IMPACT AND ANTIBIOTIC RESISTANCE OF DIARRHOEAGENIC ESCHERICHIA COLI FROM FAECAL CARRIERS IN EARLY CHILDHOOD
Abstract
The importance of the children’s faecal diarrhoeagenic E.coli carriers determines the prevalence of antibiotic resistance and the quality of medical care in paediatrics departments. We report the incidence of different categories of diarrhоeagenic E.coli isolated from faecal carriers in early childhood and antibiotic susceptibility. The exams were conducted through routine faecal examinations needed to start kindergarten. E. coli isolates were examined by culturing and real-time PCR analyses for E. coli virulence genes. All isolates of intestinal pathogens were tested for antimicrobial susceptibility by the disk diffusion method and according to EUCAST protocols. A total of 680 faecal samples were obtained, 165 with suspected diarrheagenic E. coli isolates. Only 11.51% of faecal E. coli isolates had virulence genes of various pathotypes. Antimicrobial resistance of diarrheagenic E. coli isolated from young children without diarrhoea showed the highest phenotypic resistance to AK — 12.3% and SXT — 9.7%, CIP — 4.3%, FOX — 2.83 and LEV — 1.58. Simultaneous resistance to more than two antibacterial drugs was not observed. Despite the low rate of diarrheagenic E. coli among young children, the factor for the emergence and spread of epidemics in children’s groups should not be underestimated. Risk groups should be closely and regularly monitored. Monitoring the antibiotic resistance of socially significant infectious agents should be a sustainable strategy for each nation.
References
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Chatterjee A., Keefe C.O., Cuthil S.L., Varman M. Pediatric Escherichia coli infections clinical presentation. Pediatrics: General Medicine. 2019. Medscape. https://emedicine.medscape.com/article/970451-overview.
Knutton S., Shaw R., Phillips A.D. et al. Phenotypic and genetic analysis of diarrhea-associated Escherichia coli isolated from children in the United Kingdom. J Pediatr Gastroenterol Nutr. 2001; 33: 32–40. DOI: 10.1097/00005176-200107000-00006.
Lai C.C., Chen S.Y., Ko W.C., Hsueh P.R. Increased antimicrobial resistance during the COVID-19 pandemic. Int J Antimicrob Agents. 2021; 57(4): 106324. DOI: 10.1016/j.ijantimicag.2021.106324
Msolo L., Iweriebor B.C., Okoh A.I. Antimicrobial resistance profiles of diarrheagenic E. coli (DEC) and Salmonella species recovered from diarrheal patients in selected rural communities of the Amathole District Municipality, Eastern Cape Province, South Africa. Infection and drug resistance. 2020; 13: 4615–26. DOI: 10.2147/IDR.S269219.
Ochoa T.J., Contreras C.A. Enteropathogenic Еscherichia coli infection in children. Curr Opin Infect Dis. 2011; 24(5): 478–83. DOI: 10.1097/QCO.0b013e32834a8b8b.
Ochoa T.J., Ecker L., Barletta F. et al. Age-related susceptibility to infection with diarrheagenic E. coli in infants from peri-urban areas of Lima, Peru. Clin Infect Dis. 2009; 49(11): 1694–1702. DOI: 10.1086/648069.
Polemis M., Mandilara G., Pappa O. et.al. COVID-19 and antimicrobial resistance: data from the Greek electronic system for the surveillance of antimicrobial resistance — WHONET-Greece (January 2018–March 2021). Life. 2021; 11(10): 996. DOI: 10.3390/life11100996.
Souza T.B., Lozer D.M., Kitagawa S.M.S. et al. Curve analysis for identifying real-time multiplex PCR assay and melting diarrheagenic Escherichia coli. J. Clin. Microbiol. 2013; 51(3): 1031. DOI: 10.1128/JCM.02478-12.
Strockbine N.A., Bopp C.A., Fields P.L. et al. Escherichia, Shigella and Salmonella. In Manual of Clinical Microbiology. 2015; 11(1): 686–90. DOI: 10.1128/9781555817381.ch37.
Tanoue T., Umesaki Y., Honda K. Immune responses to gut microbiota-commensals and pathogens. Gut Microbes. 2010; 1(4): 224–33. DOI: 10.4161/gmic.1.4.12613.
