Enteroaggregative Escherichia coli in diarrheic children in Egypt: molecular characterization and antimicrobial susceptibility

  • Mostafa Mohamed M Ali Faculty of Science, Cairo University, Egypt
  • Salwa Fouad Ahmed Clinical Trials Program, NAMRU-3, Cairo, Egypt
  • John D Klena Clinical Trials Program, NAMRU-3, Cairo, Egypt
  • Zienat Kamel Mohamed Faculty of Science, Cairo University, Egypt
  • Tarek AA Moussa Faculty of Science, Cairo University, Egypt
  • Khalifa Sifaw Ghenghesh Faculty of Medicine, University of Tripoli, Tripoli, Libya
Keywords: Enteroaggregative Escherichia coli, Virulence genes, Phylogenetic grouping, Antibiotic susceptibility, Diarrhea, Children, Egypt

Abstract

Introduction: Little information is available regarding the significance of enteroaggregative Escherichia coli (EAEC) in pediatric diarrhea in Egypt.

Methodology: Escherichia coli was isolated from stool samples of 62 diarrheic and 43 non-diarrheic (control) Egyptian children. Samples were screened for genes specific for enteroaggregative E. coli (EAEC), enteropathogenic E. coli (EPEC), enterotoxigenic E. coli (ETEC), Shiga toxin-producing E. coli (STEC), and enteroinvasive E. coli (EIEC) using polymerase chain reaction (PCR). Diarrheagenic E. coli were grouped phylogenetically using PCR and tested for their susceptibility to antibiotics using the disk diffusion method. Isolates designated as EAEC were examined for eight virulence factors (VFs) using PCR.

Results: EAEC was detected in 19 (30.7%) and 4 (9.3%), EPEC in 2 (3.2%) and 1 (2.3%), and ETEC in 2 (3.2%) and 0 (0.0%) diarrheic and control children, respectively; STEC and EIEC were not detected. Only EAEC was significantly isolated from diarrheic children compared with controls (p < 0.01, OR = 4.31).Three or more VFs (multivirulent isolates) were found in 52.6% and 50% of EAEC isolated from diarrheic children and controls, respectively. More than 73% (17/23) of EAEC isolates were identified as belonging to phylogenetic group D. Multiple-antibiotic resistance (resistance to three or more drugs) was observed in more than 91% of EAEC.

Conclusions: Multivirulent EAEC is a significant causative agent of pediatric diarrhea in Egypt, with the majority of isolated EAEC belong to phylogenetic group D. Multiple-antibiotic resistance among EAEC has the potential to be a serious public health problem for the country.

Published
2014-05-14
How to Cite
1.
Ali MMM, Ahmed SF, Klena JD, Mohamed ZK, Moussa TA, Ghenghesh KS (2014) Enteroaggregative Escherichia coli in diarrheic children in Egypt: molecular characterization and antimicrobial susceptibility. J Infect Dev Ctries 8:589-596. doi: 10.3855/jidc.4077
Section
Original Articles