Characteristics of diarrheagenic Escherichia coli among children under 5 years of age with acute diarrhea: a hospital based study

• DOI: 10.1186/s12879-017-2936-1
• Publication Date: 2018-02-01T12:32:30Z
• Authors: Yu Zhou; Xuhui Zhu; Hongyan Hou; Yanfang Lu; Jing Yu; Lie Mao; Liyan Mao; Ziyong Sun
• Keywords: Cefuroxime; Medical microbiology; Parasitology

Diarrhea is the leading infectious cause of childhood morbidity and mortality. Among bacterial agents, diarrheagenic Escherichia coli (DEC) major causal agent diarrhea in developing countries, particularly children under age 5 years. Here, we performed a hospital-based prospective study to explore pathotype distribution, epidemiological characteristics antibiotic resistance patterns DEC from < 5-year-old diarrheal children. Between August 2015 September 2016, 684 stool samples were collected (< years old) with acute diarrhea. All cultured identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) biochemical tests. PCR was used for subtyping, enteropathogenic E. (EPEC) isolates simultaneously serology. Furthermore, antimicrobial sensitivity tests sequencing resistance-related genes conducted. strains 7.9% samples. them, most commonly detected EPEC (50.0% DEC), which 77.8% classified as atypical (aEPEC). Age seasonal distribution revealed that tended infect younger occur summer/autumn periods. Multidrug-resistant 66.7%; rates ampicillin, co-trimoxazole, cefazolin, cefuroxime, cefotaxime, ciprofloxacin ≥ 50%. carbapenem-resistant DEC, 60.0% positive carbapenemase (2 blaNDM-1 1 blaKPC-2). 30 cephalosporin-resistant 93.3% extended-spectrum β-lactamase (ESBL) genes, blaTEM-1 blaCTX-M-55 being common types. However, no gyrA or gyrB 16 quinolone-resistant isolates. Notably, aEPEC, has not received much attention before, also exhibited high drug (81.0%, 66.7%, 14.3% co-trimoxazole , carbapenem resistance, respectively). frequent children, aEPEC emerging dominant central China. Most multidrug-resistant, making even unsuitable empiric treatment against infection. strains, those harboring blaKPC-2 main agents. genetic determinants associated levels cephalosporin resistance.