Zhang J., Y. Xu, X. Ling et al. Identification of diarrhoeagenic Escherichia coli by a new multiplex PCR assay and capillary electrophoresis. Molecular and Cellular Probes. 2019; 49: 101477. DOI: 10.1016/j.mc.2019.101477.
REFERENCES
Abbasi E., Mondanizadeh M., van Belkum A.E., Ghaznavi-Rad. Multi-drug-resistant diarrheagenic Escherichia coli pathotypes in pediatric patients with gastroenteritis from central Iran. Infect Drug Resist. 2020; 13: 1387–96. DOI: 10.2147/IDR.S247732.
Andonova R., Popov G., Plochev K. Gut Microbiota and Immune Changes in Gastrointestinal Tract — General Characteristics and Changes in Immunodeficiency Patients. Наука. Инфектология и Паразитология. 2019; 1(16): 5–10.
Araujo J.M., Tabarelli G.F., Aranda K.R.S. et al. Typical enteroaggregative and atypical enteropathogenic types of Escherichia coli are the most prevalent diarrhea-associated pathotypes among Brazilian children. J Clin Microbiol. 2007; 45: 3396–9. DOI: 10.1128/JCM.00084-07.
Chatterjee A., Keefe C.O., Cuthil S.L., Varman M. Pediatric Escherichia coli infections clinical presentation. Pediatrics: General Medicine. 2019. Medscape. https://emedicine.medscape.com/article/970451-overview.
Knutton S., Shaw R., Phillips A.D. et al. Phenotypic and genetic analysis of diarrhea-associated Escherichia coli isolated from children in the United Kingdom. J Pediatr Gastroenterol Nutr. 2001; 33: 32–40. DOI: 10.1097/00005176-200107000-00006.
Lai C.C., Chen S.Y., Ko W.C., Hsueh P.R. Increased antimicrobial resistance during the COVID-19 pandemic. Int J Antimicrob Agents. 2021; 57(4): 106324. DOI: 10.1016/j.ijantimicag.2021.106324.
Msolo L., Iweriebor B.C., Okoh A.I. Antimicrobial resistance profiles of diarrheagenic E. coli (DEC) and Salmonella species recovered from diarrheal patients in selected rural communities of the Amathole District Municipality, Eastern Cape Province, South Africa. Infection and drug resistance. 2020; 13: 4615–26. DOI: 10.2147/IDR.S269219.
Ochoa T.J., Contreras C.A. Enteropathogenic Еscherichia coli infection in children. Curr Opin Infect Dis. 2011; 24(5): 478–83. DOI: 10.1097/QCO.0b013e32834a8b8b.
Ochoa T.J., Ecker L., Barletta F. et al. Age-related susceptibility to infection with diarrheagenic E. coli in infants from peri-urban areas of Lima, Peru. Clin Infect Dis. 2009; 49(11): 1694–1702. DOI: 10.1086/648069.
Polemis M., Mandilara G., Pappa O. et.al. COVID-19 and antimicrobial resistance: data from the Greek electronic system for the surveillance of antimicrobial resistance — WHONET-Greece (January 2018–March 2021). Life. 2021; 11(10): 996. DOI: 10.3390/life11100996.
Souza T.B., Lozer D.M., Kitagawa S. M. S. et al. Curve analysis for identifying real-time multiplex PCR assay and melting diarrheagenic Escherichia coli. J. Clin. Microbiol. 2013; 51(3): 1031. DOI: 10.1128/JCM.02478-12.
Strockbine N.A., Bopp C.A., Fields P.L. et al. Escherichia, Shigella and Salmonella. In Manual of Clinical Microbiology. 2015; 11(1): 686–90. DOI: 10.1128/9781555817381.ch37.
Tanoue T., Umesaki Y., Honda K. Immune responses to gut microbiota-commensals and pathogens. Gut Microbes. 2010; 1(4): 224–33. DOI: 10.4161/gmic.1.4.12613.
Zhang J., Y. Xu, X. Ling, et al. Identification of diarrhoeagenic Escherichia coli by a new multiplex PCR assay and capillary electrophoresis. Molecular and Cellular Probes. 2019; 49: 101477. DOI: 10.1016/j.mc.2019.101477.
