Serogroups, virulence genes and antibiotic resistance in Shiga toxin-producing Escherichia coli isolated from diarrheic and non-diarrheic pediatric patients in Iran

Gut Pathogens

Maliheh Heidari⁴  Meysam Sarshar³  Mohammad Javad Hosseini³  Farhad Safarpoor Dehkordi²  Hassan Momtaz¹ 

[1] Department of Microbiology, Shahrekord Branch, Islamic Azad University, P.O. Box 166, Shahrekord, Iran;Young Researchers and Elites Club, Islamic Azad University, Shahrekord Branch, Shahrekord, Iran;Molecular Biology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran;Master of Science Microbiology, Flavarjan Branch, Islamic Azad University, Flavarjan, Iran

关键词: Iran;    Pediatric patients;    Diarrhea;    Shiga toxin-producing Escherichia coli;   

Others  :  817623
DOI  :  10.1186/1757-4749-5-39

 received in 2013-10-22, accepted in 2013-12-09,  发布年份 2013

【 摘 要 】

Background

From a clinical perspective, it is important to know which serogroups, virulence genes and antibiotic resistance patterns are present in Shiga toxin-producing Escherichia coli strains in pediatric patients suffering from diarrheic and non-diarrheic infections. This is the first study in Iran that has comprehensively investigated the Shiga toxin-producing Escherichia coli -related infection characteristics in diarrheic and non-diarrheic pediatric patients of 0–60 months of age.

Methods

Two-hundred and twenty four diarrheic and 84 non-diarrheic stool specimens were collected from the Baqiyatallah hospital of Tehran, Iran. The stool samples were cultured immediately and those that were E. coli-positive were analyzed for the presence of antibiotic resistance genes and bacterial virulence factors using PCR. Antimicrobial susceptibility testing was performed using disk diffusion method.

Results

One-hundred and fifty four out of 224 (68.75%) diarrheic stools and 31 out of 84 (36.90%) non-diarrheic stools harbored E. coli. In addition, children in 13–24 month-old age group had the highest incidence of infection with this bacterium (77.63%). A significant difference was found between the frequency of Attaching and Effacing Escherichia coli and Enterohaemorrhagic Escherichia coli (P =0.045). The genes encoding Shiga toxins and intimin were the most commonly detected virulence factors. Among all serogroups studied, O26 (27.04%) and O111 (18.85%) had the highest incidences in the diarrheic and non-diarrheic patients. The incidence of genes encoding resistance against sulfonamide (sul1), gentamicin (aac(3)-IV), trimethoprim (aadA1), cephalothin (blaSHV) and tetracycline (tetA) were 82.78%, 68.03%, 60.65%, 56.55% and 51.63%, respectively. High resistance levels against penicillin (100%), tetracycline (86.88%), gentamicin (62.29%) and streptomycin (54.91%) were observed. Marked seasonality in the serogroup distributions was evident, while STEC infections were more common in summer (P =0.041).

Conclusions

Our findings should raise awareness about antibiotic resistance in diarrheic pediatric patients in Iran. Clinicians should exercise caution when prescribing antibiotics, especially during the warmer months of the year.

【 授权许可】

   
2013 Momtaz et al.; licensee BioMed Central Ltd.

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