1887

Abstract

Diarrhoea continues to be one of the most common causes of morbidity and mortality among infants and children in developing countries. To investigate the incidence, antimicrobial resistance and genetic relationships of enteropathogenic (EPEC) in children with diarrhoea, a total of 612 stool specimens were collected in Tehran, Iran, and cultured to isolate strains of EPEC. The disc diffusion method was used to determine the susceptibility of the isolates according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. The presence of , and genes was determined by PCR. The genetic relationships between EPEC isolates were determined by pulsed-field gel electrophoresis (PFGE). Out of the 412 strains of obtained from 612 diarrhoeal stool specimens, 23 (5.6 %) were identified as EPEC, of which seven (30.4 %) were classified as typical strains of EPEC and 16 (69.6 %) were classified as atypical. Out of the 23 EPEC isolates, 69.5 % were resistant to ampicillin, 39.1 % were resistant to tetracycline and cotrimoxazole, 30.4 % were resistant to cefpodoxime, ceftazidime, ceftriaxone and aztreonam, and 26.1 % were resistant to imipenem. The isolates were classified into 21 pulsotypes by PFGE profiles. The present study shows that typical and atypical EPEC isolates displayed considerable heterogeneity in PFGE profiles and EPEC infections were only sporadic in Tehran. Overall 69 % of isolates were resistant to at least one of the antibiotics tested.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.046516-0
2013-02-01
2019-10-19
Loading full text...

Full text loading...

/deliver/fulltext/jmm/62/2/191.html?itemId=/content/journal/jmm/10.1099/jmm.0.046516-0&mimeType=html&fmt=ahah

