Diffusely Adherent E. coli Burden in Low Socio-Economic Pediatric Population
-
Karuppasamy Chellapandi
,
Lalsanglura Ralte
,
Surajit De Mandal
,
Nachimuthu Senthil Kumar
,
Tapan Kumar Dutta
,
Indu Sharma
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.
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14. Begum J, Dutta TK, Chandra R, et al. Molecular and phenotypic characterization of shiga toxigenic Escherichia coli (STEC) and enteropathogenic E. coli (EPEC) from piglets and infants associated with diarrhoea in Mizoram, India. African J Biotech 2014; 13(13).
15. Cravioto A, Gross RJ, Scotland SM, et al. An adhesive factor found in Strains of Escherichia coli belonging to the traditional infantile Enteropathogenic Serotypes. Curr Microbiol 1979; 3:95-9.
16. CLSI (Clinical and Laboratory Standards Institute). Performance standards for antimicrobial susceptibility testing; 22 informational supplement. 2012; CLSI document M100-S22. Wayne, PA.
17. Francois XW, Marie D, Didier T, et al. SHV–12-Like Extended-Spectrum--Lactamase-Producing Strains of Salmonella enterica Serotypes Babel berg and Enteritidis Isolated in France among Infants Adopted from Mali. J Clin Microbiol 2004; 2432-7.
18. Mohamad H, Marie TK, John EC, et al. Frequency of conjugative transfer of plasmid encoded ISEcp1 – blaCTX-M-15 and aac(6′)-lb-cr genes in Enterobacteriaceae at a tertiary care center in Lebanon – role of transferases. Ann Clin Microbiol Antimicrob 2010; 9:19.
19. Kim J, Lim YM, Rheem I, et al. CTX-M and SHV-12 b-lactamases are the most common extended-spectrum enzymes in clinical isolates of Escherichia coli and Klebsiella pneumoniae collected from 3 university hospitals within Korea. FEMS Microbiol Lett 2005; 245:93-8.
20. Susanne S, Carsten S, Karen AK. Transfer of antimicrobial resistance plasmids from Klebsiella pneumoniae to Escherichia coli in the mouse intestine. J Antimicrob Chemother 2008; 62:1086-93.
21. Karuppasamy C, Tapan KD, Indu S, et al. Prevalence of multi drug resistant
enteropathogenic and entero invasive Escherichia coli isolated from children with and without diarrhea in Northeast Indian population. Ann Clin Microbiol Antimicrob 2017; 16:49.
22. Ghosh PK, Ali A. Isolation of atypical enteropathogenic Escherichia coli from children with and without diarrhea in Delhi and the National Capital Region, India. J Med Microbiol 2010; 59:1156-62.
23. Scaletsky ICA, Fabbricotti SH, Carvalho RLB, et al. Diffusely adherent Escherichia coli as a cause of acute diarrhea in young children in Northeast Brazil: a case-control study. J Clin Microbiol 2002; 40(2):645-8.
24. Gupta A, Gautam S, Arup JR, et al. Risk Correlates of Diarrhea in Children Under 5 Years of Age in Slums of Bankura, West Bengal. J Glob Infect Dis 2015; 7(1):23-9.
25. Okhuysen PC, DuPont HL. Enteroaggregative Escherichia coli (EAEC): a cause of acute and persistent diarrhea of worldwide importance. J Infect Dis 2010; 202:503-5.
26. Rosane MA, Alex LP, Loreny GG. Diffusely adherent Escherichia coli strains isolated from children and adults constitute two different populations. BMC Microbiol 2013; 13:22.
27. Ochoa TJ, Ruiz J, Molina M, et al. High frequency of antimicrobial drug resistance of diarrheagenic Escherichia coli in infants in Peru. American J Trop Med & Hyg 2009; 81(2):296-301.
