Etiological agents of diarrhea in hospitalized pediatric patients with special emphasis on diarrheagenic Escherichia coli in North India

Abstract INTRODUCTION: Infectious diarrhea is leading infectious cause of childhood morbidity, hospitalizations, and mortality particularly in children living in developing countries like India. The etiological agents differ depending on geographical area, and recent data suggest increase in drug resistance to various enteropathogens. AIMS AND OBJECTIVES: The aim of the study was to investigate emerging diarrheal agents and antimicrobial resistance profile of bacterial pathogens from children (<12 years of age) hospitalized with acute diarrhea. MATERIALS AND METHODS: A cross-sectional, hospital-based observational study was conducted over 1 year in which 100 children <12 years who were hospitalized due to diarrhea were recruited. Diarrhea was defined as the passage of three or more liquid stools in a 24-h period using the World Health Organization guidelines. Samples were processed for detection of various bacterial, viral, and parasitic agents by standard microbiological, serological, and molecular tests. Antimicrobial resistance testing was performed with the Kirby–Bauer disk diffusion method. ELISA was performed for Rotavirus and Escherichia coli O157. Multiplex polymerase chain reaction test was performed to detect diarrheagenic E. coli (DEC). RESULTS: Pathogenic diarrheal agents were found in 63% patients. Rotavirus was identified in 52.5%, DEC in 29%, Vibrio cholerae in 4%, Shigella flexneri in 3%, Aeromonas sp. in 1%, Giardia lamblia in 4%, and Entamoeba histolytica in 1% cases. Enteropathogenic E. coli (EPEC) in 19 (65.5%) cases was the most common agent followed by Enteroaggregative E. coli (EAEC) in 5 (17.2%), Enterotoxigenic E. coli (ETEC) in 2 (6%), and Enteroinvasive E. coli (EIEC) in 3 (10.3%) cases. Resistance rates of DEC to first-line therapeutic drugs were high, 97.3% to ampicillin and 95.95% to co-trimoxazole. DEC was susceptible to chloramphenicol in 58.11%, gentamicin in 48.19%, and amikacin in 58.11% cases. Shigella sp. and V. cholerae isolates were 100% sensitive to gentamicin and ofloxacin. CONCLUSION: EPEC is the most common DEC pathotype and EAEC, ETEC, and EIEC are also emerging as dominant diarrheal agents. Rotavirus was the most common causative agents of diarrhea especially in children <5 years. Most of the bacterial isolates showed high level of drug resistance to first-line empirical drugs and were multidrug resistant making them unsuitable for empiric treatment. Laboratory monitoring of drug susceptibility of stool isolates appears necessary to formulate antibiotic policy for treating diarrheal illness at the local level. There is an urgent need to strengthen diarrheal surveillance to monitor susceptibility to commonly prescribed antibiotics.

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Antimicrobial resistance of non-clinical Escherichia coli strains from chicken in Nsukka, South-east Nigeria.

Nigerian Journal of Animal Production ◽

10.51791/njap.v30i1.1840 ◽

2021 ◽

Vol 30 (1) ◽

pp. 101-106

Author(s):

K. F. Chah ◽

S. C. Okafor ◽

S. I. Oboegbulem

Keyword(s):

Escherichia Coli ◽

Drug Resistance ◽

Antimicrobial Resistance ◽

Antimicrobial Agents ◽

Diffusion Method ◽

Disc Diffusion ◽

Disc Diffusion Method ◽

E Coli ◽

Sensitivity Tests ◽

Resistance Patterns

This study was carried out to determine resistance profiles of Escherichia coli strains isolated from clinically healthy chickens in Nsukka, southeast Nigeria. A total of 324 E. coli strains isolated from cloaca swabs from 390 chickens were tested against 16 antimicrobial agents using the disc diffusion method. The antibiotics used in the study were: ampicillin (25µg), amoxycillin-clavulanic acid (30µg), gentamicin (10µg), Streptomycin (30µg). cefuroxime (20µg), cephalexin (10µg), nalidixic acid (30µg), ciprofloxacin (5µg), norfloxacin (10µg), ofloxacin (5µg), pefloxacin (5µg), tetracycline (30µg), chloramphenicol (10µg), cotrimoxazole (50µg), colistin (25µg) and nitrofurantoin (100µg).The strains demonstrated high rates of resistance (34.6% 66.1%) to ampicillin, tetracycline, nitrofurantoin, cefuroxime and cotrimoxazole. None of the isolates was resistant to colistin, ofloxacin and pefloxacin. For each antimicrobial agent (except cephalexin), strains from the intensively reared chickens (layers and broilers) displayed higher resistance frequencies than those from the local birds. A total of 49 resistant patterns were recorded for the 228 strains resistant to at least one antimicrobial drug, with AmTeCoS and AmTeCfN being the predominant patterns. Because of the great variation in the drug resistance patterns of the Escherichia coli strains, use of antimicrobial agents in the management of E. coli infections in the study area should be based on results of sensitivity tests.