References

  1. Afset J. E. , Bergh K. , Bevanger L. . ( 2003; ). High prevalence of atypical enteropathogenic Escherichia coli (EPEC) in Norwegian children with diarrhoea. . J Med Microbiol 52:, 1015–1019. [CrossRef] [PubMed]
    [Google Scholar]
  2. Al-Gallas N. , Bahri O. , Bouratbeen A. , Ben Haasen A. , Ben Aissa R. . ( 2007; ). Etiology of acute diarrhea in children and adults in Tunis, Tunisia, with emphasis on diarrheagenic Escherichia coli: prevalence, phenotyping, and molecular epidemiology. . Am J Trop Med Hyg 77:, 571–582.[PubMed]
    [Google Scholar]
  3. Albert M. J. , Rotimi V. O. , Dhar R. , Silpikurian S. , Pacsa A. S. , Molla A. M. , Szucs G. . ( 2009; ). Diarrhoeagenic Escherichia coli are not a significant cause of diarrhoea in hospitalised children in Kuwait. . BMC Microbiol 9:, 62. [CrossRef] [PubMed]
    [Google Scholar]
  4. Aligholi M. , Mirsalehian A. , Halimi S. , Imaneini H. , Taherikalani M. , Jabalameli F. , Asadollahi P. , Mohajer B. , Abdollahi A. , Emaneini M. . ( 2011; ). Phenotypic and genotypic evaluation of fluoroquinolone resistance in clinical isolates of Staphylococcus aureus in Tehran. . Med Sci Monit 17:, PH71–PH74.[PubMed] [CrossRef]
    [Google Scholar]
  5. Aranda K. R. , Fabbricotti S. H. , Fagundes-Neto U. , Scaletsky I. C. . ( 2007; ). Single multiplex assay to identify simultaneously enteropathogenic, enteroaggregative, enterotoxigenic, enteroinvasive and Shiga toxin-producing Escherichia coli strains in Brazilian children. . FEMS Microbiol Lett 267:, 145–150. [CrossRef] [PubMed]
    [Google Scholar]
  6. Beutin L. , Kaulfuss S. , Herold S. , Oswald E. , Schmidt H. . ( 2005; ). Genetic analysis of enteropathogenic and enterohemorrhagic Escherichia coli serogroup O103 strains by molecular typing of virulence and housekeeping genes and pulsed-field gel electrophoresis. . J Clin Microbiol 43:, 1552–1563. [CrossRef] [PubMed]
    [Google Scholar]
  7. Blanco M. , Blanco J. E. , Dahbi G. , Mora A. , Alonso M. P. , Varela G. , Gadea M. P. , Schelotto F. , González E. A. , Blanco J. . ( 2006; ). Typing of intimin (eae) genes from enteropathogenic Escherichia coli (EPEC) isolated from children with diarrhoea in Montevideo, Uruguay: identification of two novel intimin variants (μB and ξR/β2B). . J Med Microbiol 55:, 1165–1174. [CrossRef] [PubMed]
    [Google Scholar]
  8. CLSI ( 2011; ). Performance Standards for Antimicrobial Susceptibility Testing. Twenty-fifth Informational Supplement M100–S21. . Wayne, PA: Clinical and Laboratory Standards Institute.
  9. Diniz-Santos D. R. , Silva L. R. , Silva N. . ( 2006; ). Antibiotics for the empirical treatment of acute infectious diarrhea in children. . Braz J Infect Dis 10:, 217–227. [CrossRef] [PubMed]
    [Google Scholar]
  10. Elliott S. J. , Wainwright L. A. , McDaniel T. K. , Jarvis K. G. , Deng Y. K. , Lai L. C. , McNamara B. P. , Donnenberg M. S. , Kaper J. B. . ( 1998; ). The complete sequence of the locus of enterocyte effacement (LEE) from enteropathogenic Escherichia coli E2348/69. . Mol Microbiol 28:, 1–4. [CrossRef] [PubMed]
    [Google Scholar]
  11. Emaneini M. , Khoramrooz S. S. , Taherikalani M. , Jabalameli F. , Aligholi M. . ( 2011; ). Molecular characterization of Staphylococcus aureus isolated from children with adenoid hypertrophy: emergence of new spa types t7685 and t7692. . Int J Pediatr Otorhinolaryngol 75:, 1446–1449. [CrossRef] [PubMed]
    [Google Scholar]
  12. Estrada-García T. , Cerna J. F. , Paheco-Gil L. , Velázquez R. F. , Ochoa T. J. , Torres J. , DuPont H. L. . ( 2005; ). Drug-resistant diarrheogenic Escherichia coli, Mexico. . Emerg Infect Dis 11:, 1306–1308. [CrossRef] [PubMed]
    [Google Scholar]
  13. Hernandes R. T. , Elias W. P. , Vieira M. A. , Gomes T. A. . ( 2009; ). An overview of atypical enteropathogenic Escherichia coli . . FEMS Microbiol Lett 297:, 137–149. [CrossRef] [PubMed]
    [Google Scholar]
  14. Kaper J. B. , Nataro J. P. , Mobley H. L. . ( 2004; ). Pathogenic Escherichia coli . . Nat Rev Microbiol 2:, 123–140. [CrossRef] [PubMed]
    [Google Scholar]
  15. Mahon C. R. , Lehman D. C. , Manuselis G. . ( 2007; ). Text Book of Diagnostic Microbiology, , 3rd edn.. Philadelphia, PA, USA:: Saunders;.
    [Google Scholar]
