1887

Abstract

Enteroaggregative (EAEC) is an important agent of diarrhoeal diseases worldwide. The role of EAEC virulence factors in the clinical outcome of infection is not completely defined. This case–control study investigated the prevalence of EAEC, its virulence genes and the antimicrobial resistance profile of adult patients with and without diarrhoea attending three different hospitals in Zanjan, Iran. A total of 550 individual stool specimens (350 from diarrhoeal patients and 200 from patients without diarrhoea) were collected. One hundred and forty-one EAEC isolates were identified by a HEp-2 cell assay and PCR. EAEC isolates were detected with slightly higher frequency in patients with (27.7 %) than in patients without (22 %) diarrhoea ( ≥ 0.05). The EAEC genes , and were identified more frequently in case patients compared with controls ( ≤ 0.05). Many of the EAEC isolates from the diarrhoeal patients had two or more virulence genes compared with those without diarrhoea ( ≤ 0.05). EAEC isolates exhibited high-level resistance to amoxicillin (82.3 %), co-amoxiclav (78 %), aztreonam (73.8 %), tetracycline (66.6 %) and ceftazidime (63.8 %). In addition, 53.2 % of isolates were resistant to at least three different classes of antimicrobial agents and were considered to be multidrug resistant. These results indicate a high prevalence and heterogeneity of gene profiles of EAEC in diarrhoeal and control patients, and suggest that the presence of and , the number of genes present and the antimicrobial resistance profile may be markers for more-virulent EAEC isolates.

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2015-05-01
2024-12-08
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References