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Phenotypic Antimicrobial Susceptibility of Escherichia coli from Raw Meats, Ready-to-Eat Meats, and Their Related Samples in One Health Context

Microorganisms ◽

10.3390/microorganisms9020326 ◽

2021 ◽

Vol 9 (2) ◽

pp. 326

Author(s):

Frederick Adzitey ◽

Nurul Huda ◽

Amir Husni Mohd Shariff

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Antimicrobial Susceptibility ◽

Resistance Index ◽

Diffusion Method ◽

Resistant Bacteria ◽

Disk Diffusion Method ◽

E Coli ◽

The Usa ◽

Raw Meats

Meat is an important food source that can provide a significant amount of protein for human development. The occurrence of bacteria that are resistant to antimicrobials in meat poses a public health risk. This study evaluated the occurrence and antimicrobial resistance of E. coli (Escherichia coli) isolated from raw meats, ready-to-eat (RTE) meats and their related samples in Ghana. E. coli was isolated using the USA-FDA Bacteriological Analytical Manual and phenotypic antimicrobial susceptibility test was performed by the disk diffusion method. Of the 200 examined meats and their related samples, 38% were positive for E. coli. Notably, E. coli was highest in raw beef (80%) and lowest in RTE pork (0%). The 45 E. coli isolates were resistant ≥ 50% to amoxicillin, trimethoprim and tetracycline. They were susceptible to azithromycin (87.1%), chloramphenicol (81.3%), imipenem (74.8%), gentamicin (72.0%) and ciprofloxacin (69.5%). A relatively high intermediate resistance of 33.0% was observed for ceftriaxone. E. coli from raw meats, RTE meats, hands of meat sellers and working tools showed some differences and similarities in their phenotypic antimicrobial resistance patterns. Half (51.1%) of the E. coli isolates exhibited multidrug resistance. The E. coli isolates showed twenty-two different resistant patterns, with a multiple antibiotic resistance index of 0.0 to 0.7. The resistant pattern amoxicillin (A, n = 6 isolates) and amoxicillin-trimethoprim (A-TM, n = 6 isolates) were the most common. This study documents that raw meats, RTE meats and their related samples in Ghana are potential sources of antimicrobial-resistant E. coli and pose a risk for the transfer of resistant bacteria to the food chain, environment and humans.

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Molecular characterisation of antimicrobial resistance and virulence genes in Escherichia coli strains isolated from diarrhoeic and healthy rabbits in Tunisia

World Rabbit Science ◽

10.4995/wrs.2020.10879 ◽

2020 ◽

Vol 28 (2) ◽

pp. 81

Author(s):

Raouia Ben Rhouma ◽

Ahlem Jouini ◽

Amira Klibi ◽

Safa Hamrouni ◽

Aziza Boubaker ◽

...

