Enteroaggregative Escherichia coli (EAEC): An Emerging Enteric Pathogen in South of Iran
Abstract
Background: Enteroaggregative E. coli (EAEC) is increasingly recognized as a cause of often persistent diarrhea in children and adults in both developing and developed countries. The aim of the present study was to investigate the presence and the frequency of EAEC as etiologic agent of diarrhea in Shiraz.Methods: A total of 715 stool samples were collected from patients with diarrhea in Shiraz. Diarrheagenic E. coli were isolated by biochemical tests and culture from 715 stool samples collected from different hospitals. Diarrheagenic E. coli strains isolated from diarrheal stool samples were examined for the detection of the aggR gene by Real time PCR and PCR method.
Results: In this study, a total of 101 (14.12%) diarrheagenic E. coli were isolated from 715 stool samples collected from different hospitals. The infected patients were 58 (57%) males and 43 (43%) females. Out of these 101 diarrheagenic E. coli identified, 5 were confirmed as EAEC in
patient. The EAEC strains were isolated from 3 of the 43 females (43%) and 2 of the 58 males ( 57%) with the mean age of 11.4±1.2 age. In this study, 5 EAEC strains were isolated from one patient with bloody diarrhea and 4 patients with watery diarrhea. The high prevalence of EAEC solates was also found in watery diarrhea.
Conclusion: We therefore, recommend the routine isolation and identification of EAEC strains from patient with diarrhea in all the clinical laboratories and other pathotype diarrheagenic E.coli in Iran.
Fischer Walker CL, Sack D, Black RE.Etiology of diarrhea in older children, adolescents and adults: a systematic review. PLoS Negl Trop Dis 2010; 4: e768.
Alikhani MY, Hashemi SH, Aslani MM, Farajnia S. Prevalence and antibiotic resistance patterns of diarrheagenic Escherichia coli isolated from adolescents and adults in Hamedan, Western Iran. Iran J Microbiol 2013; 5: 42-7.
Allocati N, Masulli M, Alexeyev MF, Di Ilio C. Escherichia coli in Europe: An Overview. Int J Environ Res Public Health 2013; 10: 6235-54.
Nataro JP, Kaper JB. Diarrheagenic Escherichia coli. Clin Microbiol Rev 1998;5. Souza TB, Lozer DM, Kitagawa SM, Spano LC, Silva NP, Scaletsky IC. Real- time multiplex PCR assay and melting curve analysis for identifying diarrheagenic Escherichia coli. J Clin Microbiol 2013;51: 1031-33.
Okeke IN, Wallace-Gadsden F, Simons HR, Matthews N, Labar AS, Hwang J, Wain J. Multi-locus sequence typing of enteroaggregative Escherichia coli isolates from Nigerian children uncovers multiple lineages. PLoS One 2010; 5: e14093.
Kaper JB, Nataro JP, Mobley HL.Pathogenic Escherichia coli. Nat Rev Microbiol 2004; 2: 123-40.
Zamboni A, Fabbricotti SH, Fagundes- Neto U, Scaletsky IC. Enteroaggregative Escherichia coli virulence factors are found to be associated with infantile diarrhea in Brazil. J Clin Microbiol 2004; 42: 1058-63.
Vila J, Vargas M, Henderson IR, Gascón J, Nataro JP. Enteroaggregative Escherichia coli virulence factors in traveler's diarrhea strains. J Infect Dis 2000; 182: 1780-83.
Kaur P, Chakraborti A, Asea A.Enteroaggregative Escherichia coli: An Emerging Enteric Food Borne Pathogen. Interdiscip Perspect Infect Dis 2010; 2010:254159.
Weintraub A. Enteroaggregative Escherichia coli: epidemiology, virulence and detection. J Med Microbiol 2007; 56:4-8.
Guion CE, Ochoa TJ, Walker CM, Barletta F, Cleary TG. Detection of diarrheagenic Escherichia coli by use of melting-curve analysis and real-time multiplex PCR. J Clin Microbiol 2008; 46: 1752-57.
Jafari F, Shokrzadeh L, Hamidian M, Salmanzadeh-Ahrabi S, Zali MR. Acute diarrhea due to enteropathogenic bacteria in patients at hospitals in Tehran. Jpn J Infect Dis 2008; 61: 269-73.
Pourakbari B, Ferdosian F, Mahmoudi S, Teymuri M, Sabouni F, Heydari H, Ashtiani MT, Mamishi S. Increase resistant rates and ESBL production between E. coli isolates causing urinary tract infection in young patients from Iran. Braz J Microbiol 2012; 43: 766-69.
Morin N, Santiago AE, Ernst RK, Guillot SJ, Nataro JP. Characterization of the AggR regulon in enteroaggregative Escherichia coli. Infect Immun 2013;81:122-32.
Andrade JA, Freymüller E, Fagundes-Neto U. Pathophysiology of enteroaggregative Escherichia coli infection: an experimental model utilizing transmission electron microscopy. Arq Gastroenterol 2010; 47:306-12.
Hegde A, Ballal M, Shenoy S. Detection of diarrheagenic Escherichia coli by multiplex PCR. Indian J Med Microbiol 2012; 30: 279-84.
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.
Jafari A, Aslani M Mi, Bouzari S.Enteroaggregative Escherichia coli, a heterogenous, underestimated and under- diagnosed E. coli pathotype in Iran. Gastroenterol Hepatol Bed Bench 2013; 6:71-79.
Aslani MM, Alikhani MY, Zavari A, Yousefi R, Zamani AR. Charactereization of enteroaggregative Escherichia coli (EAEC) clinical isolates and their antibiotic resistance pattern. Int J Infect Dis 2011; 15: e136-39.
Salmanzadeh-Ahrabi S, Habibi E, Jaafari F, Zali MR. Molecular epidemiology of Escherichia coli diarrhoea in children in Tehran. Ann Trop Med 2005; 25: 35-9.
Soleimani M, Morovvati A, Hosseini SZ, Zolfaghari MR. Design of an improved multiplex PCR method for diagnosis of enterohaemoraghic E.coli and enteropathogic E.coli pathotypes. Gastroenterol Hepatol Bed Bench 2012; 5: 106-11.
Souza TB, Lozer DM, Kitagawa SM, Spano LC, Silva NP, Scaletsky IC. Real-time multiplex PCR assay and melting curve analysis for identifying diarrheagenic Escherichia coli. J Clin Microbiol 2013; 51: 1031-33.
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Issue | Vol 3 No 3-4 (2014) | |
Section | Original Articles | |
Keywords | ||
Diarrhea Enteroaggregative Escherichia coli Real-Time PCR |
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