Pathotyping and Antibiotic Resistance Profiling of Escherichia coli Isolates from Children with Acute Diarrhea in Amatole District Municipality of Eastern Cape, South Africa.

BACKGROUND: Diarrhea has been reported as the leading cause of childhood mortality and morbidity globally but with disproportionate impacts in developing nations. Among bacterial etiologic agents of diarrhea, diarrheagenic Escherichia coli is the main cause of the disease among children under the age of 5 years. This study is aimed at determining the prevalence and antibiogram pattern of diarrheagenic Escherichia coli (DEC) pathotypes associated with diarrhea cases in the study area. METHODS: A total of 120 presumptive isolates of E. coli were obtained from diarrheal stool samples from male and female patients below 12 years of age using chromogenic agar. Confirmation of the isolates and screening for virulence genes were determined by polymerase chain reaction (PCR) while antimicrobial susceptibility testing was performed using the disk diffusion method. The presence of antibiotic resistance genes to chloramphenicol and tetracycline among the confirmed isolates was also profiled by PCR based on the observed phenotypic resistance pattern. RESULTS: Of the 120 presumptive isolates, 88.3% (106/120) were confirmed as E. coli through PCR. The molecular pathotyping of the confirmed isolates showed their distribution as 41% (43/106) of diffusely adhering E. coli (DAEC), 17% (18/106) of enterohemorrhagic E. coli (EHEC), 17% (18/106) of enteropathogenic E. coli (EPEC), and 10% (11/106) of enteroinvasive E. coli (EIEC), while enteroaggregative E. coli (EAEC) and enterotoxigenic E. coli (ETEC) were not detected, and the remaining 15% did not belong to any pathotype. Notably, high resistance of the isolates to commonly used antimicrobials was observed as follows: ampicillin (98%), chloramphenicol (94%), trimethoprim-sulfamethoxazole (96%), and tetracycline (90.6%), while a relatively low number of the confirmed isolates were resistant to ciprofloxacin (45%) and imipenem (36%). In addition, 94% of the isolates that exhibited phenotypic resistance against chloramphenicol harbored the catA1 resistance gene while 89% that showed resistance to tetracycline had tetA genes. CONCLUSIONS: These findings showed that DEC could be considered as the leading etiologic bacterial agent responsible for diarrhea in the study community, and the observable high degree of resistance of the isolates to antimicrobial agents is of huge significance, calling for stakeholders to adopt and consolidate the existing antimicrobial stewardship scheme of the government, in order to ensure an uncompromised public health.

Prevalence of intestinal parasitic infections among HIV/AIDS patients from two health institutions in Abuja, Nigeria.

BACKGROUND: Intestinal parasitic infections play a vital role in the prognosis of HIV/AIDS in patients. OBJECTIVES: The aim of this study was to determine the prevalence of intestinal parasitic infections (IPIs) in HIV-infected individuals in two health facilities in Abuja-Nigeria. METHODS: A cross sectional study was conducted in two sites: the GEDE AIDS and Infectious Diseases Research Institute (GAIDRI), and the Human Virology Institute-General Hospital Asokoro-Abuja, Nigeria. A total of 119 subjects were recruited (85 HIV infected and 34 HIV negative). Stool specimens collected were analyzed macroscopically and microscopically for consistency and the presence of enteric parasites. RESULTS: The overall prevalence rate of enteroparasites obtained in this study was 22.7% (27/119). The prevalence of intestinal parasitic infections in HIV infected patients was 24.7 %; while in HIV negative persons, it was 17.6%. However, the high rate obtained for HIV infected patients was not statistically significant (p> 0.05). CONCLUSION: Although the prevalence rate of enteric parasites in HIV/AIDS patients was higher than in HIV negative individuals, this difference is not statistically significant. Even though there was no statistical difference in the two groups, parasitic infections in HIV/AIDS patients often result in debilitating illness.