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Virulence Genes ◽

Antimicrobial Agents ◽

Antibiotic Resistance Genes ◽

Virulence Gene ◽

Diffusion Method ◽

Class 1 Integron ◽

E Coli ◽

Class 1

The purpose of this study was to identify Escherichia coli isolates in diarrhoeic and healthy rabbits in Tunisia and characterise their virulence and antibiotic resistance genes. In the 2014-2015 period, 60 faecal samples from diarrhoeic and healthy rabbits were collected from different breeding farms in Tunisia. Susceptibility to 14 antimicrobial agents was tested by disc diffusion method and the mechanisms of gene resistance were evaluated using polymerase chain reaction and sequencing methods. Forty E. coli isolates were recovered in selective media. High frequency of resistance to tetracycline (95%) was detected, followed by different levels of resistance to sulphonamide (72.5%), streptomycin (62.5%), trimethoprim-sulfamethoxazole (60%), nalidixic acid (32.5%), ampicillin (37.5%) and ticarcillin (35%). E. coli strains were susceptible to cefotaxime, ceftazidime and imipenem. Different variants of blaTEM, tet, sul genes were detected in most of the strains resistant to ampicillin, tetracycline and sulphonamide, respectively. The presence of class 1 integron was studied in 29 sulphonamide-resistant E. coli strains from which 15 harboured class 1 integron with four different arrangements of gene cassettes, dfrA17+aadA5 (n=9), dfrA1 + aadA1 (n=4), dfrA12 + addA2 (n=1), dfrA12+orf+addA2 (n=1). The qnrB gene was detected in six strains out of 13 quinolone-resistant E. coli strains. Seventeen E. coli isolates from diarrhoeic rabbits harboured the enteropathogenic eae genes associated with different virulence genes tested (fimA, cnf1, aer), and affiliated to B2 (n=8) and D (n=9) phylogroups. Isolated E. coli strains from healthy rabbit were harbouring fim A and/or cnf1 genes and affiliated to A and B1 phylogroups. This study showed that E. coli strains from the intestinal tract of rabbits are resistant to the widely prescribed antibiotics in medicine. Therefore, they constitute a reservoir of antimicrobial-resistant genes, which may play a significant role in the spread of antimicrobial resistance. In addition, the eae virulence gene seemed to be implicated in diarrhoea in breeder rabbits in Tunisia.

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Antimicrobial Resistance Pattern of Escherichia coli Isolated from Frozen Chicken Meat in Bangladesh

Pathogens ◽

10.3390/pathogens9060420 ◽

2020 ◽

Vol 9 (6) ◽

pp. 420 ◽

Cited By ~ 1

Author(s):

Mst. Sonia Parvin ◽

Sudipta Talukder ◽

Md. Yamin Ali ◽

Emdadul Haque Chowdhury ◽

Md. Tanvir Rahman ◽

...

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Foodborne Pathogens ◽

Biochemical Properties ◽

Chicken Meat ◽

Diffusion Method ◽

Resistance Pattern ◽

Isolation And Identification ◽

E Coli ◽

Encoding Genes

Escherichia coli is known as one of the most important foodborne pathogens in humans, and contaminated chicken meat is an important source of foodborne infection with this bacterium. The occurrence of extended-spectrum β-lactamase (ESBL)-producing E. coli (ESBL-Ec), in particular, in chicken meat is considered a global health problem. This study aimed to determine the magnitude of E. coli, with special emphasis on ESBL-Ec, along with their phenotypic antimicrobial resistance pattern in frozen chicken meat. The study also focused on the determination of ESBL-encoding genes in E. coli. A total of 113 frozen chicken meat samples were purchased from 40 outlets of nine branded supershops in five megacities in Bangladesh. Isolation and identification of E. coli were done based on cultural and biochemical properties, as well as PCR assay. The resistance pattern was determined by the disc diffusion method. ESBL-encoding genes were determined by multiplex PCR. The results showed that 76.1% of samples were positive for E. coli, of which 86% were ESBL producers. All the isolates were multidrug-resistant (MDR). Resistance to 9–11 and 12–13 antimicrobial classes was observed in 38.4% and 17.4% isolates, respectively, while only 11.6% were resistant to 3–5 classes. Possible extensive drug resistance (pXDR) was found in 2.3% of isolates. High single resistance was observed for oxytetracycline (93%) and amoxicillin (91.9%), followed by ampicillin (89.5%), trimethoprim–sulfamethoxazole, and pefloxacin (88.4%), and tetracycline (84.9%). Most importantly, 89.6% of isolates were resistant to carbapenems. All the isolates were positive for the blaTEM gene. However, the blaSHV and blaCTX-M-2 genes were identified in two ESBL-non producer isolates. None of the isolates carried the blaCTX-M-1 gene. This study provided evidence of the existence of MDR and pXDR ESBL-Ec in frozen chicken meat in Bangladesh, which may pose a risk to human health if the meat is not properly cooked or pickled raw only. This emphasizes the importance of the implementation of good slaughtering and processing practices by the processors.

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Influence of Housing Systems on Microbial Load and Antimicrobial Resistance Patterns of Escherichia coli Isolates from Eggs Produced for Human Consumption

Journal of Food Protection ◽

10.4315/0362-028x.jfp-11-182 ◽

2012 ◽

Vol 75 (5) ◽

pp. 847-853 ◽

Cited By ~ 9

Author(s):

