 (9): 348-51.
9. Stypułkowska-Misiurewicz H, Augustynowicz E, Andziak J, Kałuzewski S. Susceptibility to vibriostatic factor 0/129 of Shigella, Salmonella and entero-invasive Escherichia coli (EIEC). Med Dosw Mikrobiol. 1994; 46 (4): 277-83.
10. Gomes TA, Elias WP, Scaletsky IC, Guth BE, Rodrigues JF, Piazza RM, et al. Diarrheagenic Escherichia coli. Braz J Microbiol. 2016; 47 Suppl 1(Suppl 1): 3-30. [DOI:10.1016/j.bjm.2016.10.015] [PMID] []
11. Mansour Amin MS, Javaherizadeh H, Motamedifar M, Saki M, Veisi H, Ebrahimi S, et al. Antibiotic resistance pattern and molecular characterization of extended-spectrum β-lactamase producing enteroaggregative Escherichia coli isolates in children from southwest Iran. Infect Drug Resist. 2018; 11: 1097-1104. [DOI:10.2147/IDR.S167271] [PMID] []
12. Vallance B, Finlay B. Exploitation of host cells by enteropathogenic Escherichia coli. Proc Natl Acad Sci U S A. 2000; 97 (16): 8799-806. [DOI:10.1073/pnas.97.16.8799] [PMID] []
13. Thapar N, Sanderson IR. Diarrhoea in children: an interface between developing and developed countries. Lancet. 2004; 363 (9409): 641-53. [DOI:10.1016/S0140-6736(04)15599-2] [PMID]
14. Kumarasinghe G, Lim Y, Chow C, Bassett D. Prevalence of bacterial agents of diarrhoeal disease at the National University Hospital, Singapore and their resistance to antimicrobial agents. Trop Geogr Med. 1992; 44 (3): 229-32.
15. Byrne C, Erol I, Call J, Kaspar C, Buege D, Hiemke C, et al. Characterization of Escherichia coli O157: H7 from downer and healthy dairy cattle in the upper Midwest region of the United States. Appl Environ Microbiol. 2003; 69 (8): 4683-8. [DOI:10.1128/AEM.69.8.4683-4688.2003] [PMID] []
16. Zarringhalam M, Nahaei MR, Angouti G, Safaeyan F. Detection of Escherishia coli pathotypes and their antibiotic resistance in cases of diarrhea in hospitals of Tabriz in 2013. Res Med. 2015; 38 (4): 233-8.
17. Kaper JB, Nataro JP, Mobley HL. Pathogenic Escherichia coli. Nat Rev Microbiol. 2004; 2 (2): 123-40. [DOI:10.1038/nrmicro818] [PMID]
18. Zahedani SS, Tahmasebi H, Jahantigh M. Coexistence of Virulence Factors and Efflux Pump Genes in Clinical Isolates of Pseudomonas aeruginosa: Analysis of Biofilm-Forming Strains from Iran. Int J Microbiol. 2021; 5557361. [DOI:10.1155/2021/5557361] [PMID] []
19. Yang J-R, Wu F-T, Tsai J-L, Mu J-J, Lin L-F, Chen K-L, et al. Comparison between O serotyping method and multiplex real-time PCR to identify diarrheagenic Escherichia coli in Taiwan. J Clin Microbiol. 2007; 45 (11): 3620-5. [DOI:10.1128/JCM.00596-07] [PMID] []
20. Dobrindt U. (Patho-)genomics of Escherichia coli. Int J Med Microbiol. 2005; 295 (6-7): 357-71. [DOI:10.1016/j.ijmm.2005.07.009] [PMID]
21. López-Saucedo C, Cerna JF, Villegas-Sepulveda N, Thompson R, Velazquez FR, Torres J, et al. Single multiplex polymerase chain reaction to detect diverse loci associated with diarrheagenic Escherichia coli. Emerg Infect Dis. 2003; 9 (1): 127-31. [DOI:10.3201/eid0901.010507] [PMID] []
22. Alikhani MY, Hashemi SH, Aslani MM, Farajnia S. Prevalence and antibiotic resistance patterns of diarrheagenic Escherichia coli isolated from adolescents and adults in Hamedan, Western Iran. Iran J Microbiol. 2013; 5 (1): 42-7.