28. Canizalez-Roman A, Flores-Villaseñor HM, Gonzalez-Nuñez E, et al. Surveillance of Diarrheagenic Escherichia coli strains isolated from diarrhea cases from children, adults and elderly at Northwest of Mexico. Front Microbiol 2016; 7:1924.
29. Baraniak A, Fiett J, Hryniewicz W, et al. Ceftazidime-hydrolysing CTX-M-15 extended-spectrum b-lactamase (ESBL) in Poland. J Antimicrob Chemother 2002; 50(3):393-6.
2. Hegde A, Ballal M, Shenoy S. Detection of diarrheagenic Escherichia coli by PCR. Indian J Med. Microbiol 2012; 30(3): 279-84.
3. Rajendran P, Ajjampur SS, Chidambaram D, et al. Pathotypes of diarrheagenic Escherichia coli in children attending a tertiary care hospital in south India. Diag Microbiol Infect Dis 2010; 68(2):117-22.
4. Veena AS, Sanath HK, Aviash KS, et al. Prevalence and characterization of
diarrheagenic Escherichia coli isolated form Adults and children in Mangalore, India. J Lab Phys 2012; 4(1):24-9.
5. Bora HR, Yadav A, Zohmingliana JH. Traditional practices in Mizoram, Northeast India to remove irritant of Amorphophallus nepalensis (Wall.) Bonger& Mayo: A highly irritating aroid. Int J Recent Scien Res 2017; 8(12): 22494-5.
6. Servin AL. Pathogenesis of Afa/Dr diffusely adhering Escherichia coli. Clin Microbiol Reviews 2005; 18(2):264-92.
7. Bouguenec C, Servin AL. Diffusely adherent Escherichia coli strains expressing Afa/Dradhesins (Afa/Dr DAEC): hitherto unrecognized pathogens. FEMS Microbiol Lett 2006; 256(2):185-94.
8. Vidal M, Kruger E, Duran C, et al. Single assay to identify simultaneously the six categories of Diarrheagenic Escherichia coli associated with enteric infections. J Clin Microbiol 2005; 43(10):5362-5.
9. Rajeshwari K, Beena U, Singh R, et al. Multi drug resistant Enteropathogenic E. coli Diarrhea in children. America J Res Communication 2015; 3(9): 27-48.
10. Lanjewar M, De Anuradha S, Mathur M. Diarrheagenic E. coli in hospitalized patients: Special reference to Shiga-like toxin producing Escherichia coli. Indian J Path Microbiol 2010; 53(1):75.
11. Meraz IM, Jiang ZD, Ericsson CD, et al. Enterotoxigenic Escherichia coli and diffusely adherent e. coli as likely causes of a proportion of pathogen negative travelers’ diarrhea—a PCR based study. J Travel med 2008; 15(6):412-8.
12. Collee JG, Miles RS, Wan B. Tests for the identification of bacteria. In: Collee, J.G., Fraser, A.G., Marmion, B.P., Simmons, A. Mackie and McCartney Practical Medical Microbiology. 1996; 14th ed. Edinburgh: Churchill Livingstone, Reprint–2014.
13. Edwards PR, Ewing WH. Identification of Enterobacteriaceae. Minneapolis, Minnesota: Burgess Publishing Company. 1986; 4th
edition.
14. Begum J, Dutta TK, Chandra R, et al. Molecular and phenotypic characterization of shiga toxigenic Escherichia coli (STEC) and enteropathogenic E. coli (EPEC) from piglets and infants associated with diarrhoea in Mizoram, India. African J Biotech 2014; 13(13).
15. Cravioto A, Gross RJ, Scotland SM, et al. An adhesive factor found in Strains of Escherichia coli belonging to the traditional infantile Enteropathogenic Serotypes. Curr Microbiol 1979; 3:95-9.
16. CLSI (Clinical and Laboratory Standards Institute). Performance standards for antimicrobial susceptibility testing; 22 informational supplement. 2012; CLSI document M100-S22. Wayne, PA.