ELENA ÁLVAREZ-FERNÁNDEZ ◽

JESSICA DOMÍNGUEZ-RODRÍGUEZ ◽

ROSA CAPITA ◽

CARLOS ALONSO-CALLEJA

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Housing System ◽

Diffusion Method ◽

Aerobic Bacteria ◽

Human Consumption ◽

E Coli ◽

Free Range ◽

Housing Systems ◽

Enterococcus Spp

Microbial counts (aerobic bacteria, psychrotrophs, Enterobacteriaceae, coliforms, Pseudomonas spp., Enterococcus spp., Staphylococcus spp., and molds and yeasts) were obtained for the shells of 240 table eggs in northwestern Spain. Eggs from six sources (40 samples in each) were analyzed: chicken eggs from five different housing systems (conventional battery cages, barn, free range, organic, and domestic breeding) and quail eggs (cages). A total of 120 Escherichia coli strains (20 from each source) were tested by the disk diffusion method for resistance to 12 antimicrobial drugs of veterinary and human health significance. Aerobic plate counts ranged from 1.96 ± 1.0 (barn) to 3.69 ± 0.7 (domestic) log CFU/cm2. Counts for most microbial groups differed significantly between sources. Eggs from domestic production had the highest contamination loads (P < 0.05) for aerobic bacteria, Enterococcus spp., and molds and yeasts and the highest prevalence of E. coli. Twenty-three E. coli isolates (19.17%) were susceptible to all antimicrobials tested, and 80.83% were resistant to one (22.50%) or more (58.33%) antimicrobials. The housing system had a significant influence (P < 0.05) on the average resistance per strain, with the highest resistance in conventional cage (2.85) and barn (3.10) systems followed by free range (1.55) and quail (1.95). Eggs from organic (1.00) and domestic (0.75) production systems had the lowest resistance per strain. The highest prevalence of resistance was observed for the groups of antimicrobials more frequently used on poultry farms. Our results suggest that a relationship exists between the prevalence of antimicrobial resistance in E. coli strains and the more frequent use of antimicrobials in conventional (cage, barn, and free range) than in domestic and organic chicken housing systems. Education covering good sanitary practices for handling eggs to avoid cross-contamination or inadequate cooking is needed.

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Antibiotic-resistant Salmonella species and Escherichia coli in broiler chickens from farms, abattoirs, and open markets in selected districts of Zambia

Journal of Epidemiological Research ◽

10.5430/jer.v6n1p13 ◽

2020 ◽

Vol 6 (1) ◽

pp. 13

Author(s):

Nelson Phiri ◽

Geoffrey Mainda ◽

Mercy Mukuma ◽

Ntazana N. Sinyangwe ◽

Luke J. Banda ◽

...

Keyword(s):

Public Health ◽

Escherichia Coli ◽

Antimicrobial Resistance ◽

Broiler Chickens ◽

Health Concern ◽

Diffusion Method ◽

Salmonella Spp ◽

Antibiotic Resistant ◽

E Coli ◽

Open Markets

Objective: Salmonella species and Escherichia coli are major bacterial enteropathogens of worldwide public health importance that cause devastating foodborne diseases, thereby contributing to increased human morbidity and mortality. Both pathogens have also been found to contribute towards the spread of antimicrobial resistance through the food chain, especially in poultry. This study aimed to determine the occurrence of antibiotic-resistant Salmonella spp. and E. coli in broiler chickens at farm level, abattoirs, and open markets in selected districts of Zambia.Methods: A cross-sectional study was undertaken in seven districts of Zambia to determine the resistance profiles of Salmonella spp. and E. coli obtained from broiler chickens at farms, abattoirs, and open markets. A total of 470 samples were collected which include; litter, cloacal swabs, and carcass swabs. Samples were inoculated into buffered peptone water and incubated for 24 hours then sub-cultured onto MacConkey and Xylose Lysine Deoxycholate agar plates. Identification of Salmonella spp. and E. coli was done using the API-20E kit and confirmation by 16S rDNA sequencing. Confirmed isolates were tested against a panel of 09 antibiotics using the Kirby-Bauer disc diffusion method and interpreted according to the Clinical Laboratory Standards Institute guidelines. Data analysis of the antibiotic sensitivity test results was done using WHONET 2018 software.Results: Overall, 4 Salmonella spp. and 280 E. coli were isolated. One of the Salmonella spp. was resistant to ampicillin (25%), amoxicillin/clavulanic acid (25%), and cefotaxime (25%). E. coli antibiotic resistance was highest to tetracycline (81.4%) and 100% susceptibility to imipenem. The antibiotic susceptibility profile revealed 75.7% (237/280) multidrug-resistant (MDR). The highest MDR profile was observed in 8.2% (23/280) isolates in which 6 out of the 9 classes of antibiotics tested were resistant. Out of the 280 isolates, 11.4% (32/280) exhibited Extensive Drug resistance (XDR).Conclusion: The study found antimicrobial resistance to E. coli and Salmonella spp. in market-ready broiler chickens which were resistant to important antibiotics and is of public health concern.