23. Churgay CA, Aftab Z. Gastroenteritis in children: Part II. Prevention and management. Am Fam Physician. 2012; 85 (11): 1066-70.
24. O'Ryan M, Prado V, Pickering LK. A millennium update on pediatric diarrheal illness in the developing world. Semin Pediatr Infect Dis; 2005: 16 (2): 125-36. [DOI:10.1053/j.spid.2005.12.008] [PMID]
25. Feizizadeh S, Salehi-Abargouei A, Akbari V. Efficacy and safety of Saccharomyces boulardii for acute diarrhea. Pediatrics. 2014; 134 (1): e176-e91. [DOI:10.1542/peds.2013-3950] [PMID]
26. Jones ME, Karlowsky JA, Draghi DC, Thornsberry C, Sahm DF, Nathwani D. Epidemiology and antibiotic susceptibility of bacteria causing skin and soft tissue infections in the USA and
27. Europe: a guide to appropriate antimicrobial therapy. Int J Antimicrob Agents. 2003; 22 (4): 406-19. [DOI:10.1016/S0924-8579(03)00154-7] [PMID]
28. Aslani MM, Ahrabi S-A, Alikhani YM, Jafari F, Zali RM, Mani M. Molecular detection and antimicrobial resistance of diarrheagenic Escherichia coli strains isolated from diarrheal cases. Saudi Med J. 2008; 29 (3): 388-92.
29. Chopra I, Roberts M. Tetracycline antibiotics: mode of action, applications, molecular biology, and epidemiology of bacterial resistance. Microbiol Mol Biol Rev. 2001; 65 (2): 232-60. [DOI:10.1128/MMBR.65.2.232-260.2001] [PMID] []
30. Nahayi M SN, Beygoli N. Genotyping and Antibiotic Susceptibility Patterns of Pseudomonas aeruginosa Isolated from Burn Ward of Sina Hospital in Tabriz. Med J Tabriz Uni Med Sciences. 2017; 38 (6): 74-83.
31. Albert MJ, Faruque S, Faruque A, Neogi P, Ansaruzzaman M, Bhuiyan N, et al. Controlled study of Escherichia coli diarrheal infections in Bangladeshi children. J Clin Microbiol. 1995; 33 (4): 973-7. [DOI:10.1128/jcm.33.4.973-977.1995] [PMID] []
32. Haghi F, Zeighami H, Hajiahmadi F, Khoshvaght H, Bayat M. Frequency and antimicrobial resistance of diarrhoeagenic Escherichia coli from young children in Iran. J Med Microbiol. 2014; 63 (3): 427-32. [DOI:10.1099/jmm.0.064600-0] [PMID]
33. Arif SK, Salih LI. Identification of different categories of diarrheagenic Escherichia coli in stool samples by using multiplex PCR technique. Asian J Me Sci. 2010; 2 (5): 237-43.
34. Shahraki Zahedani S, Jahantigh M, Amini Y. Determining a pattern for antibiotic resistance in clinical isolations of Pseudomonas aeruginosa. Tehran Univ Med J. 2018; 76 (8): 517-22.
35. Zelelie TZ, Eguale T, Yitayew B, Abeje D, Alemu A, Seman A, et al. Molecular epidemiology and antimicrobial susceptibility of diarrheagenic Escherichia coli isolated from children under age five with and without diarrhea in Central Ethiopia. PloS One. 2023; 18 (7): e0288517. [DOI:10.1371/journal.pone.0288517] [PMID] []
36. Belete MA, Demlie TB, Chekole WS, Sisay Tessema T. Molecular identification of diarrheagenic Escherichia coli pathotypes and their antibiotic resistance patterns among diarrheic children and in contact calves in Bahir Dar city, Northwest Ethiopia. PloS One. 2022; 17 (9): e0275229. [DOI:10.1371/journal.pone.0275229] [PMID] []
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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.