Diffusely Adherent E. coli Burden in Low Socio-Economic Pediatric Population

Abstract

Background: DAEC seems to be a neglected pathogen among diarrheagenic E. coli since its association with pediatric diarrhea is rarely reported. But, the emergence and spread of MDR diarrhea causing bacterial pathogens have become a global burden. This study investigated the prevalence of MDR DAEC among the Mizo pediatric diarrheal patients aged less than 5 years. Methods: A total of 334 E. coli isolates isolated from the fecal samples were subjected to multiplex PCR assays to categorize the pathotypes of diarrheagenic E. coli and subjected to antimicrobial sensitivity assay, phenotypic and genotypic ESBL assays (blaCTX-M-9, blaCTX-M-15, blaOXA and CMY-2). Results: Of 334 E. coli isolates, only 0.9% of the isolates were detected as DAEC, when compared with 0.9% and 1.2% of the isolates categorized as ETEC and EAEC from diarrheic samples and 0.6% of the EAEC also detected from the non-diarrheic samples. Among the isolates, 25%, 50% and 8.3% of the isolates were carrying the blaCTX-M-9, blaCTX-M-15 and CMY-2 respectively and 8.3% isolates from non-diarrheic samples also carried CMY-2. Conclusion: Though a low frequency of DAEC was observed in comparison to other pathotypes of DEC, majority of them being resistant to commonly used antibiotics and having a high MDR rate, which is a matter of concern to the public health. This pathotype could possibly a natural source for MDR spread among the other diarrheal pathogens of pediatric population.

Keywords

• CTX-M-9
• CTX-M-15
• CMY-2
• DAEC
• MDR
• Pediatric diarrhea