Diarrhoeagenic Escherichia Coli Isolated from Children with Acute Diarrhoea by Culture and Multiplex PCR in Tertiary Care Hospitals of Dhaka, Bangladesh

Abstract

Background: Diarrhoeal diseases are a major childhood health problem and an important cause of morbidity and mortality, especially in developing countries. 

Objective: This study aimed to detect Diarrhoeagenic Escherichia coli (DEC) by detecting virulence genes (lt, st, bfp, and aat) and to determine the antimicrobial susceptibility pattern of all identified DEC isolates in fecal samples.

Methodology: This cross-sectional study was carried out in the Department of Microbiology at Dhaka Medical College Hospital, Dhaka, Bangladesh and Dhaka Shishu Hospital, Dhaka, Bangladesh from July, 2012 to June, 2013 for around one year. Identification of Diarrhoeagenic Escherichia coli (DEC) in fecal samples from children under 5 years old was done by culture and standard biochemical tests. Virulence factor genes for DEC were detected by Polymerase Chain Reaction (PCR). Susceptibility to antimicrobial agents of all identified DEC isolates was observed by disc diffusion method.

Results: Out of total 200 stool samples, E. coli was isolated in 130(65.0%). The prevalence of DEC was 52(40.0%) and the most common was enterotoxigenic Escherichia coli (55.8%) followed by enteropathogenic Escherichia coli (34.6%) and enteroaggregative Escherichia coli (26.9%). Among 52 DEC, 12(23.1%) contained more than one pathogenic genes of DEC in various combinations. Colistin, imipenem and amikacin were found to be the most effective against isolated DEC. Most of the strains were resistant to ampicillin, erythromycin, tetracycline and nalidixic acid.

Conclusion: Differentiation between the Diarrhoeagenic Escherichia coli pathotypes is of great importance since they are involved in acute diarrhoeal diseases and may require specific antimicrobial chemotherapy.

Bangladesh Journal of Medical Microbiology, January 2024;18(1):17-21