Role of enteropathogenic escherichia coli in paediatric diarrhoeas in South India.

ABSTRACT

Background: Enteropathogenic Escherichia coli( EPEC) is a major cause of diarrhoea in children below 5 years of age. Serotyping is the classical method and PCR detection of virulence factors is a rapid way of detecting diarrhoeagenic Esch.coli. Objectives: To study the role of EPEC in Paediatric diarrhoea by both Serogrouping and Multiplex PCR assay and to analyse the antibiotic susceptibililty pattern of EPEC strains in our area. Materials and Methods: Prospective study of stool samples collected from children with diarrhoea and without diarrhoea who were below 5 years of age was conducted from May to November 2011. EPEC isolates were identified by Serogrouping. Escherichia coli isolates were subjected to Serogrouping and Multiplex PCR assay and those isolates which showed pathogenic genes were further serotyped. Antibiotic susceptibility pattern of EPEC isolates was determined by Clinical and Laboratory Standards Institute guidelines. Results: Among the Escherichia coli isolates in the diarrhoeal group, 36.8% were identified as EPEC by Serogrouping and 38.8% of them were found to possess EAEC genes by molecular characterisation. In the nondiarrhoeal Esch. coli strains , none agglutinated with EPEC polyvalent sera, 46.6% showed EAEC genes out of which 85.7% were of a single serotype O153. Among the Escherichia coli isolates which agglutinated with EPEC polyvalent antisera , 33.3% were positive for Enteroaggregative genes. Conclusion: EPEC is still an important pathogen in paediatric diarrhoeas . O serogrouping can still be relied upon for detection of EPEC. EAEC are present in classical ‘ O ‘ serogroups. Serotype O 153 has an increasing potential for asymptomatic carrier state in children below 5 years of age.