Evaluation of the prevalence of typical and atypical enteropathogenic Escherichia coli isolated from stool specimens of patients with diarrhea admitted to Tehran Children's Hospital by the PCR Method

Abstract

Background: Infectious diarrheal diseases are a major cause of death in community, especially in children. Enteropathogenic Escherichia coli (EPEC) are considered as a major cause of children's diarrhea in developing countries. The aim of this study was to evaluate the prevalence of both typical Enteropathogenic (tEPEC) and atypical Enteropathogenic (aEPEC) E. coli isolated from patients admitted to the children's hospital in Tehran by the PCR method. Materials and Methods: In this cross-sectional study, a total of 157 children diarrheal samples were collected from February 2016 to August 2017 and were sent to the microbiology department in the School of Public Health in Tehran University of Medical Sciences for testing. The identification of isolates was performed by conventional biochemical tests. The typical and atypical E. coli isolates were identified for the presence of eae, sxt1, sxt2 genes, and bfp A by the PCR method. The drug resistance patterns of isolated EPEC were tested by the agar disk diffusion method. The antibiotics used were amoxicillin-clavulanic, ampicillin, gentamicin, trimethoprim- sulfamethoxazole, ciprofloxacin, cefepim, Nitrofurantoin and imipenem. Results: Out of 101 E. coli isolates, 7 were identified as EPEC. All the isolated strains carried eae but not stx1, stx2, and bfp A genes. Also, 100% of the isolates were resistant to amoxicillin-clavulanic and ampicillin. Conclusion: A high prevalence of EPEC in children can be considered as a threat to the children's health. In this study, all the isolates were aEPEC