Frequency, antimicrobial susceptibility and plasmid profiles of Escherichia coli pathotypes obtained from children with acute diarrhea

Introduction and objective: Escherichia coli is an important group of pathogens associated with diarrhea among children. The objective of this study was to determine the frequency, antimicrobial susceptibility and plasmid profiles of E. coli pathotypes obtained from children with acute diarrhea. Materials and methods: In a prospective study during 2008, 466 rectal swabs of inpatient children were examined for the presence of E. coli strains.Results: Of the total number of specimens examined, 99 (21.2%) were positive for E. coli.The highest number of isolates, 37(37.4%), was recovered from the 13-24 month age group.Of the 466 children, 191(41%) were girls and 275(59%) were boys. Based on the serological tests, 59(59.6%) of the E. coli strains were identified as enteropathogenic E. coli (EPEC) and 22 (22.2%) were identified as enteroinvasive E. coli (EIEC). The in vitro antibiotic susceptibility pattern of E. coli strains showed that 89.9 %, 88.9%, 79.8%, and 75% of isolates were found to be resistant to tetracycline, chloramphenicol, ampicillin and cefixime respectively. In plasmid profiling, out of the 99 E. coli pathotypes, 35 (35.4%) were found to possess plasmids, which ranged in sizes from 1.7kb to 4.5kb. These plasmids were seen in 33% of EPEC. Only two pathotypes possessed single size plasmid in EIEC.Conclusion: Our results revealed that EPEC, EIEC, enterohemorrhagic E. coli (EHEC), and enterotoxigenic E. coli (ETEC), had significant association with acute diarrhea among children in Sanandaj and should be considered as potential pathogens. Guidelines for appropriate use of antibiotics in Sanandaj need updating.