  16. Moura R. A. , Sircili M. P. , Leomil L. , Matté M. H. , Trabulsi L. R. , Elias W. P. , Irino K. , Pestana de Castro A. F. . ( 2009; ). Clonal relationship among atypical enteropathogenic Escherichia coli strains isolated from different animal species and humans. . Appl Environ Microbiol 75:, 7399–7408. [CrossRef] [PubMed]
    [Google Scholar]
  17. Moyo S. J. , Maselle S. Y. , Matee M. I. , Langeland N. , Mylvaganam H. . ( 2007; ). Identification of diarrheagenic Escherichia coli isolated from infants and children in Dar es Salaam, Tanzania. . BMC Infect Dis 7:, 92. [CrossRef] [PubMed]
    [Google Scholar]
  18. Nguyen T. V. , Le Van P. , Le Huy C. , Gia K. N. , Weintraub A. . ( 2005; ). Detection and characterization of diarrheagenic Escherichia coli from young children in Hanoi, Vietnam. . J Clin Microbiol 43:, 755–760. [CrossRef] [PubMed]
    [Google Scholar]
  19. Nguyen R. N. , Taylor L. S. , Tauschek M. , Robins-Browne R. M. . ( 2006; ). Atypical enteropathogenic Escherichia coli infection and prolonged diarrhea in children. . Emerg Infect Dis 12:, 597–603. [CrossRef] [PubMed]
    [Google Scholar]
  20. Nweze E. I. . ( 2010; ). Aetiology of diarrhoea and virulence properties of diarrhoeagenic Escherichia coli among patients and healthy subjects in southeast Nigeria. . J Health Popul Nutr 28:, 245–252. [CrossRef] [PubMed]
    [Google Scholar]
  21. Ochoa T. J. , Contreras C. A. . ( 2011; ). Enteropathogenic Escherichia coli infection in children. . Curr Opin Infect Dis 24:, 478–483. [CrossRef] [PubMed]
    [Google Scholar]
  22. Ochoa T. J. , Barletta F. , Contreras C. , Mercado E. . ( 2008; ). New insights into the epidemiology of enteropathogenic Escherichia coli infection. . Trans R Soc Trop Med Hyg 102:, 852–856. [CrossRef] [PubMed]
    [Google Scholar]
  23. Pérez C. , Gómez-Duarte O. G. , Arias M. L. . ( 2010; ). Diarrheagenic Escherichia coli in children from Costa Rica. . Am J Trop Med Hyg 83:, 292–297. [CrossRef] [PubMed]
    [Google Scholar]
  24. Putnam S. D. , Riddle M. S. , Wierzba T. F. , Pittner B. T. , Elyazeed R. A. , El-Gendy A. , Rao M. R. , Clemens J. D. , Frenck R. W. . ( 2004; ). Antimicrobial susceptibility trends among Escherichia coli and Shigella spp. isolated from rural Egyptian paediatric populations with diarrhoea between 1995 and 2000. . Clin Microbiol Infect 10:, 804–810. [CrossRef] [PubMed]
    [Google Scholar]
  25. Ratchtrachenchai O. A. , Subpasu S. , Hayashi H. , Ba-Thein W. . ( 2004; ). Prevalence of childhood diarrhoea-associated Escherichia coli in Thailand. . J Med Microbiol 53:, 237–243. [CrossRef] [PubMed]
    [Google Scholar]
  26. Robins-Browne R. M. , Bordun A. M. , Tauschek M. , Bennett-Wood V. R. , Russell J. , Oppedisano F. , Lister N. A. , Bettelheim K. A. , Fairley C. K. . & other authors ( 2004; ). Escherichia coli and community-acquired gastroenteritis, Melbourne, Australia. . Emerg Infect Dis 10:, 1797–1805. [CrossRef] [PubMed]
    [Google Scholar]
  27. Scaletsky I. C. , Souza T. B. , Aranda K. R. , Okeke I. N. . ( 2010; ). Genetic elements associated with antimicrobial resistance in enteropathogenic Escherichia coli (EPEC) from Brazil. . BMC Microbiol 10:, 25. [CrossRef] [PubMed]
    [Google Scholar]
  28. Tenover F. C. , Arbeit R. D. , Goering R. V. , Mickelsen P. A. , Murray B. E. , Persing D. H. , Swaminathan B. . ( 1995; ). Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. . J Clin Microbiol 33:, 2233–2239.[PubMed]
    [Google Scholar]
  29. Toma C. , Lu Y. , Higa N. , Nakasone N. , Chinen I. , Baschkier A. , Rivas M. , Iwanaga M. . ( 2003; ). Multiplex PCR assay for identification of human diarrheagenic Escherichia coli . . J Clin Microbiol 41:, 2669–2671. [CrossRef] [PubMed]
    [Google Scholar]
  30. Trabulsi L. R. , Keller R. , Tardelli Gomes T. A. . ( 2002; ). Typical and atypical enteropathogenic Escherichia coli . . Emerg Infect Dis 8:, 508–513. [CrossRef] [PubMed]
    [Google Scholar]
  31. Vallance B. A. , Finlay B. B. . ( 2000; ). Exploitation of host cells by enteropathogenic Escherichia coli . . Proc Natl Acad Sci U S A 97:, 8799–8806. [CrossRef] [PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.046516-0
Loading
/content/journal/jmm/10.1099/jmm.0.046516-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error