  1. Aslani MM, Alikhani MY, Zavari A, Yousefi R, Zamani AR. 2011; Characterization of enteroaggregative Escherichia coli (EAEC) clinical isolates and their antibiotic resistance pattern. Int J Infect Dis 15:e136–e139 doi: [View Article]
    [Google Scholar]
  2. Azevedo Feitosa Ferro T, Costa Moraes F, Meneses da Silva A, Porcy C, Amorim Soares L, Andrade Monteiro C, Thyara Melo Lobão N, Amazonas Assis de Mello F, Monteiro-Neto V, de Maria Silva Figueirêdo P. 2012; Characterization of virulence factors in enteroaggregative and atypical enteropathogenic Escherichia coli strains isolated from children with diarrhea. Adv Infect Dis 2:135–142 doi: [View Article]
    [Google Scholar]
  3. Betancourt-Sanchez M, Navarro-Garcia F. 2009; Pet secretion, internalization and induction of cell death during infection of epithelial cells by enteroaggregative Escherichia coli . Microbiology 155:2895–2906 doi: [View Article]
    [Google Scholar]
  4. Cennimo D, Abbas A, Huang DB, Chiang T. 2009; The prevalence and virulence characteristics of enteroaggregative Escherichia coli at an urgent-care clinic in the USA: a case-control study. J Med Microbiol 58:403–407 doi: [View Article]
    [Google Scholar]
  5. CLSI 2013 Performance Standards for Antimicrobial Susceptibility Testing 23rd Informational Supplement M100-S23 Wayne, PA: Clinical and Laboratory Standards Institute;
    [Google Scholar]
  6. Dallman TJ, Chattaway MA, Cowley LA, Doumith M, Tewolde R, Wooldridge DJ, Underwood A, Ready D, Wain J, other authors. 2014; An investigation of the diversity of strains of enteroaggregative Escherichia coli isolated from cases associated with a large multi-pathogen foodborne outbreak in the UK. PLoS One 9:e98103 doi: [View Article]
    [Google Scholar]
  7. Donnenberg MS, Nataro JP. 1995; Methods for studying adhesion of diarrheagenic Escherichia coli . Methods Enzymol 253:324–336 doi: [View Article]
    [Google Scholar]
  8. Gündog˘du A, Long YB, Vollmerhausen TL, Katouli M. 2011; Antimicrobial resistance and distribution of sul genes and integron-associated intI genes among uropathogenic Escherichia coli in Queensland, Australia. J Med Microbiol 60:1633–1642 doi: [View Article]
    [Google Scholar]
  9. Haghi F, Zeighami H, Hajiahmadi F, Khoshvaght H, Bayat M. 2014; Frequency and antimicrobial resistance of diarrhoeagenic Escherichia coli from young children in Iran. J Med Microbiol 63:427–432 doi: [View Article]
    [Google Scholar]
  10. Huang DB, Mohamed JA, Nataro JP, DuPont HL, Jiang ZD, Okhuysen PC. 2007; Virulence characteristics and the molecular epidemiology of enteroaggregative Escherichia coli isolates from travellers to developing countries. J Med Microbiol 56:1386–1392 doi: [View Article]
    [Google Scholar]
  11. Jafari A, Aslani MM, Bouzari S. 2013; Enteroaggregative Escherichia coli, a heterogenous, underestimated and under-diagnosed E. coli pathotype in Iran. Gastroenterol Hepatol Bed Bench 6:71–79 .
    [Google Scholar]
  12. Kahali S, Sarkar B, Rajendran K, Khanam J, Yamasaki S, Nandy RK, Bhattacharya SK, Ramamurthy T. 2004; Virulence characteristics and molecular epidemiology of enteroaggregative Escherichia coli isolates from hospitalized diarrheal patients in Kolkata, India. J Clin Microbiol 42:4111–4120 doi: [View Article]
    [Google Scholar]
  13. Mendez Arancibia E, Pitart C, Ruiz J, Marco F, Gascón J, Vila J. 2009; Evolution of antimicrobial resistance in enteroaggregative Escherichia coli and enterotoxigenic Escherichia coli causing traveller's diarrhoea. J Antimicrob Chemother 64:343–347 doi: [View Article]
    [Google Scholar]
  14. Kaur P, Chakraborti A, Asea A. 2010; Enteroaggregative Escherichia coli: an emerging enteric food borne pathogen. Interdisciplinary Perspectives Infect Dise 2010:254159
    [Google Scholar]
  15. Khoshvaght H, Haghi F, Zeighami H. 2014; Extended spectrum betalactamase producing enteroaggregative Escherichia coli from young children in Iran. Gastroenterol Hepatol Bed Bench 7:131–136 .
    [Google Scholar]
  16. Lima IFN, Boisen N, Silva JQ, Havt A, de Carvalho EB, Soares AM, Lima NL, Mota RMS, Nataro JP, other authors. 2013; Prevalence of enteroaggregative Escherichia coli and its virulence-related genes in a case-control study among children from north-eastern Brazil. J Med Microbiol 62:683–693 doi: [View Article]
    [Google Scholar]
  17. Nataro JP, Mai V, Johnson J, Blackwelder WC, Heimer R, Tirrell S, Edberg SC, Braden CR, Morris JG Jr, Hirshon JM. 2006; Diarrheagenic Escherichia coli infection in Baltimore, Maryland, and New Haven, Connecticut. Clin Infect Dis 43:402–407 doi: [View Article]
    [Google Scholar]
  18. Nguyen TV, Le Van P, Le Huy C, Gia KN, Weintraub A. 2005; Detection and characterization of diarrheagenic Escherichia coli from young children in Hanoi, Vietnam. J Clin Microbiol 43:755–760 doi: [View Article]
    [Google Scholar]
  19. Ochoa TJ, Ecker L, Barletta F, Mispireta ML, Gil AI, Contreras C, Molina M, Amemiya I, Verastegui H, other authors. 2009; Age-related susceptibility to infection with diarrheagenic Escherichia coli among infants from periurban areas in Lima, Peru. Clin Infect Dis 49:1694–1702 doi: [View Article]
    [Google Scholar]
  20. Pereira AL, Ferraz LR, Silva RS, Giugliano LG. 2007; Enteroaggregative Escherichia coli virulence markers: positive association with distinct clinical characteristics and segregation into 3 enteropathogenic E. coli serogroups. J Infect Dis 195:366–374 doi: [View Article]
    [Google Scholar]
  21. Regua-Mangia AH, Gomes TAT, Vieira MAM, Irino K, Teixeira LM. 2009; Molecular typing and virulence of enteroaggregative Escherichia coli strains isolated from children with and without diarrhoea in Rio de Janeiro city, Brazil. J Med Microbiol 58:414–422 doi: [View Article]
    [Google Scholar]
  22. Salmanzadeh-Ahrabi S, Habibi E, Jaafari F, Zali MR. 2005; Molecular epidemiology of Escherichia coli diarrhoea in children in Tehran. Ann Trop Paediatr 25:35–39 doi: [View Article]
    [Google Scholar]
  23. Scavia G, Staffolani M, Fisichella S, Striano G, Colletta S, Ferri G, Escher M, Minelli F, Caprioli A. 2008; Enteroaggregative Escherichia coli associated with a foodborne outbreak of gastroenteritis. J Med Microbiol 57:1141–1146 doi: [View Article]
    [Google Scholar]
  24. Tobias J, Vutukuru SR. 2012; Simple and rapid multiplex PCR for identification of the main human diarrheagenic Escherichia coli . Microbiol Res 167:564–570 doi: [View Article]
    [Google Scholar]
  25. Usein CR, Tatu-Chitoiu D, Ciontea S, Condei M, Damian M. 2009; Escherichia coli pathotypes associated with diarrhea in Romanian children younger than 5 years of age. Jpn J Infect Dis 62:289–293 .
    [Google Scholar]
  26. Vilchez S, Reyes D, Paniagua M, Bucardo F, Möllby R, Weintraub A. 2009; Prevalence of diarrhoeagenic Escherichia coli in children from León, Nicaragua. J Med Microbiol 58:630–637 doi: [View Article]
    [Google Scholar]
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