Molecular characterization and drug susceptibility of diarrheagenic Escherichia coli isolates from children under five at a referral hospital in north - Western Kenya.

Abstract

Background: Escherichia coli are well known to be part of the normal intestinal flora. However, some may be pathogenic hence capable of causing diarrhoea commonly in children under five. To understand the pathogenic E. Coli, virulence genes had to be investigated. Antimicrobial resistance was also studied this being a global concern. Objective: To determine the molecular pathotypes of E.coli isolated from diarrheal children and their antibiotic resistance trends to the commonly used antibiotics. Methodology: A descriptive experimental study was conducted using 196 stool samples collected from diarrheal children under five between 1st January to 30th June 2019. E. coli was isolated and Polymerase chain reaction was used to characterize the pathogenic subtypes. Antibiotic resistance was evaluated using the Kirby-Bauer technique. Results: From the 196 samples collected, 79(40%) cases of enteric pathogens were isolated out of which Enteroaggregative E.coli were 27(34.2%), Enterohaemorrhagic E.coli 14(17.7%), Enterotoxigenic E.coli 12(15.2%) while Enteropathogenic E.coli was 6(10%). Virulence genes detected include: Intimin (eae), Shigatoxin (stx), est, elt, AggR, Cvd432, Aspu. All E.coli pathotypes isolated were over 75% resistant to Tetracycline, Augmentin and Cotrimoxazole except EHEC being 100% resistant to Ampicillin. Conclusion: Diarrheagenic E. coli is a key contributor to children below five years. Drug resistance to the isolated bacteria was found to be a challenge.

Background: Escherichia coli are well known to be part of the normal intestinal flora. However, some may be pathogenic hence capable of causing diarrhoea commonly in children under five. To understand the pathogenic E. Coli, virulence genes had to be investigated. Antimicrobial resistance was also studied this being a global concern. Objective: To determine the molecular pathotypes of E.coli isolated from diarrheal children and their antibiotic resistance trends to the commonly used antibiotics. Methodology: A descriptive experimental study was conducted using 196 stool samples collected from diarrheal children under five between 1st January to 30th June 2019. E. coli was isolated and Polymerase chain reaction was used to characterize the pathogenic subtypes. Antibiotic resistance was evaluated using the Kirby-Bauer technique. Results: From the 196 samples collected, 79(40%) cases of enteric pathogens were isolated out of which Enteroaggregative E.coli were 27(34.2%), Enterohaemorrhagic E.coli 14(17.7%), Enterotoxigenic E.coli 12(15.2%) while Enteropathogenic E.coli was 6(10%). Virulence genes detected include: Intimin (eae), Shigatoxin (stx), est, elt, AggR, Cvd432, Aspu. All E.coli pathotypes isolated were over 75% resistant to Tetracycline, Augmentin and Cotrimoxazole except EHEC being 100% resistant to Ampicillin. Conclusion: Diarrheagenic E. coli is a key contributor to children below five years. Drug resistance to the isolated bacteria was found to be a challenge.