AUTHOR=Saka Habeeb Kayode , Dabo Nasir Tukur , Muhammad Bashir , García-Soto Silvia , Ugarte-Ruiz Maria , Alvarez Julio 

TITLE=Diarrheagenic Escherichia coli Pathotypes From Children Younger Than 5 Years in Kano State, Nigeria

JOURNAL=Frontiers in Public Health

VOLUME=7

YEAR=2019

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2019.00348

DOI=10.3389/fpubh.2019.00348

ISSN=2296-2565

ABSTRACT=<p>Diarrheagenic <italic>Escherichia coli</italic> (DEC) is one of the leading causes of gastrointestinal disorders worldwide and an important public health challenge. DEC infection is often underdiagnosed during routine microbiological analysis, especially in resource constrained settings; the use of molecular tests could however help to determine the distribution of DEC and its clinical significance. Here, a study to assess the prevalence of DEC in clinical samples from patients &lt;5 years attending three hospitals in Kano state, Nigeria, was carried out. Samples from 400 patients and 50 controls were collected and screened for <italic>E. coli</italic>. Compatible colonies from 248 individuals (215 patients and 33 controls) were characterized using biochemical test, a set of real-time PCRs for detection of nine virulence factors (VF: <italic>eae, bfp</italic>A, <italic>elt, est, stx</italic>1, <italic>stx</italic>2, <italic>ehx</italic>A, <italic>agg</italic>R, and <italic>inv</italic>A) associated with five DEC pathotypes (EPEC, ETEC, EHEC, EAEC, and EIEC) and antimicrobial susceptibility tests. One or more VFs typical of specific pathotypes were detected in 73.8% (183/248) of the isolates, with those associated with EAEC (36.3%), ETEC (17.3%), and EPEC (6.0%) being the most common, although proportion of specific pathotypes differed between hospitals. <italic>est</italic> was the only VF detected in a significantly higher proportion in cases compared to controls (<italic>P</italic> = 0.034). Up to 86.9% of DEC were resistant to at least one class of antibiotics, with trimethoprim-sulfamethoxazole being the least effective drug (77.6% resistance). Our results demonstrate the widespread circulation of different DEC pathotypes that were highly resistant to trimethoprim-sulfamethoxazole among children in Kano state, and highlight the need of characterizing the causative agents in cases of gastrointestinal disorders.</p>