Characteristics of cases with foodborne diarrheagenic Escherichia coli infection in Huzhou, China

Abstract

Diarrheagenic Escherichia coli (DEC) is a common pathogen around the world that can cause disease with symptoms of diarrhoea. We collected all clinical DEC isolates from diarrhoea samples in three sentinel hospitals for active surveillance of foodborne diseases in Huzhou, China, between 2020 and 2022. The isolates were characterised according to demographic characteristics, time distribution, distribution of suspected culprit foods, antimicrobial results of susceptibility testing, analysis of virulence genes, and pulsed-field gel electrophoresis (PFGE) typing. The positive detection rate was 7.28%, the highest for enteroaggregative E. coli (EAEC) strains, followed by enterotoxic E. coli (ETEC) strains. The predominant virulence genes were astA/pic in EAEC (57.25%) and estIa/estIb in ETEC (17.94%) strains. The proportion of cases was relatively high in children aged 6 years old (15.27%), and the peak of incidence was between June and September. The rates of drug resistance in DEC were high in Huzhou, and the spectrum of drug resistance was wide. The highest rate of drug resistance was for AMP (63.51%), and multiple drug resistance was common. The household was the leading site of DEC infection, and meat and meat products were the main suspected culprit foods (18.15%). EAEC strains showed 52.4-100.00% sequence identity, and ETEC strains showed 52.2-100.00% sequence identity. All cases of DEC infection in Huzhou were sporadic between 2020 and 2022. Strengthening continuous surveillance will be useful in the risk assessment of foodborne diseases caused by DEC.

Keywords

• foodborne pathogens
• foodborne disease
• drug sensitivity
• etiology
• pulsed-field gel electrophoresis