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Prevalence of blaCTX-M, blaSHV, and blaTEM Genes in Escherichia coli Strains Isolated From Urinary Tract Infection Samples of Patients in the Intensive Care Unit in Qom, Iran

Gene Cell and Tissue ◽

10.5812/gct.102700 ◽

2020 ◽

Vol 7 (2) ◽

Author(s):

Shima Sadat Lesani ◽

Mohammad Soleimani ◽

Pegah Shakib ◽

Mohammad Reza Zolfaghari

Keyword(s):

Escherichia Coli ◽

Drug Resistance ◽

Urinary Tract Infection ◽

Intensive Care ◽

Urinary Tract ◽

Tract Infection ◽

Intensive Care Units ◽

Diffusion Method ◽

E Coli ◽

Tract Infections

Background: Escherichia coli is considered as one of the causes of opportunistic infections. Nowadays, due to the increase in drug resistance, the treatment of these infections has become very difficult and they are recognized as the main causes of death in hospitalized patients. Objectives: The aim of this study was to determine the prevalence of blaTEM, blaSHV, and blaCTX-M genes in E. coli strains isolated from the urinary tract infection in patients in Intensive Care Units of three different hospitals in Qom, Iran. Methods: This study was conducted in three months from October to December 2014. A total of 200 E. coli samples were taken from the patients with urinary tract infections in Intensive Care units of Qom hospital. The disc diffusion method was used to determine the susceptibility pattern of antibiotic and phenotypic confirmatory tests for screening of the expanded spectrum beta-lactamase (ESBL) isolates. The presence of blaTEM, blaSHV, and blaCTX-M genes was evaluated by the polymerase chain reaction (PCR) assay. Results: Of 200 samples, ampicillin (96%) and nitrofurantoin (19.5%) showed the highest and lowest drug resistance, respectively. A total of 156 isolates (78%) were identified as ESBLs using the phenotypic method. Moreover, 76 (38%), 90 (45%), and 123 (61.5%) isolates consisted of blaCTX-M, blaSHV, and blaTEM, respectively. Conclusions: Overall, the findings of this study showed that blaTEM was the most common gene with a frequency of 61.5% in ESBL E. coli.

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Antimicrobial resistance, diarrheagenic and avian pathogenic virulence genes in Escherichia coli from poultry feed and the ingredients

Arquivo Brasileiro de Medicina Veterinária e Zootecnia ◽

10.1590/1678-4162-10355 ◽

2019 ◽

Vol 71 (6) ◽

pp. 1968-1976 ◽

Cited By ~ 1

Author(s):

J.M. Rossato ◽

B.G. Brito ◽

R.K.T. Kobayashi ◽

V.L. Koga ◽

J.J.P. Sarmiento ◽

...

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Antimicrobial Susceptibility ◽

Susceptibility Gene ◽

Poultry Feed ◽

Diffusion Method ◽

Multi Drug Resistance ◽

E Coli ◽

Phylogenetic Classification ◽

Mar Index

ABSTRACT Diarrheagenic (DEC) and avian pathogenic Escherichia coli (APEC) are associated with intestinal and extra-intestinal infections (ExPEC), respectively. We aimed to analyze the antimicrobial susceptibility, gene encoding virulence factors associated to DEC and APEC, and phylogenetic classification in E. coli isolated from 320 samples of feed and ingredients. Antimicrobial susceptibility was performed using the disk diffusion method and Multiple Antibiotic Resistance (MAR) Index and Multi-Drug Resistance (MDR) were calculated. Phylogenetic classification was performed on samples harboring DEC and/or APEC virulence-associated genes. A total of 110 E. coli strains were isolated in 15% (49/320) of the evaluated inputs (n=13 vegetable meal; n=33 animal meal, n=3 feed). In general, the isolates showed the highest rates of antimicrobial resistance to sulfonamide and cefazolin and 18% (20/110) were multi-drug resistant. MAR index of feed samples was the highest (0.467). Six and five strains had APEC and DEC virulence-associated genes, respectively, and belonging to phylogenetic groups A and B1. These findings point to the need for strict microbiological control during the production process of these foods.

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Drug Resistance Mutations Among South African Children Living With HIV on WHO-recommended ART Regimens

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1068 ◽

2020 ◽

Author(s):

Stephanie Hackett ◽

Chloe A Teasdale ◽

Sherri Pals ◽

Anthony Muttiti ◽

Mary Mogashoa ◽

...