17. Francois XW, Marie D, Didier T, et al. SHV–12-Like Extended-Spectrum--Lactamase-Producing Strains of Salmonella enterica Serotypes Babel berg and Enteritidis Isolated in France among Infants Adopted from Mali. J Clin Microbiol 2004; 2432-7.
18. Mohamad H, Marie TK, John EC, et al. Frequency of conjugative transfer of plasmid encoded ISEcp1 – blaCTX-M-15 and aac(6′)-lb-cr genes in Enterobacteriaceae at a tertiary care center in Lebanon – role of transferases. Ann Clin Microbiol Antimicrob 2010; 9:19.
19. Kim J, Lim YM, Rheem I, et al. CTX-M and SHV-12 b-lactamases are the most common extended-spectrum enzymes in clinical isolates of Escherichia coli and Klebsiella pneumoniae collected from 3 university hospitals within Korea. FEMS Microbiol Lett 2005; 245:93-8.
20. Susanne S, Carsten S, Karen AK. Transfer of antimicrobial resistance plasmids from Klebsiella pneumoniae to Escherichia coli in the mouse intestine. J Antimicrob Chemother 2008; 62:1086-93.
21. Karuppasamy C, Tapan KD, Indu S, et al. Prevalence of multi drug resistant
enteropathogenic and entero invasive Escherichia coli isolated from children with and without diarrhea in Northeast Indian population. Ann Clin Microbiol Antimicrob 2017; 16:49.
22. Ghosh PK, Ali A. Isolation of atypical enteropathogenic Escherichia coli from children with and without diarrhea in Delhi and the National Capital Region, India. J Med Microbiol 2010; 59:1156-62.
23. Scaletsky ICA, Fabbricotti SH, Carvalho RLB, et al. Diffusely adherent Escherichia coli as a cause of acute diarrhea in young children in Northeast Brazil: a case-control study. J Clin Microbiol 2002; 40(2):645-8.
24. Gupta A, Gautam S, Arup JR, et al. Risk Correlates of Diarrhea in Children Under 5 Years of Age in Slums of Bankura, West Bengal. J Glob Infect Dis 2015; 7(1):23-9.
25. Okhuysen PC, DuPont HL. Enteroaggregative Escherichia coli (EAEC): a cause of acute and persistent diarrhea of worldwide importance. J Infect Dis 2010; 202:503-5.
26. Rosane MA, Alex LP, Loreny GG. Diffusely adherent Escherichia coli strains isolated from children and adults constitute two different populations. BMC Microbiol 2013; 13:22.
27. Ochoa TJ, Ruiz J, Molina M, et al. High frequency of antimicrobial drug resistance of diarrheagenic Escherichia coli in infants in Peru. American J Trop Med & Hyg 2009; 81(2):296-301.
28. Canizalez-Roman A, Flores-Villaseñor HM, Gonzalez-Nuñez E, et al. Surveillance of Diarrheagenic Escherichia coli strains isolated from diarrhea cases from children, adults and elderly at Northwest of Mexico. Front Microbiol 2016; 7:1924.
29. Baraniak A, Fiett J, Hryniewicz W, et al. Ceftazidime-hydrolysing CTX-M-15 extended-spectrum b-lactamase (ESBL) in Poland. J Antimicrob Chemother 2002; 50(3):393-6.
| Files | ||
| Issue | Vol 8 No 5-6 (2019) | |
| Section | Original Articles | |
| Keywords | ||
| CTX-M-9 CTX-M-15 CMY-2 DAEC MDR Pediatric diarrhea Mizoram. | ||
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How to Cite
1.
Chellapandi K, Ralte L, De Mandal S, Senthil Kumar N, Dutta T, Sharma I. Diffusely Adherent E. coli Burden in Low Socio-Economic Pediatric Population. J Med Bacteriol. 2019;8(5-6):44-55.