Keyword(s):

Drug Resistance ◽

Reverse Transcriptase ◽

South African ◽

World Health ◽

Resistance Testing ◽

Reverse Transcriptase Inhibitors ◽

First Line ◽

African Children ◽

Genotypic Resistance Testing ◽

South African Children

Abstract Background Children living with human immunodeficiency virus (HIV) (CLHIV) receiving antiretroviral therapy (ART) in resource-limited settings are susceptible to high rates of acquired HIV drug resistance (HIVDR), but few studies include children initiating age-appropriate World Health Organization (WHO)-recommended first-line regimens. We report data from a cohort of ART-naive South African children who initiated first-line ART. Methods ART-eligible CLHIV aged 0–12 years were enrolled from 2012 to 2014 at 5 public South African facilities and were followed for up to 24 months. Enrolled CLHIV received standard-of-care WHO-recommended first-line ART. At the final study visit, a dried blood spot sample was obtained for viral load and genotypic resistance testing. Results Among 72 successfully genotyped CLHIV, 49 (68.1%) received ABC/3TC/LPV/r, and 23 (31.9%) received ABC/3TC/EFV. All but 2 children on ABC/3TC/LPV/r were <3 years, and all CLHIV on ABC/3TC/EFV were ≥3 years. Overall, 80.6% (58/72) had at least one drug resistance mutation (DRM). DRMs to nonnucleoside reverse transcriptase inhibitors (NNRTIs) and nucleoside reverse transcriptase inhibitors (NRTIs) were found among 65% and 51% of all CLHIV, respectively, with no statistical difference by ART regimen. More CLHIV on ABC/3TC/EFV, 47.8% (11/23), were found to have 0 or only 1 effective antiretroviral drug remaining in their current regimen compared to 8.2% (4/49) on ABC/3TC/LPV/r. Conclusions High levels of NNRTI and NRTI DRMs among CLHIV receiving ABC/3TC/LPV/r suggests a lasting impact of failed mother-to-child transmission interventions on DRMs. However, drug susceptibility analysis reveals that CLHIV with detectable viremia on ABC/3TC/LPV/r are more likely to have maintained at least 2 effective agents on their current HIV regimen than those on ABC/3TC/EFV.

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Prevalence and Antimicrobial Resistance of DiarrheagenicEscherichia coliandShigellaSpecies Associated with Acute Diarrhea in Tehran, Iran

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2009/341275 ◽

2009 ◽

Vol 20 (3) ◽

pp. e56-e62 ◽

Cited By ~ 31

Author(s):

Fereshteh Jafari ◽

Mohammad Hamidian ◽

Maryam Rezadehbashi ◽

Michael Doyle ◽

Siavosh Salmanzadeh-ahrabi ◽

...

Keyword(s):

Escherichia Coli ◽

Antibiotic Resistance ◽

Antimicrobial Resistance ◽

Shiga Toxin ◽

Acute Diarrhea ◽

Antimicrobial Agents ◽

High Rate ◽

Appropriate Use ◽

E Coli ◽

Etiological Agents

A study was performed to determine the prevalence and antimicrobial resistance ofShigellaspecies and diarrheagenicEscherichia coliisolates cultured from patients with acute diarrhea in Tehran, Iran. Between May 2003 and May 2005, 1120 diarrheal specimens were collected and assayed for bacterial enteropathogens by conventional and molecular methods. Etiological agents were isolated from 564 (50.3%) specimens, and included 305 (54%)E coli, 157 (27.8%)Shigellaspecies, and 102 (18%) from other genera of bacteria. The predominantE coliwas Shiga toxin-producingE coli(105 isolates [34.5%]) and the predominantShigellaserotype wasShigella sonnei(88 isolates [56.1%]). A high rate of antibiotic resistance was observed amongE coli,with 40 of 53 (75.5%) Shiga toxin-producingE coliisolates resistant to amoxicillin and tetra-cycline, and eight (5.2%)E coliisolates resistant to more than six antibiotics. MostShigellaisolates were resistant to tetracycline (95%) and trimethoprim-sulfamethoxazole (91.7%), with greatest antibiotic resistance observed amongS sonnei(53 of 88 [60.2%] isolates). Antibiotic resistance is widespread in diarrheagenicE coliandShigellain children with acute diarrhea in Tehran, Iran; hence, updated strategies for appropriate use of antimicrobial agents in Iran are needed.

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